You put your health at risk everyday – Protect yourself with Police Health Insurance
Private health cover is something every Australian must consider. Not only does private health insurance ensure that you have access the health care but stops you being hit with extra fees and charges by the Australian government. One way of finding better value on your private health insurance is to join an members own fund and if you or a member of your family is part of the police force, you might want to consider the range of covers available from Police Health.
This restricted access health fund opens membership to Australians with connections to the police force. Specialising in top-level cover and with an aim to make health insurance as easy to understand as possible, Police Health has four competitive cover options to choose from: Top Hospital, SureCover Extras, Platinum Health and Platinum Plus.
Membership of Police Health is open to employees of state, territory and federal police departments, as well as any employees of police unions. Former employees of police associations, unions and services who retired after January 1, 2001 are also eligible. As are the partners, former partners and children of all those eligible to join.
As Police Health is a not-for-profit fund, any profits it makes are used to benefit its members. It offers personalised customer service and guarantees that you will talk to a real person every time you call for assistance, while it aims to offer value for money cover to all its members. Other features include generous rebates on extras and a fast claims processing service.
Police Health Insurance Levels of Cover
- Top Hospital. This hospital-only cover option provides a high level of protection for treatment in any registered private or public hospital or day surgery anywhere in Australia. With no excesses or co-payments required, you have freedom of choice when it comes to your doctor and your hospital. It offers 100% cover for all your hospital costs and covers an extensive range of procedures.
- SureCover Extras. The sole extras-only option available from Police Health, SureCover Extras offers top-level cover for the cost of a wide range of general treatments. It covers general dental, major dental, orthodontic, optical, physio, exercise physiology, chiropractic, naturopathy, acupuncture, osteopath, complementary therapies, speech therapy, occupational therapy, eye therapy, dietitian, podiatry, psychology, ambulance, pharmaceutical, health appliances and school accidents.
- Platinum Health. This combined hospital and extras option is chosen by 85% of Police Health members. It combines Top Hospital Cover with SureCover Extras Cover, but your premiums are a whole lot cheaper than if you take out these two cover options separately.
- Platinum Plus. This family cover option is designed to suit Police Health members with older children. Under this policy, your children can be covered until they reach 25 years of age - as long as they’re not married or in a de facto relationship. This options is available for a small premium increase over the Platinum Health option.
Are there any additional benefits?
- Rollover Benefit. When you have an unused extras benefit limit with Police Health, you can roll the remaining balance over into the following calendar year.
- Pharmaceutical benefits. You can visit any private pharmacy and claim your Police Health pharmaceutical benefits.
- Eyewear discounts. Police Health has joined forces with Luxottica, which owns Sunglass Hut, OPSM and Laubman & Pank, to offer discounts on sunglasses, frames, glasses and lenses.
- [Section 3] n/a words - Police Health Policy comparison table [done internally] [at end of article]
The list of general exclusions from Police Health stipulate that your claim will not be paid if:
- It is for services received before you have served any relevant waiting periods
- It is for treatments for which Medicare does not pay a benefit, for example cosmetic surgery
- It is for services provided outside Australia
- It is for services that you may be able to claim the cost through some other form of cover, for example workers’ compensation insurance
- It is submitted more than two years after the date you receive the service
- It is for outpatient services, unless Police Health has an agreement in place with the hospital
- It is for pharmaceuticals that are not related to your reason for hospitalisation or are provided upon your discharge from hospital
- It is for exceptionally expensive drugs
- It is for prostheses that are not on the Federal Government’s approved list
- It is for personal and take-home items, for example television rental and newspapers
- It is for treatment you receive in a hospital emergency department
- It is for ambulance services covered by a third party arrangement, for example a state transportation scheme.
Just like any other private health fund, Police Health requires you to serve a waiting period before you can receive any policy benefits. Waiting periods are designed to prevent people taking out cover and then dropping it whenever it suits them, and a two-month waiting period applies across the board for all hospital and extras benefits, excluding accidents.
In addition, certain treatments and procedures attract longer waiting periods. For example, under hospital cover you will need to wait 12 months for obstetric care, pre-existing conditions and aids and appliances. Extras cover members will need to wait 12 months before they can receive major dental and orthodontics, hearing aids, and treatment for pre-existing conditions.
Police Health Insurance excess
If you’re admitted to hospital, many health funds require you to pay an excess to contribute to the cost of your hospital accommodation. As Police Health only offers top-level policies to its members, no excess or co-payment is required when you are admitted to hospital. However, you may be required to pay a excess during your waiting period if you were required to pay one by your previous health fund.
Police Health aims to make it as easy as possible for you to make a claim. Under hospital cover, most hospitals will send the bill directly to Police Health for you. However, if you receive the bill you can complete a Police Health claim form and then lodge the documents with the fund.
In situations where you are admitted to hospital as an inpatient, for example for radiology services, the services you receive will be covered up to the Medicare Benefits Schedule fee. If the doctor bills under Police Health’s Access Gap Cover scheme you will receive an even higher level of cover.
When it comes to extras claims, many providers will offer instant on-the-spot claiming electronically ... all you will have to do is swipe your membership card. All other claims can be completed by filling out and signing a Police Health claim form which can then be mailed, emailed or faxed back to the insurer.
Grab the Police Health mobile claims app
Q. My partner is a police employee – am I eligible to join?
- A. Yes you are - you don’t have to be a member of a state, territory or federal police force to join, as partners, former partners and children of eligible people can all take out cover.
Q. Do I need to pay an excess when I am admitted to hospital?
- A. No. None of Police Health’s hospital cover products requires you to pay an excess.
Q. What happens if I change my mind about taking out cover?
- A. A 30-day cooling-off period applies, during which time you can notify Police Health of your wish to cancel your cover and you will receive a full refund of your premium.
Q. I’m transferring from another health fund - what do I need to do to join Police Health?
- A. When you fill out a Police Health application form, make sure to fill out the ‘Transferring from another health fund’ section. Police Health will take care of the rest including notifying your previous fund that you are leaving.
Q. Can I stay a member once I’ve left the police force?
- A. Yes you can, and your dependents are also still eligible to remain on your policy.
Q. What payment options are available?
- A. You can pay your Police Health premiums by direct debit, automatic payroll deduction and BPAY. Credit card facilities are not available.
Q. When does cover start?
- A. Police Health cover starts once your application has been accepted and any premium payments have been made. However, keep in mind that you may need to serve waiting periods before you can claim any benefits.
Q. When do I pay my premiums?
- A. You can elect to set up a fortnightly direct debit or payroll deduction, or otherwise you will receive a renewal notice every three, six or 12 months.
In Australia there is no regulation that standardises the benefit amount for each medical service, so this varies from health fund to health fund. What remains the same however, is how each provider, Police Health included, allocates amounts, with each one following the logical path of increasing the benefit commensurate to the seriousness of the condition or treatment claimed for.
So you can get an idea of how this translates into dollar amounts, this table, generated from data taken from the Australian Medical Association's annual report card on health insurers, lists 22 commonly claimed for treatments and the corresponding benefit amount payable to Police Health members, along with the equivalent Medicare (MBS) benefit for comparison.
Due to them being a member of the Australian Health Service Alliance (AHSA), Police Health are listed under that organisations name below:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health