Emergency Services Health Insurance

First responders deserve top quality care, which is why Emergency Services Health only offers top-level cover. The wellbeing of emergency services employees and volunteers, along with their close relatives, is in good hands.

Who is Emergency Services Health?

Emergency Services Health is a not-for-profit health fund designed to look after the health and wellbeing of Australia's emergency services community. Backed by Police Health, Emergency Services Health is a Members Own Health Fund with a focus on providing straightforward products and comprehensive cover for emergency services personnel and volunteers.

As a not-for-profit health fund, it's tailored to looking after the health care needs of the first responder community. Run entirely to benefit members, it offers products that are easy to understand, provide a high level of cover and are available at an affordable price. Members are given the freedom to choose their preferred hospital, doctor and any other health care service provider, as long as that provider is recognised by Emergency Services Health.

With restricted access membership, Emergency Services Health eligibility includes current or previous employees or volunteers and their families in the following professions:

• Fire response and recovery sector. Employees/volunteers of a not-for-profit, commercial, or national, state or territory government fire department/service or association/union. Those who work for registered training organisations and/or specialist emergency service equipment suppliers in this sector are also eligible.
• Ambulance and medical response and recovery sector. Employees/volunteers of a not-for-profit, commercial, or national, state or territory government ambulance department, hospital service or association/union. People working in a medical, nursing or allied health capacity and registered with the Australian Health Practitioners Regulation Agency can also be covered, as can employees and volunteers of registered training organisations and/or specialist emergency service equipment suppliers.
• Water response and recovery sector. Employees/volunteers of a not-for-profit, commercial, or national, state or territory government life saving department/service or association/union. Employees and volunteers of registered training organisations and/or equipment suppliers in this sector are also covered.
• State emergency response and recovery sector. Employees/volunteers of a not-for-profit, commercial, or national, state or territory government emergency services department or association/union. Employees/volunteers of registered training organisations and/or specialist emergency service equipment suppliers in this sector are also covered.

What health insurance options are available?

With a focus on keeping cover as simple as possible, Emergency Services Health offers only three cover options: Rolling Extras, Gold Hospital and Gold Combined, all of which provide top-level cover.

• Rolling Extras. Provides cover for an extensive range of general health services, allowing you and your family to stay in top shape. The policy covers 80% of the cost of most extras services and you have the freedom to visit the recognised health provider of your choice. Plus, Emergency Service Health is the only insurance group in Australia that offers rollover benefits.
• Gold Hospital. This hospital-only product provides cover for treatment in any private or public hospital or day surgery around Australia. Its aim is to give you and your family freedom of choice in health care with no excesses, no benefit limitation periods or exclusions and no co-payments. Lifelong Hospital covers all treatments and procedures where Medicare pays a benefit.
• Gold Combined. This comprehensive policy brings together all the benefits of the Gold Hospital and Rolling Extras policies. In addition, this policy also provides benefits towards the cost of corrective laser eye surgery.

Member offers

Emergency Services Health Insurance offer members the following benefits:

• COVID-19 discount. A 4% COVID-19 is being issued to all Emergency Services Health members and will be automatically applied to your policy from 13 April for an initial period of 3 months. Check the Emergency Services Health website for updates on the discount.
• Gap cover. Access Gap Cover eliminates or reduces the out-of-pocket expenses that are commonly part of your hospital stay when you go through private health insurance. Emergency Services Health Insurance has arrangements with a majority of doctors around Australia so that you will be fully covered for in-hospital medical treatment.
• Bushfire Relief Options for Members. Emergency Services Health has a number of relief options for members who have been significantly impacted by the Australian bushfires.

How to make a claim

Lodging claims differs based on the service and the provider.

• Hospital: Hospital claims usually go directly to Emergency Services Health from the hospital and a claim payment is sent back to the hospital, so you don't have to worry about making a claim.
• On the spot: The majority of extras claims can be processed on the spot if the health provider has HICAPS or iSOFT HealthPoint claiming facilities. Most eligible claims are processed this way, and you just pay any out-of-pocket gap then and there.
• Other extras services claims: For claims that can't be made on the spot, you can fill out a claim form send it with the relevant accounts and receipts via one of four ways;

• Email (myclaim@eshealth.com.au) with your membership number in the subject line
• Email mail to Emergency Services Health, Reply Paid 84966, Halifax St SA 5000.
• Fax to 1300 151 152.
• Upload to the Emergency Services Health Mobile Claiming App.