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Pros
A great option for emergency services staff and volunteers, plus their families.
Health policies are refreshingly straightforward and easy to understand.
Some of Emergency Services Health insurance's policies will half your excess for same-day stays in a private hospital – other top policies have no excess for same-day stays.
Cons
Beware if you're after a lower level of cover – Emergency Services Health insurance only offers 2 types of gold cover and an extras package.
It's only available to emergency services employees, volunteers and their family.
Emergency Services Health policies
Emergency Services Health only offer 3 different policy options.
Gold Hospital. This hospital-only option provides cover for treatment in any private or public hospital or day surgery around Australia for all 38 treatments required to make it a gold policy. Cover includes:
Pregnancy and birth
Weight loss surgery
Assisted reproductive services
Dialysis for chronic kidney failure
Extras coverage
Rolling Extras. 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 Services Health is one of the only insurance groups in Australia that offers rollover benefits. Cover includes:
Acupuncture
General Dental
Major Dental
Optical
Physiotherapy
Exercise Physiology
Combined coverage
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.
Ambulance coverage
All Emergency Services Health policies include ambulance cover for anywhere in Australia. There is a 2-month waiting period before you're covered, but there is no annual limit. It can cover you for:
Emergency transport
Clinically required non-emergency transport
Treatment not requiring transport
Emergency Services Health frequently asked questions
Yes, Emergency Services Health is a not-for-profit health fund.
No, not everyone can join Emergency Services Health. It's a restricted fund, and you must be part of the Australian emergency services community to join.
Emergency Services Health offers members the following benefits:
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 has arrangements with a majority of doctors around Australia, so you will be fully covered for in-hospital medical treatment.
Contracted Hospitals. Emergency Services Health has agreements with most private hospitals to make sure you are charged an agreed schedule of fees.
Nourish Baby. If you're trying for or expecting a baby, you can get access to the Nourish Learning Hub. It gives you access to things like Fertility & Pregnancy Health, Labour & Birth Preparation and Breastfeeding & Bottle Feeding.
Rollover Benefit. This lets you carry over any used Annual Maximum Benefit that you haven't claimed during the previous calendar year, giving you access to higher annual limits.
Tele-Consult Benefit. This gives you access to treatment from the comfort of home including Physiotherapy, Psychology, Counselling, Occupational Therapy, Dietary and Speech Therapy.
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 and send it with the relevant accounts and receipts via 1 of 4 ways:
Email (myclaim@eshealth.com.au) with your membership number in the subject line
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
As Finder's insurance group publisher, Alex Holderness aims to make confusing topics easy to understand. She's been published in Money Mag, Yahoo Finance, Hospital Health, and is a contributing author for Google's Startup Grind. She has a keen passion for running and is currently studying for her General Insurance certification.
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