Doctors Health Insurance Fund Review

Doctors’ Health Fund is a restricted health fund that focuses on serving the health insurance needs of Australian medical professionals and their families.

The health fund was created in 1977, following the implementation of the government’s Medibank. Before this time, doctors traditionally wouldn’t charge anything to treat their colleagues and families of their colleagues.

Medibank offered a rebate to doctors who treated other doctors and their families, which led to doctors charging the rebate rate. Private health funds could then reimburse 80% of the fees, which paved the way for Doctors’ Health Fund to be created and expand.

  • Restricted health fund for Australian medical professionals and their families.
  • Choose from three different hospital and extras policies, or combine them together.
  • You can make a claim with Doctors’ Health Fund by mail, email, or fax.

Doctors’ Health Fund is a restricted health fund, so there aren’t too many member benefits to speak of.

Still, members are able to receive optical discounts from places like Clearly, Eyebenefit, and OPSM. Members also gain access to health management programs, a youth discount, and exclusive travel insurance.

You can select hospital cover, extras cover, or both from Doctors’ Health Fund. The lowest level of extras cover is only available as a combination policy with Smart Starter Bronze Plus.

Hospital Cover

There are three different policies for hospital cover from Doctors’ Health Fund. You have one low-level coverage option and two high-level options. Your choice of policies is as follows:

  • Smart Starter Bronze Plus: Receive coverage as a private patient in a public or private hospital. Covers you for all benefits in the Bronze category along with blood, plastic and reconstructive surgery, dental surgery, podiatric surgery, and sleep studies.
  • Prime Choice Gold: A Gold-level policy with no exclusions or restrictions. You can choose an excess to reduce premium costs.
  • Top Cover Gold: Highest level of benefits with no exclusions or restrictions. There is no opt-in requirement for doctors, so you can select whichever option you need. There is no excess option in this policy.

Extras Cover

There are also three extras policies from Doctors’ Health Fund. These are:

  • Starter Extras: Entry-level extras for singles and couples with 100% cover of one general dental check-up per year. This policy is only available with Smart Starter Bronze Plus.
  • Essential Extras: Mid-range extras for singles and couples with 100% cover of two general dental check-ups per year. There is a $500 optical limit over two years along with coverage for major dental, physio, and more.
  • Total Extras: Top-level extras with unlimited general dental services and a $600 two-year optical limit. Receive benefits for a range of extras services like weight management and Quit Smoking.

The Private Health Insurance Ombudsman compiles the statistics on customer complaints and fund performance. Here’s how Doctors’ health stacks up against the rest of the private health insurance market.

Hospital Related Charges Covered
Doctors’: 91%
Industry average: 90.68%

Medicare Services with No Gaps
Doctors’: 89.28%
Industry average: 86.4%

Medicare Services No or Known Gap
Doctors’: 98.16%
Industry average: 94.77%

General Treatment Covered
Doctors’: 55.82%
Industry average: 53.52%
Doctors’ Health Summary Report Card

Doctors’ PHIO Complaints

To make a claim with Doctors’ Health Fund, all you have to do is visit their website, navigate to the ‘Make a Claim’ tab, put in your membership details, and follow the instructions from there.

You can also claim your extras benefits on the Doctors’ Health Android and iOS mobile apps.

To get started, you can download a Claims Form here:

At this time, Health Insurance Comparison does not compare Doctors’ Health Fund with other insurers. You can take a look at the funds we do compare here. You’ll notice a green checkmark next to all of the comparable funds.

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