Phoenix Health Fund Review
Phoenix Health Fund started in 1953 as a health insurance provider exclusively for Stewarts & Lloyds employees but expanded its services in later years. Unlike funds that lock members into specific networks, Phoenix Health allows members to choose any provider for extra coverage without restricting benefits. Dependents can stay covered until age 25, including options for extended coverage.
| 🔎 Date Established | 1953 |
| 📌 Headquartered | Newcastle, New South Wales, Australia |
| 📍 Registration Number | ABN 93 000 124 863 |
| 👤 The average number of members | 28,978 members (as of June 2024) |
| 👥 Number of Employees | 10 – 50 |
| 🛡️ APRA-Regulated | ✅Yes |
| 📉 The most recent Market Cap reported | Not-for-profit |
| 5️⃣ Average Customer Rating | 4.9/5 (based on 360+ 5-star reviews) |
| ✏️ Average Number of Reviews | 360+ |
| 📈 Market Share | 0.1% |
| 📊 Number of plans offered | 6 Hospital-Only, 3 Extras |
| 💹 Sponsorships | Mother’s Day Classic (2024) |
| 📲 Is a Mobile App offered | ✅Yes |
| 💻 Medical Claims Portal | ✅Yes |
| ⏰ Customer Support Operating Hours | 8:30 am – 5 pm AEDT, Monday to Friday |
| 📝 Information Hub and Blog | ✅Yes |
| 💊 Chronic Illness Benefits | Support for conditions like diabetes, osteoarthritis, and cancer through specialized programs |
| 🌡️ Screening and Prevention offered | Preventive dental care, bulk-billed eye exams, and healthy lifestyle programs |
| 🍼 Maternity Benefit | Bumps & Bubs program |
| 💶 Health Insurance Premium Range (AUD) | $68.53 (Basic Accident-Only) to $161.99 per month on Silver Plus Advantage Hospital |
| ⌛ Average Waiting Period | Varies by service, e.g., 1 day for an ambulance, 12 months for orthodontics, and major dental services |
| 🌎 Is International Medical Cover Offered | ✅Yes |
| ✈️ International Travel Benefit | ✅Yes |
Phoenix Health Fund Plan Overview
| 🔎 Plan | 💶 Premium Range AUD | ❌ Exclusions | ❤️ Ideal For | ↪️ Gap Cover | 📌 Rebate Percentage | ⏰ Average Waiting Period | 📍 Key Features |
| 🥇 Basic Accident-Only Cover | $68.53/ month | Non-accident-related treatments, maternity, chronic conditions | Singles, families; affordable accident-focused cover | ✅Yes | Based on income + age | 1 day for ambulance, 12 months for pre-existing | Accidental hospital admissions, ambulance cover |
| 🥈 Bronze Hospital | From $80.81/ month | Pregnancy, advanced surgeries, weight loss surgery | Budget-conscious individuals who need basic cover | ✅Yes | Based on income + age | 1 day to 12 months | Flexible excess options, essential treatments like ENT, chemotherapy |
| 🥉 Bronze Plus Essentials | From $83.11/ month | Pregnancy, cataracts, joint replacements, weight loss surgery | Families and singles who require moderate cover | ✅Yes | Based on income + age | 2 to 12 months | Access to 550+ hospitals and 36,000 doctors, unlimited ambulance cover, dental surgery inclusion |
| 🏅 Silver Plus Support Hospital | From $102.46/ month | Pregnancy, cataracts, joint replacements, weight loss surgery | Moderate to high healthcare needs | ✅Yes | Based on income + age | 2 to 12 months | Choice of excess, essential treatments, including cancer therapies, musculoskeletal issues |
| 🎖️ Silver Plus Family Hospital | From $203.56/ month | Cataracts, joint replacements, sleep studies | Families focusing on reproductive and chronic care | ✅Yes | Based on income + age | 2 to 12 months | Family-focused cover, waived excess for dependents, unlimited ambulance cover |
| 🥇 Silver Plus Advantage | From $161.99/ month | Weight loss surgery assisted reproductive services | Seniors and families who require advanced care | ✅Yes | Based on income + age | 2 to 12 months | Joint replacements, cancer therapies, chronic condition management, flexible excess options |
Phoenix Health Fund Plans – Features and Benefits
The plans are diverse and cater to different healthcare needs across member types according to lifestyle stages. Below is a detailed breakdown of the available plans, their unique features and benefits, and a table summarising exclusions.
Basic Accident-Only Cover
The Basic Accident-Only Cover is an entry-level plan providing targeted support for accidental injuries that require immediate medical attention.
- Covers treatments related to accidents, including private hospital admissions, day surgeries, and essential in-hospital services.
- Dependents under 25 are covered without any excess. Ambulance services are also included, ensuring emergency transport is taken care of.
This plan offers essential coverage for accidents, making it a great choice for those seeking affordable, focused protection.
Bronze Hospital
Bronze Hospital provides expanded coverage for members with moderate healthcare needs. This plan includes private hospital benefits for cancer therapies, digestive system care, and musculoskeletal procedures.
Members can access a wide network of private hospitals and participating doctors. Unlimited ambulance cover ensures that emergencies are managed seamlessly.
While offering robust basic cover, it excludes high-cost treatments like joint replacements and heart surgeries, making it a practical choice for those prioritizing essential medical services over-specialized or advanced care.
Bronze Plus Essentials Hospital
Bronze Plus Essentials Hospital extends the benefits of Bronze Hospital by including additional treatments and flexible premium options.
- Covers gynecology, plastic and reconstructive surgeries, and miscarriage management, addressing more diverse healthcare needs.
- Members can adjust their premiums using different excess options for financial flexibility.
Bronze Plus Essentials Hospital provides enhanced coverage and flexibility, catering to a wider range of healthcare needs while allowing for adjustable premiums.
Silver Plus Support Hospital
Silver Plus Support Hospital caters to members who need access to more complex treatments. This plan covers critical services such as heart and vascular procedures, podiatric surgeries, and reconstructive care.
- Dependents under 25 benefit from waived excess for cost-effective family support.
- Includes travel benefits for members living over 300 kilometers from treatment facilities
Silver Plus Support Hospital offers comprehensive coverage for complex treatments, with added benefits for families and those living remotely.
Silver Plus Family Hospital
Designed for families, Silver Plus Family Hospital emphasizes maternity and reproductive health.
- Includes pregnancy care and assisted reproductive treatments.
- Offers comprehensive miscarriage management.
- Ambulance and travel benefits are included.
- Dependents under 25 remain covered without excess.
Silver Plus Family Hospital provides extensive maternity and reproductive health coverage, along with added benefits for families and dependents under 25.
Silver Plus Advantage Hospital
Silver Plus Advantage Hospital offers Phoenix Health’s most comprehensive cover, addressing significant medical and chronic condition needs.
- Includes services like joint replacements, cataract surgeries, and diabetes management.
- Families benefit from waived excess for dependents under 25.
- Offers unlimited ambulance cover.
Silver Plus Family Hospital provides extensive maternity and reproductive health coverage, along with added benefits for families and dependents under 25.
Plan Exclusions
| 🔎 Plan Name | ❌ Key Exclusions |
| 🥇 Basic Accident-Only Cover | Non-accident-related treatments, maternity, elective surgeries, and chronic conditions |
| 🥈 Bronze Hospital | Joint replacements, heart and vascular treatments, weight loss surgery, maternity |
| 🥉 Bronze Plus Essentials Hospital | Dialysis, advanced surgeries, assisted reproductive services, cataracts |
| 🏅 Silver Plus Support Hospital | Cataracts, dialysis, advanced weight loss surgeries |
| 🎖️ Silver Plus Family Hospital | Joint replacements, dialysis, advanced weight loss surgeries, cataracts |
| 🥇 Silver Plus Advantage Hospital | Maternity, assisted reproductive services, weight loss surgery |
Phoenix Health Fund Recent User Reviews
🥇 Helpful Pregnancy Support
During my pregnancy, I took advantage of the Bumps & Bubs Programme and found the resources incredibly helpful. Having access to maternal health nurses and educational resources helped me so much. – Abby
🥈 Exceptional Mental Health Support
I recently wanted mental health support services, and the working relationship between Phoenix Health Fund and mental health coaching was amazing. The support I got was just what I was looking for, and it exceeded expectations. – Lucy
🥉 Quick Resolution for Claim Issue
I encountered a small problem with a claim being processed, but after reaching out to customer support, it was sorted out quickly. Their commitment to getting things done and ensuring customers are happy is impressive. – Nico
Phoenix Health Fund vs Latrobe Health Insurance vs HCF Health Insurance
| 🔎 Provider | 🥇 Phoenix Health Fund | 🥈 Latrobe Health Insurance | 🥉 HCF Health Insurance |
| 📉 Years in Operation | 70+ years | 74 years | Since 1932 |
| 📈 Average Number of Members | 28,978 (as of 2024) | 100,000+ | Over 1.8 million |
| 📊 APRA Regulation | ✅Yes | ✅Yes | ✅Yes |
| 💹 Number of Employees | 10 – 50 | 51 - 200 | Over 1,800 |
| 💱 Market Share | <0.1% | 1.7% of the private health insurance market | Approximately 12.5% |
| ↪️ Market Cover | National (Australia) | Australia | Primarily Australia, with an extensive branch network |
| 5️⃣ Customer Rating | 4.9/5 | 4.2/5 | High satisfaction ratings with multiple awards |
| 🔟 Number of reviews | 360+ | 800+ | Over 5,000 across major platforms |
| 📲 Mobile App | ✅Yes | ✅Yes | My Membership App |
| 💶 Premium Range (AUD) | From $68.53 to $161.99 per month | From $24.49 to $37.79 per week for different plans | Varies by plan and location |
| 🌎 International Travel Benefit | ✅Yes | None | Limited cover through additional policies |
| ⚙️ Market Capitalisation | Not-for-profit | Not publicly listed | Not applicable (Not-for-profit) |
| ⭐ Unique Features | Member-owned, profits reinvested into benefits; Bumps & Bubs Program; 100% back on dental check-ups | Owns Maryvale Private Hospital, member-owned, high community involvement, Connected Communities program, Shane Warne Legacy Partnership | No-gap dental, Home healthcare programs, community-driven approach |
Advantages over Competitors
Phoenix Health Fund is a not-for-profit organization dedicated to prioritizing member well-being through reduced premiums, enhanced services, and tailored support.
Key Features:
- Unlimited ambulance cover for emergencies and non-emergencies
- Up to 10% premium discounts for members aged 18-29
- Freedom to choose healthcare providers without network restrictions
- Exclusive discounts on health, wellness, and lifestyle products
- Full cover for two annual preventative dental check-ups under all Extras covers
- Easy claim submissions via app, online portal, or email
- Children covered until age 21, and full-time students up to age 25 at no extra cost
Phoenix Health Fund ensures comprehensive, flexible, and affordable healthcare for all members.
Overview of Phoenix Health Fund Gap Cover
The Access Gap Cover Scheme ensures that if your doctor agrees to participate, their fees for your hospital procedure are capped within certain limits. This can mean no additional costs or a small fee, so you’re not left with surprises.
How Does It Work?
Your Doctor’s Participation
Over 36,000 doctors across Australia are familiar with and participate in the Access Gap Cover. If your doctor agrees to participate in your procedure, they’ll charge within the set limits of the scheme.
Clear Communication
Participation is entirely the doctor’s choice and is decided for each procedure. Before agreeing to treatment, ask your doctor if they will use Access Gap Cover and if any additional specialists involved (like anesthetists) will do the same.
Support When Needed
Phoenix Health provides tools, like a provider search, to help you identify doctors who have participated in Access Gap previously. If your doctor doesn’t participate, you can explore other options, including asking for referrals or a second opinion.
Why Costs May Vary
Medical fees are determined by the government’s Medicare Benefits Schedule (MBS), which sets a baseline for what procedures should cost. Medicare and your private health insurance cover this baseline fee, but many doctors charge more.
Without an Access Gap Cover, you’d have to pay this extra amount entirely yourself. The scheme limits these extra charges, ensuring transparency and predictability.
If Your Doctor Doesn’t Participate
You can explore other avenues if your doctor opts out of Access Gap. You can get a second opinion or check with Phoenix Health for a list of other specialists. Transparency is key, so always ask for an itemized cost estimate, known as “informed financial consent,” to avoid unexpected charges.
Phoenix Health Fund App Features
The Phoenix Health Fund App streamlines the way members manage their healthcare, offering real-time access to essential information and simplifying the claims process.
Key Features:
- Face ID login for quick access without needing membership numbers or passwords
- Photo Claims to easily submit receipts for fast processing if Fast Claims can’t be used
- Digital membership card accessible via Google Wallet for Android users
- Instant claim tracking to see what’s claimed and what’s still available
- Instant benefit estimates to help members plan their healthcare costs
- Flexible claim options through Fast Claims for quick reimbursements, often as soon as the next business day
The Phoenix Health Fund App makes managing your health coverage simpler and more convenient than ever.
Phoenix Health Fund App Key Features Summary
| 🔎 Feature | 📌 Description | 📍 How to Access/Use |
| 🥰 Face ID Login | Secure login with Face ID for easy access to your account | Open the app and scan your face to log in |
| ⏰ Real-Time Tracking of Benefits | View claimed and remaining benefits across services | Access the "Benefits" section in the app for updates |
| 📉 Instant Benefit Estimates | Get immediate estimates of treatment costs | Use the "Benefit Estimate" section to calculate cover |
| 📈 Fast Claims | Submit claims with minimal details and get reimbursed quickly | Select the "Fast Claims" option and enter basic claim details |
| 📊 Photo Claims | Submit itemized receipts for quicker claim processing | Use the "Photo Claims" feature to upload receipts directly |
| 💹 Digital Membership Card | Access your digital card anytime, anywhere | Find your digital card in the "Membership" section of the app |
How to apply for Health Insurance with Phoenix Health Fund
The application process with Phoenix Health Fund is simple, ensuring you can quickly start your coverage. Steps to Apply:
Eligibility check
Ensure you meet the minimum age of 16 and your policy aligns with your state of residence.
Prepare required documents
Proof of identity, proof of age, and any additional documents requested.
Submit forms
Send your completed forms and documents online or by mail.
Application review
Phoenix Health will review your submission and may conduct identity verification checks.
Receive approval
Once approved, you’ll get policy details, product information, and membership confirmation.
Phoenix Health Fund makes the application process easy, ensuring you’re covered as soon as possible.
Applying for Gap Cover
Applying for Gap Cover with Phoenix Health Fund is straightforward since it’s included in most plans. Here’s how you can check eligibility and use it effectively if you’re already a member:
How to Apply for Gap Cover:
Check Eligibility
Review your Policy Information Sheet or contact Phoenix Health to confirm that your hospital cover includes Access Gap Cover.
Book your procedure
Once eligible, schedule your hospital procedure and identify the doctors involved, including specialists.
Discuss with your doctor
Ask your doctor if they participate in the Access Gap Cover scheme and confirm in writing.
Get fee estimates
Verify all participating specialists and request a detailed estimate of non-participating provider fees.
Use provider search
If your doctor doesn’t participate, use Phoenix Health’s search tool to find eligible professionals.
Confirm details
Ensure all paperwork is in order before the procedure and confirm all arrangements with your doctor.
Submit claims
After treatment, if any unexpected costs arise, submit a claim for review and reimbursement.
Phoenix Health makes accessing Gap Cover easy by ensuring you’re well-informed and supported throughout the process.
How to Submit a Claim with Phoenix Health Fund
Submitting a claim with Phoenix Health Fund is easy and can be done through the app, the Online Member Services (OMS) portal, or by email/post. Here’s a guide to help you navigate the process:
Claim Submission Methods:
- Phoenix Health App: Download the app, log in, take a photo of your treatment invoice, and submit it directly for quick processing and tracking.
- Online Member Services (OMS): Register, log in, upload a scanned or photographed invoice, and track your claim progress electronically.
- Email or Post: Download and complete the Phoenix Claim Form, then submit it with your invoice via email ([email protected]) or post (Phoenix Health Fund, PO Box 156, Newcastle NSW 2300).
Required Information for Claim Submission:
- Claim Form: Complete all sections accurately.
- Itemized Invoice: Include provider details, patient information, treatment date, and cost breakdown.
- Additional Documentation: For specific claims like Healthy Lifestyle or Aids to Recovery, extra forms or a doctor’s letter may be needed.
Phoenix Health offers multiple convenient ways to submit claims, ensuring your healthcare costs are processed quickly and efficiently.
How to Upgrade or Downgrade My Plan
Phoenix Health Fund allows members to upgrade or downgrade their health insurance plans, giving flexibility to adjust coverage based on evolving healthcare needs or financial priorities. Here’s how to make these changes:
Steps to Upgrade or Downgrade Your Plan:
1. Step 1: Decide What’s Changing
Upgrade: Add services like maternity or orthodontics for broader cover.
Downgrade: Switch to a more basic plan to reduce premiums, e.g., moving from major dental to general dental.
2. Step 2: Understand Waiting Periods and Limitations
Upgrades: New benefits may have waiting periods (e.g., maternity services typically require 12 months).
Downgrades: Changes take effect immediately; earlier claims will count under the downgraded plan’s limits.
3. Step 3: Submit Your Request
Contact Member Services via phone or email, fill out the request form, and specify the desired effective date.
4. Step 4: Monitor Your Membership Updates
After changes are processed, review your updated plan details through the OMS portal or Phoenix Health app and check new premiums and benefits.
Phoenix Health Fund provides an easy process to modify your cover, ensuring your plan aligns with your needs and budget.
How do I add a Beneficiary to Phoenix Health Fund?
Adding a dependent or beneficiary to your Phoenix Health Fund policy is straightforward, but it requires ensuring their eligibility and selecting the right cover. Here’s a simple guide to help you navigate the process:
Steps to Add a Dependent or Beneficiary
1. Step 1: Confirm Eligibility
- Children under 21: Automatically included under family or single-parent policies until their 21st birthday.
- Full-time students aged 21-25: Can remain on the policy at no extra cost until they turn 25 or stop studying.
- Extended dependents aged 21-25 (Not Studying): Eligible for coverage at an additional cost on most policies except Extras-only plans.
2. Step 2: Contact Member Services
Initiate the process by contacting Phoenix Health Fund through:
- Phone
Online Member Services (OMS) Portal
3. Step 3: Submit Required Documentation
Provide the necessary details, including:
- Personal Information: Full name, date of birth, and relationship to the policyholder.
- For Student Dependents: Proof of full-time enrollment (e.g., enrollment certificate).
- For Extended Dependents: Proof of financial dependency and non-student status.
4. Step 4: Choose the Appropriate Cover
Select the cover type based on eligibility:
- Family or Single-Parent Policy: Automatically covers dependents under 21.
- Student Dependent: Continued cover at no extra cost for full-time students aged 21-25.
- Extended Dependent Cover: Available for non-studying young adults aged 21-25 for an additional premium.
5. Step 5: Review Updated Policy Documents
Once the addition is processed, you’ll receive updated policy documents with the new dependent and any applicable premium adjustments.
Keep track of your dependent’s eligibility, as changes like stopping studies or turning 25 will require them to transition to their policy.
How to Submit a Compliment or Complaint with Phoenix Health Fund
Phoenix Health Fund provides several channels for members to communicate feedback and escalate concerns to ensure any issues are properly addressed. Here’s how you can share your feedback or escalate complaints:
Steps to Communicate Feedback or Escalate Concerns
1. Step 1: Reach Out to Phoenix Health Fund
Phone: Call 1800 028 817 to speak directly with a representative.
Email: Send your feedback to [email protected].
Mail: Address correspondence to Phoenix Health Fund, PO Box 156, Newcastle, NSW 2300.
Include all relevant information, describe the issue, provide supporting documents, and mention any steps already taken to resolve the matter.
2. Step 2: Request Acknowledgment
Ask for acknowledgment of your submission to confirm it has been received and logged for review.
3. Step 3: Internal Escalation Process
If the initial response isn’t satisfactory, request the Member Service Manager to review your complaint.
If the Manager’s review doesn’t resolve the issue, escalate it to the Chief Executive Officer or the Board of Directors.
4. Step 4: External Escalation to the Commonwealth Ombudsman
If your issue is not resolved internally, you can contact the Commonwealth Ombudsman for Private Health Insurance:
Online Submission: Visit ombudsman.gov.au to file your complaint.
Phone: Call 1300 362 072 for assistance.
The Ombudsman will investigate your complaint impartially and recommend a fair resolution, but only after all internal options with Phoenix Health Fund have been exhausted.
How to Switch My Health Insurance to Phoenix Health Fund
Switching to Phoenix Health Fund is a simple process that ensures continuous coverage without any gaps. Phoenix Health handles most of the transition, including coordinating benefit transfers and assisting with required documentation. Here’s a step-by-step guide to switching your health insurance to Phoenix Health Fund:
Steps to Switch Your Health Insurance
1. Step 1: Evaluate Your Current Policy
Review your existing health insurance policy, including benefits, waiting periods served, and claim limits used.
2. Step 2: Confirm Eligibility for Transfer
Ensure the gap between funds is less than 30 days to maintain benefit portability.
3. Step 3: Contact Phoenix Health
Reach out to Phoenix Health’s Member Services team to begin the application process.
4. Step 4: Provide Policy Information
Share details of your current policy, including membership number, cover information, and any waiting periods already served.
5. Step 5: Request Transfer Certificate
Obtain a Transfer Certificate from your current insurer, outlining your cover level, waiting periods, and benefits claimed.
6. Step 6: Authorize Phoenix Health
Permit Phoenix Health to request the Transfer Certificate on your behalf.
7. Step 7: Understand New Waiting Periods
Phoenix Health will honor completed waiting periods unless upgrading to a higher cover level, adding new benefits, or if previous waiting periods were incomplete.
8. Step 8: Review Updated Policy
Once processed, you’ll receive updated policy details, including premiums, benefits, and cover start dates.
Benefits of Switching to Phoenix Health Fund
- Phoenix Health honors benefits for incomplete waiting periods from your previous fund until the new waiting period is completed.
- Existing claim limits and benefits are carried over to ensure no coverage gaps.
- Completed waiting periods with your previous insurer are recognized, maintaining continuity of coverage.
- The transfer process is handled directly with your old fund, ensuring a smooth transition.
Switching to Phoenix Health Fund is a seamless process that ensures no disruption to your cover while transitioning to your new plan.
Phoenix Health Fund Travel Insurance
Phoenix Health Fund Travel Insurance partners with Allianz Global Assistance and ensures robust support, including 24/7 access to Australian-based case managers, doctors, and nurses.
This cover minimizes the financial and logistical impact of unexpected events, such as medical emergencies, trip cancellations, and lost belongings.
Cover Details
Phoenix Health Travel Insurance covers critical areas that can disrupt travel plans.
- Offers compensation for delayed, lost, or damaged luggage, helping replace essential items during your trip.
- Protects against financial responsibilities if you accidentally injure someone or damage their property while traveling.
- Provides comprehensive cover for hospital, medical, and dental expenses while traveling abroad, ensuring access to immediate care.
- Covers costs incurred if you need to cancel or cut short your trip due to unforeseen circumstances, including emergencies.
With Phoenix Health Travel Insurance, you can travel with peace of mind, knowing you’re protected against unexpected events that may disrupt your plans.
Travel Plans Offered
Phoenix Health Fund offers the following insurance plans to accommodate travelers and trips:
Domestic Plan
Covers travel within Australia, including trip cancellations, lost luggage, and personal liability. Ideal for short trips or interstate holidays.
Essentials Plan
A budget-friendly option for single overseas trips, covering medical expenses, trip cancellations, lost luggage, and personal liability.
Comprehensive Plan
Includes all the benefits of the Essentials Plan, with additional cover for dental emergencies, trip interruptions, and other travel-related incidents.
Multi-Trip Plan
Designed for frequent travelers, this plan provides cover for multiple trips (each up to 45 days), both domestic and international, with the same extensive benefits as the Comprehensive Plan.
Phoenix Health Fund offers a range of travel insurance plans to suit different needs, ensuring comprehensive coverage for any type of trip.
Optional Extras
Phoenix Health Fund offers optional extras for travelers to enhance their travel insurance coverage:
Snow Pack
Covers snow sport-related emergencies, equipment damage, and other incidents unique to skiing and snowboarding.
Cruise Pack
Covers medical emergencies, evacuation, and cancellations of pre-paid shore excursions while on a cruise.
Adventure Pack
Ideal for adventurous travelers who participate in activities like zip-lining or motorcycle riding, ensuring cover for higher-risk sports.
Increased Item Limits
Members can extend cover for high-value items like electronics or jewelry, ensuring full compensation in case of theft or damage.
Phoenix Health Fund provides optional extras to enhance your travel insurance, offering tailored coverage for specific activities and high-value items.
Phoenix Health Fund Corporate Responsibility
Phoenix Health Fund takes a proactive approach to corporate responsibility, directly contributing to community well-being through health-focused initiatives and partnerships.
Phoenix Health sponsored the 2024 Mother’s Day Classic in Newcastle, New South Wales. This annual event raises funds for breast cancer research and promotes physical activity through community participation in walks and runs.
The Mother’s Day Classic Sponsorship in Newcastle is a prime example of their community involvement. By funding this annual event, Phoenix Health contributes to breast cancer research and encourages physical activity and community engagement.
Phoenix Health Fund Regulation
Phoenix Health Fund complies with the following key regulations and standards:
Private Health Insurance Act 2007
Establishes the legal framework for private health insurers in Australia, ensuring Phoenix Health operates within set rules to protect member interests.
Private Health Insurance (Prudential Supervision) Act 2015
Governs financial solvency and risk management practices, requiring Phoenix Health to maintain reserves to meet its financial obligations.
APRA Oversight
APRA monitors Phoenix Health’s financial stability, ensuring the fund meets member claims and remains financially viable.
Private Health Insurance Code of Conduct
This voluntary code promotes high standards of ethical practice, requiring Phoenix Health to provide transparent communication, fair treatment of members, and accurate information about policies and premiums.
Privacy Act 1988 (Cth) and Australian Privacy Principles (APPs)
Phoenix Health manages member data securely, ensuring compliance with national privacy laws to protect personal and financial information.
Phoenix Health discloses accurate and timely information about premiums, benefits, and policy changes, ensuring members are fully informed and protected under consumer laws.
Phoenix Health Fund Awards and Recognition
Phoenix Health Fund has received notable recognition and awards, including the following:
| 🔎 Award | 📌 Year | 📍 Category | 🏆 Recognition |
| 🅰️ ProductReview.com.au Award | 2024 | Best Health Insurance | Recognized for exceptional member satisfaction and positive reviews |
| 🅱️ Finder Awards | 2018 | Best Health Insurance Comprehensive | Honored for the Top Hospital & Top Extras product |
Phoenix Health Fund Customer Support and Contact Details
Phoenix’s customer support is available via phone, email, postal mail, and an online feedback form, with specified hours for direct communication.
| 🔎 Support Channel | 🅰️ Contact Information | 🅱️ Availability |
| ☎️ Phone | 1800 028 817 | 8:30 am – 5:00 pm AEDT, Monday to Friday |
| Via online feedback form or claims submission portal | 24/7 submission; response during business hours | |
| 📌 Postal Address | PO Box 156, Newcastle NSW 2300 | Business hours for processing |
| 📍 Online Feedback Form | Available on Phoenix Health website | 24/7 submission; response during business hours |
Phoenix Health Fund Rebates and Discounts
Phoenix offers government-supported rebates, discounts for younger Australians, and exclusive offers for members. Below is a detailed overview of the available rebates and discounts, and how to claim them.
| 🔎 Type | 🅰️ Eligibility Criteria | 🅱️ Amount/Percentage |
| 1️⃣ Australian Government Rebate | Based on income and age | Varies (higher rebates for lower incomes and older members) |
| 2️⃣ Lifetime Health Cover Loading | Members under 31 who take hospital cover early | Avoid up to 70% premium loading; loading removed after 10 years of continuous cover |
| 3️⃣ Age-Based Discounts | Members aged 18-29 joining hospital cover | Up to 10% off premiums, reducing by 2% annually after age 40 |
| 4️⃣ Nova Optical Discount | Phoenix Health members purchasing prescription glasses | 40% off frames with prescription lenses |
| 5️⃣ Q Optical Network Offers | Members accessing eyewear from QON providers | Free or discounted second pair of glasses; 15% off contact lenses |
| 6️⃣ eGift Card Discounts | Members using Phoenix Health Rewards | Discounted cards for health, fitness, electronics, and entertainment |
Phoenix Health Fund Additional Health Services and Products
Phoenix Health Fund offers additional health services and products to support members through health challenges and improve their overall well-being, including the following:
- Members with spinal conditions can access the spinal program in certain Australian states by obtaining a referral from their healthcare provider.
- Eligible members diagnosed with Type 2 diabetes or pre-diabetic conditions can access this program by providing proof of diagnosis.
- Members can access osteoarthritis programs by consulting their GP or specialist. Eligibility requires an active hospital cover policy
- Members with joint replacement benefits under their hospital cover can access this program. Criteria include completion of a 12-month waiting period and suitability for short-stay surgery.
- Members can start mental health coaching with an initial nursing assessment to develop a tailored care plan. Sessions are delivered via phone or video and include follow-up support to ensure long-term benefits.
- Expectant parents can register for the Bumps & Bubs Program through the Phoenix Health website. The program includes access to the Nourish Online Learning Hub and sleep support services for eligible members.
Members diagnosed with cancer can enroll in the program through Valion Health. After an initial assessment, participants receive tailored care plans, including dietary advice, exercise sessions, and mental health support.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Extensive hospital network access with cover at over 550 private hospitals | Higher premiums for top-tier plans |
| Partnerships with health providers like Short Stay Joint Replacement Program | Limited cover for maternity services |
| Age-based discounts for younger members of up to 10% | Waiting periods apply for upgraded cover and certain services, such as joint replacements |
| No preferred provider network for Extras | Optical rebates have annual limits |
| Offers 100% back on preventive dental check-ups | Not all optional extras, like mental health coaching, are available under every plan |
| Access to targeted health programs like Diabetes Support and Cancer Care Complete | Restrictions on states that can access additional services/products |
| Comprehensive Access Gap Cover Scheme | The digital membership card can’t be added to Apple Wallets, only to Google Wallets |
Our Verdict on Phoenix Health Fund
Phoenix Health Fund offers personalized support and value-added services with a range of plans, from Basic Accident-Only Cover to Silver Plus Family Hospital, catering to different needs and budgets.
Key strengths include the Access Gap Cover scheme, comprehensive hospital, extras, and combined plans, plus services like mental health coaching and the Bumps & Bubs program. The no-preferred-provider Extras network gives members flexibility in choosing healthcare providers.
Programs like Cancer Care Complete and Spinal Care Plans show Phoenix’s focus on long-term health conditions. However, limitations include exclusions for joint replacements or maternity in certain tiers, and the inability to add the digital card to Apple Wallets. Additionally, some programs are state-restricted.
Overall, Phoenix Health Fund is a great choice for those seeking comprehensive coverage, flexibility, and additional support services.
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Frequently Asked Questions
Does Phoenix Health Fund provide cover for children?
Yes, children included on a policy are under family cover until they turn 21. Full-time students can register as Student Dependents and remain covered at no additional cost until their 25th birthday or until they stop studying full-time.
How can I submit feedback or file a complaint with Phoenix Health Fund?
To submit comments or file a complaint, phone 1800 028 817, email [email protected], or write to PO Box 156 Newcastle NSW 2300.
How can I switch to Phoenix Health Fund from another insurer?
Phoenix Health Fund will contact your former fund and handle the transfer. Remember to provide information about your former fund and membership during the application process and authorize Phoenix Health to complete the transfer.
