RT Health Review
RT Health is a not-for-profit health fund that has been operating for 130 years. RT Health offers a Hospital at Home program for eligible members and operates under the regulation of APRA. RT Health offers a variety of extra benefits, including dental and optical coverage. RT Health’s customer support is available from 8:30 am to 5:00 pm, Monday to Friday.
| 🔎 Date Established | 1889 |
| 📌 Headquartered | Sydney, Australia |
| 📍 Registration Number | ACN 000 026 746 |
| 👥 The average number of members | ±48,000 |
| 👤 Number of Employees | 50 - 200 |
| 🛡️ APRA-Regulated | ✅Yes |
| 🚩 The most recent Market Cap reported | Not applicable; not-for-profit |
| ⭐ Average Customer Rating | 4.8/5 (750+ reviews) |
| 🧡 Average Number of Reviews | 750+ |
| 📉 Market Share | ±12.5% |
| 📈 The number of plans offered | 5 Hospital-only, 3 extras |
| 📊 Sponsorships | None |
| 💹 Is a Mobile App offered | ✅Yes |
| 🖱️ Medical Claims Portal | ✅Yes |
| ⏰ Customer Support Operating Hours | Monday to Friday, 8:30 am to 5 pm |
| ✏️ Information Hub and Blog | ✅Yes |
| 🧑⚕️ Chronic Illness Benefits | ✅Yes |
| 🩺 Screening and Prevention offered | ✅Yes |
| 🍼 Maternity Benefit | ✅Yes |
| 💶 Health Insurance Premium Range (AUD) | Varies based on state, age, income, rebates |
| ⌛ Average Waiting Period | From 1 day – 12 months |
| 🌎 Is International Medical Cover Offered | Via a partnership with HCF Travel Insurance+ |
| ✈️ International Travel Benefit | Via a partnership with HCF Travel Insurance+ |
RT Health Plan Overview
| 🔎 Plan | 💶 Excess Options | ❌ Exclusions | ❤️ Ideal For | 📉 Gap Cover | 📈 Rebate Percentage | 📊 Average Waiting Period | 💹 Key Features |
| 🥇 Gold Optimum Hospital | $750 | Non-contracted private Hospitals, Outpatient Treatment, TV hire, newspapers, non-medical pharmaceuticals, hospital administration fees, Discharge Pharmaceuticals | Comprehensive cover | ✅Yes | Based on income and Age | 1 day to 12 months | Full hospital cover, including travel/accommodation and Hospital at Home benefits |
| 🥈 Silver Plus Assure Hospital | $500 $750 | Pregnancy & Birth, Assisted Reproductive Services, Weight Loss Surgery, Treatments and procedures not covered by Medicare, Outpatient treatment and private hospital emergency department fees | Families and individuals with broad needs | ✅Yes | Based on income and Age | 1 day to 12 months | Intensive care, flexible Medicover options, excess-free cover for dependents, Hospital at Home, Travel, and Accommodation Benefits |
| 🥉 Silver Plus Standard Hospital | $250 $500 $750 | Cataracts, Joint Replacements, Dialysis, Pregnancy & Birth, Dialysis, Insulin Pumps, etc. | General hospital cover | ✅Yes | Based on income and Age | 1 day to 12 months | Private hospital accommodation, Ambulance benefits, Hospital at Home, Prostheses and Pharmaceutical Costs |
| 🏅 Bronze Plus Essential Hospital | $350 $700 | Heart & Vascular System, Back & Spine Conditions, Insulin Pumps, Dialysis, Insulin Pumps, Joint Replacements, etc. | Basic private hospital cover | ✅Yes | Based on income and Age | 1 day to 12 months | Prostheses and Pharmaceutical Costs, Travel and Accommodation Benefits, Ambulance benefits, Basic hospitalization and ambulance services |
| 🎖️ Basic Plus Starter Hospital | $500 $750 | Heart and vascular system, Weight loss surgery, Cataracts, Assisted reproductive services, Back, neck, and spine conditions, Pregnancy and birth | Entry-level health cover | ✅Yes | Based on income and Age | 1 day to 12 months | Entry-level hospital services, Hospital at Home, Ambulance benefits, prostheses and essential ambulance cover, Doctors' Costs |
RT Health Plans – Features and Benefits
Gold Optimum Hospital Plan
The Gold Optimum Hospital Plan is notable for its comprehensive hospital cover. It includes support for advanced medical services, such as cover for prostheses and medications that meet strict approval standards.
Target Audience: Ideal for singles, families, senior members, and individuals with pre-existing conditions.
Features
- Full cover for no-gap prostheses and approved pharmaceuticals related to hospital stays.
- Ambulance cover varies by state, unlimited in some regions.
- Additional benefits include Hospital at Home and travel/accommodation allowances for medical trips over 200km.
- Private hospital accommodation, private or shared rooms (subject to availability).
- 100% cover of Medicare Benefits Schedule (MBS) fees for hospital doctors’ services.
- Access to Medicover, reducing out-of-pocket doctor fees.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Comprehensive hospital cover, including private room accommodation | Higher premiums due to extensive cover |
| 100% MBS fee cover for in-hospital doctor services with Medicover | Excess applies, with a higher charge for same-day treatments |
| Full cover for prostheses and TGA/PBS-listed pharmaceuticals | No cover for outpatient services or emergency department visits |
| Emergency ambulance cover, up to $5,000 in some states or unlimited | Limited benefits for treatment at non-contracted hospitals |
| Includes additional benefits like Hospital at Home and travel support | 12-month waiting period for pre-existing conditions and pregnancy care |
Silver Plus Assure Hospital Plan
The Silver Plus Assure Hospital Plan has a well-rounded approach to hospital care. It offers flexible solutions for handling extra payments and tailored ambulance benefits for each state to meet emergency transport requirements.
Target Audience: Best for singles, families, and couples who need solid hospital cover but don’t require pregnancy-related or weight loss surgery cover.
Features
- Ambulance coverage is unlimited in some states and $5,000 annually in others.
- Options for $500 or $750 excess, with exemptions for dependents under 22.
- Covers private or shared room accommodation.
- 100% cover of MBS fees and Medicover access for fee reductions.
- Includes government-approved no-gap prostheses.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Comprehensive hospital accommodation and in-hospital doctor cover | Pregnancy, birth, and assisted reproductive services not covered |
| Full cover for approved prostheses and related pharmaceuticals | Psychiatric care is limited to public hospitals only |
| Ambulance services up to $5,000 or unlimited, depending on the state | Non-contracted private hospitals incur significant out-of-pocket costs |
| Includes Hospital at Home, travel, and accommodation benefits | Waiting periods apply, including 12 months for pre-existing conditions |
| Comprehensive hospital accommodation and in-hospital doctor cover | Pregnancy, birth, and assisted reproductive services not covered |
Silver Plus Standard Hospital Plan
The Silver Plus Standard Hospital Plan provides greater access to hospital services, making it affordable while offering essential benefits. Members enjoy flexibility with different excess levels and cover essential pharmaceuticals during hospitalization.
Target Audience: Best for Singles and Families, couples, and senior members who want basic hospital cover for typical treatments and Medicover assistance with out-of-pocket expenses.
Features
- Access to Medicover and flexible excess choices ($250, $500, $750).
- Affordable plan covering key hospital services, including heart and vascular treatments.
- Comprehensive ambulance cover, hospital-at-home options, and travel allowances.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Provides affordable hospital cover for essential procedures | Excludes cataracts, joint replacements, and dialysis |
| Full cover for in-hospital doctor services with Medicover | Pregnancy and birth not included |
| Ambulance services covered up to $5,000 or unlimited based on the state | Psychiatric care is limited to public hospitals |
| Travel and accommodation benefits for long-distance medical needs | Higher premiums compared to basic plans |
Bronze Plus Essential Hospital Plan
The Bronze Plus Essential Hospital Plan makes hospital care easier by concentrating on essential treatments. It offers straightforward benefits for typical medical needs, removing complicated inclusions that can increase costs.
Target Audience: Best for singles, families, couples, senior members, and anyone who requires affordable and essential hospital cover.
Features
- Hospital-at-home services allow recovery or treatment outside a traditional hospital setting.
- Covers pharmaceuticals and prostheses directly related to hospitalization.
- Offers ambulance services, with benefits varying by state.
- Includes travel and accommodation benefits for medical care requiring long-distance travel.
- Day surgery is capped at $100 excess.
- No additional costs for dependents under 22.
- Benefits extend to government-approved no-gap prostheses.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Affordable cover for essential hospital and ambulance services | Excludes pregnancy, weight loss surgery, and assisted reproductive care |
| Includes Medicover for reducing out-of-pocket doctor fees | Limited cover for specialized treatments like joint replacements |
| Travel and accommodation benefits for medical care over 200 km away | Waiting period of 12 months for pre-existing conditions |
| Cover for TGA/PBS-listed pharmaceuticals and prostheses | Does not cover chronic kidney failure or other complex medical needs |
Basic Plus Starter Hospital Plan
The Basic Plus Starter Hospital Plan provides essential benefits for important health requirements. The affordable design includes vital support, such as hospitalization benefits and provisions for travel-related care.
Target Audience: Best for singles and families who want nothing more except basic cover.
Features
- Covers services in coronary care units and provides access to critical cardiac treatment.
- Offers members access to the Medicover program for reduced doctor fees.
- Supports long-term recovery options through its cover of intensive care services.
- Provides flexibility in room allocation (private or shared) based on hospital availability.
- Waiting periods for accidents are just one day.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Entry-level plan with low premiums for basic hospital cover | Limited to fundamental medical services; excludes major surgeries |
| Full cover for MBS doctor fees and basic prostheses | Excludes cataracts, joint replacements, and specialized treatments |
| Includes Hospital at Home, travel, and accommodation benefits | No cover for pregnancy, weight loss surgery, or assisted reproduction |
| Emergency ambulance services covered (state-dependent) | Waiting periods apply, including 12 months for pre-existing conditions |
Recent User Reviews
🥇 Great Customer Service from Preeti
I recently spoke with Preeti, and she’s great! I was afraid to move from my top hospital and extras to Silver Assure, but Preeti patiently explained everything until I was sure. – Wayne
🥈 Excellent Support from Josie
Josie was excellent when I called to replace my card. She provided clear, detailed answers to all my inquiries. I like that RT Health answers the phone quickly, and they’re always so polite and helpful. – Claire
🥉 Fantastic Experience with RT Health
The past few years with RT Health have been amazing. I love that they have the best prices and almost zero phone holding times. They react quickly to emails too, which I like. – Ben
RT Health vs GU Health vs onemedifund – A Comparison
| 🔎 Provider | 🥇 RT Health | 🥈 GU Health | 🥉 onemedifund |
| 📉 Years in Operation | 130+ years | 18 years | 2007 |
| 📈 Average Number of Members | ±48,000 | Offers health insurance to over 300 businesses | Not Published |
| 📊 APRA Regulation | ✅Yes | ✅Yes | ✅Yes |
| 💹 Number of Employees | 50 - 200 | 50 – 200 | 10 – 50 |
| 🅰️ Market Share | ±12.5% | 9.6% | <0.1% |
| 🅱️ Market Cover | Nationwide (Australia) | Australia | Australia |
| ⭐ Customer Rating | 4.8/5 (750+ reviews) | Limited customer reviews | Limited customer reviews and ratings |
| 💛 Number of reviews | 750+ | Limited | Limited |
| 📲 Mobile App | ✅Yes | ✅Yes | Only for Android |
| 💶 Premium Range (AUD) | Varies based on state, age, income, rebates | Customized | Varies |
| 🌎 International Travel Benefit | Yes, via a partnership with HCF Travel Insurance+ | No, but offers OVCH | None |
| 📌 Market Capitalisation | None; not-for-profit | Not published | None published |
| 📍 Unique Features | Hospital at Home, flexible excess options, Medicover program for reducing out-of-pocket costs, Travel & Accommodation benefits for medical care | No Gap" experience, First Choice dental and optical providers, GU Health app, Care at Home programs | Comprehensive hospital cover, dental, optical, physiotherapy, complementary therapies, pharmaceuticals, and health management programs |
Advantages of Using RT Health
RT Health has a rich history that dates back more than 130 years, starting in 1889 when a group of railway workers at the Eveleigh rail workshops in Sydney came together to form a cooperative.
Throughout the years, RT Health has been there for its members during major national events, from the Spanish Flu in 1919 to the worldwide COVID-19 pandemic.
The health fund was vital during wartime, offering support to railway workers who were vital to Australia’s war efforts and helping to produce essential military equipment and materials.
RT Health has maintained its strong presence in Australian healthcare, even as government initiatives such as Medibank in the 1970s and Medicare in the 1980s transformed the healthcare environment.
Despite the move towards Medicare, RT Health remained an essential cover provider for Australian workers, adapting to various economic and social changes, such as the Granville train disaster in 1977 and significant natural disasters.
In November 2021, RT Health achieved an important milestone by merging with HCF, Australia’s largest not-for-profit health insurer.
This partnership enhanced RT Health’s services and brought its governance in line with the HCF Board, further solidifying its dedication to Australian workers and their families.
Key Historical Milestones
| 🔎 Year | 📌 Event/Development |
| 1️⃣ 1889 | Formation of RT Health by railway workers in Sydney’s Eveleigh workshops |
| 2️⃣ 1919 | Assisted members through the Spanish Flu pandemic |
| 3️⃣ 1940s | Supported railway workers involved in WWII, producing military equipment |
| 4️⃣ 1977 | Helped victims of the Granville train disaster |
| 5️⃣ 2021 | Merged with HCF, with governance transferred to HCF’s Board |
| 6️⃣ 2024 | RT Health was named Health Insurance of the Year in the ProductReview.com.au annual awards for the second year running |
Unique Selling Points/Advantages of RT Health
By merging with HCF, RT Health tapped into improved resources and wider cover options while focusing on personalized support for members.
- RT Health plans have adaptable covers for different life stages, featuring options for singles, families, and seniors.
- Members enjoy the advantages of its not-for-profit model, which guarantees that surplus funds are returned to services and benefits instead of being distributed as profits.
- The Gold Optimum Hospital Plan is notable for its all-encompassing cover, which includes prostheses, medications, and private hospital accommodations, offering significant financial security.
- Members receive extra perks such as hospital-at-home services and travel allowances for medical care that requires long-distance travel.
The gap cover program helps close the gap between what insurance pays and medical expenses, greatly lowering out-of-pocket costs for hospital treatments.
Overview of RT Health Gap Cover
Gap cover from RT Health is a health insurance benefit that bridges the difference between what Medicare pays and the total cost of medical services. This is useful when your policy doesn’t fully cover the total charges.
Gap cover helps members avoid paying additional costs for specific medical services, like those related to hospital stays or specialist care.
RT Health offers Access Gap Cover for its members. It works via an agreement with participating providers who consent to lessen or remove the difference between their fees and the benefits provided by Medicare and RT Health.
Eligibility and Accessing Gap Cover
Eligibility Requirements
- Available to members who are covered by a relevant RT Health hospital plan.
- Access is limited to treatments and services where the healthcare provider participates in the gap cover arrangement.
- Specialist consultations, inpatient surgeries, and other hospital treatments are covered if they fall within the gap cover agreement.
Steps for Accessing Gap Cover
- Check if your healthcare provider participates: Confirm with your doctor or hospital whether they are part of RT Health’s Access Gap Cover program.
- Confirm eligibility with RT Health: Ensure your RT Health plan includes gap cover for the required services or treatment.
- Submit your claim: RT Health will work directly with the provider to cover any gaps in the cost.
RT Health App Features
The RT Health app has important features that help users manage their health insurance effortlessly, like submitting claims, tracking benefits, and updating personal information. The app lets users submit and monitor extra claims, making it easy to track how RT Health is processing their claims.
It also allows members to view cover details whenever they want, making it simple to check what’s included in their plan before making appointments for treatment. This feature is useful in checking if certain treatments or services are included in your cover.
The app maintains a record of submitted claims, so you won’t have to sift physical documentation, offering a straightforward view of past services used.
Users can also easily update their personal information in the app, eliminating lengthy procedures and keeping their contact details up to date.
In our experience, while the app works well in these areas, users have pointed out ways it could improve. The app is rated 2.9 stars based on 44 reviews, and some users demand improved usability and more features.
How to apply for Health Insurance with RT Health
To apply for health insurance with RT Health, follow these simple steps to ensure your application is complete and successful:
1. Step 1: Confirm Eligibility
Applicants must be Australian residents with access to Medicare. If not eligible for Medicare, consider options like Overseas Visitor coverage.
2. Step 2: Complete the Application
Fill out the RT Health membership application form online, via paper, or by phone. Provide accurate personal details, and be prepared to submit additional supporting documents if needed.
3. Step 3: Make the Membership Contribution
Pay the required contribution either directly or through automatic bank deductions.
4. Step 4: Ensure Full Disclosure
Provide complete and honest information. RT Health may ask for additional documentation to verify your details.
5. Step 5: RT Health Review
RT Health will review the application. They reserve the right to reject any application. If rejected, any payments made will be refunded.
6. Step 6: Cooling-Off Period
You have 30 days to cancel your membership and receive a full refund, as long as no claims have been made.
7. Step 7: Membership Activation
Membership begins on the date RT Health receives your completed application and first payment or the date specified on the application form.
By following these steps, you can easily apply for health insurance with RT Health and enjoy the benefits of their comprehensive coverage.
How to apply for Gap Cover with RT Health
To apply for gap cover with RT Health, applicants must meet the eligibility criteria, including being a resident of Australia and over 18 years of age. Membership with RT Health is required to access gap cover, and additional conditions may apply depending on the type of cover selected.
Application Process
- Complete the RT Health membership application form, which can be done online or in person. Ensure that all required personal and health information is accurately provided.
- Provide any additional documentation requested by RT Health to verify the details provided in the application, such as health-related information.
- After applying, you must pay the required contributions. Payment options include direct debit, bank transfer, or other approved methods.
- RT Health will review your application.
- If your application is approved, RT Health will notify you of your membership and provide details about the available gap cover options.
Key Considerations
- You must provide informed consent for treatments covered by gap cover.
- Carefully review the terms of your cover, including waiting periods, exclusions, and any applicable excesses that may affect your gap cover before proceeding with treatment.
How to Submit a Claim with RT Health
Submitting claims with RT Health is easy and can be done through the mobile app, by post, or via an online form. Here’s a step-by-step guide for each method:
Mobile App Claims
- Download the RT Health app from the Apple App Store (iOS) or Google Play Store (Android).
- Log in using your RT Health membership number and password. First-time users must register.
- To submit a claim, select “Make a Claim.”
- Upload or take a photo of the receipt. Ensure photos are high resolution, and you can include up to three attachments.
- Click “Submit” to complete the process.
Manual Claims
- Download and complete the claim form.
- Send the form along with the itemized receipt to RT Health, ensuring the receipt includes the recipient’s full name, date of service or product purchase, and the healthcare provider’s name, contact details, and provider number.
- If the healthcare provider issues an unpaid invoice, the benefit will be paid to the policyholder’s nominated account, and the policyholder is responsible for paying the provider.
By following these simple steps, you can easily submit your claims and enjoy the benefits of RT Health coverage.
Key Considerations for Claims
- Receipts must be itemized and contain the necessary details, such as the provider’s name, date of service, and the provider’s contact information.
- Additional documents could be required for health aids, orthotics, or inpatient medical claims.
- Claims must be submitted within two years from the date of service or purchase.
- Claims for products or services received during a waiting period are not eligible for benefits.
How to Upgrade or Downgrade my Plan with RT Health
If you want to upgrade or downgrade your health insurance plan with RT Health, you must be an existing member with a valid and paid-up policy. You can make changes depending on your needs and eligibility by reaching out to RT Health directly and by following these steps:
Upgrade Process
Contact RT Health via customer service or the online portal to request an upgrade to a higher-level plan.
- Some benefits require new waiting periods after an upgrade, especially for hospital treatments or specific services.
- Expect an increase in premiums when upgrading to a higher cover plan.
RT Health will provide written confirmation with details of the new plan and updated premiums.
Downgrade Process
To downgrade, contact RT Health and specify the lower-level plan to switch to.
- Downgrading could require new waiting periods for certain benefits, such as hospital or extra services.
- Premiums typically decrease with a downgrade, but cover may also be reduced.
Some benefits, like hospital cover or extras, might be limited or removed with a downgrade.
How do I add a Beneficiary to RT Health?
To add a beneficiary to your RT Health membership, they must meet the following eligibility criteria:
- Child Dependent: A person under 18, unmarried, and primarily supported by the policyholder.
- Student Dependent: A full-time student aged 21-24, unmarried, and primarily supported by the policyholder.
- Non-Student Dependent: A person aged 21-24, unmarried, not a student, and primarily supported by the policyholder.
- Non-Classified Dependent: A person aged 18-21, unmarried, and dependent on the policyholder for support.
Once eligibility is confirmed, follow these steps to complete the process:
To add a dependent to your RT Health membership, complete the required form and provide their details. For children, you will need to include a birth certificate or proof of guardianship, while for students, proof of full-time enrollment is required.
Once the dependent is added, your membership category may change, and your premium will be adjusted accordingly.
Consider waiting periods
- Babies added within 12 months of birth are exempt from waiting periods if added within 2 months.
- Other dependents may have waiting periods depending on their age and relationship to the policyholder.
- RT Health may request additional verification, such as proof of student enrollment or financial dependency for adult children.
How to Submit a Compliment or Complaint with RT Health
To submit a compliment or complaint to RT Health, members can reach out via email, phone, or postal mail. The process is simple, and if the issue is not resolved during the initial contact, RT Health will assign a Resolution Officer to handle the complaint.
When making a complaint, members should provide a detailed description of the issue, including whether it relates to a specific claim or interaction, their desired resolution, and any special requests, such as preferred contact methods or support needs.
Compliment/Complaints Contact Methods
| 🔎 Contact Method | 📌 Details | 📍 Use For |
| [email protected] | Submitting compliments, feedback, or complaints | |
| ☎️ Phone | 1300 886 123 | Direct support for feedback or complaints |
| 🅰️ Postal Mail | Feedback and Resolutions Team, PO Box 545, Strawberry Hills NSW 2012 | For written feedback, complaints, or formal requests |
| 🅱️ Ombudsman (Private Health Insurance) | 1300 362 072 (Option 4 for private health insurance) ombudsman.gov.au GPO Box 442, Canberra, ACT 2601 | If you are unsatisfied with the resolution from RT Health |
How to Switch My Health Insurance to RT Health
To switch your health insurance to RT Health, follow these clear steps:
1. Step 1: Eligibility Requirements
You must be an Australian resident. Ensure you have an active membership with another Australian health fund.
2. Step 2: Request a Transfer Certificate (Clearance Certificate)
Contact your current insurer to request a transfer certificate. The certificate includes:
- Length of membership
- Level of cover
- Claims history
- Lifetime Health Cover (LHC) loading (if applicable)
Submit the transfer certificate ideally within 14 days of your request to avoid delays in recognizing waiting periods and LHC loading.
3. Step 3: Submit Required Documents
Provide RT Health with the transfer certificate from your previous insurer to complete the switch. RT Health will verify your membership details and check for any applicable waiting periods.
4. Step 4: Waiting Periods
RT Health will recognize waiting periods served with your previous insurer if you join RT Health within two months of leaving your old fund. If you upgrade to a higher level of coverage, you may need to serve new waiting periods for the additional benefits.
5. Step 5: Payment and Excess Considerations
If transferring from a policy with a higher excess to one with a lower excess, you may need to pay the higher excess until the new lower excess’s waiting period is served.
6. Step 6: Extras and Annual Limits
RT Health will review your previous Extras claims and adjust annual limits accordingly. Claims made under lifetime limits with your previous fund will reduce the available lifetime limits under your RT Health cover.
After all documents are submitted and processed, RT Health will provide details about your new membership, including the cover level and premiums.
RT Health Pet Cover
RT Health provides pet insurance policies in partnership with HCF, covering veterinary expenses, including unforeseen injuries and illnesses.
Pet Insurance Plans
| 🔎 Feature | 🥇 Pet Essentials | 🥈 Pet Premium | 🥉 Pet Premium plus Routine Care |
| 🩺 Covered Conditions | Specified accidental injuries and illnesses | Specified accidental injuries and illnesses | Specified accidental injuries and illnesses |
| 🧬 Benefit Percentage | Up to 80% (example) | Up to 80% (example) | Up to 80% (example) |
| 🩹 Benefit Limit | Applicable based on selected cover | Applicable based on selected cover | Applicable based on selected cover |
| ❤️ Routine Care | Not included | Not included | Included (non-insurance benefit) |
| 🦷 Dental Illness Benefit | Not included | Available as an optional benefit | Available as an optional benefit |
| 📌 Emergency Boarding | Not covered | Covered (up to the sub-limit) | Covered (up to the sub-limit) |
| 📍 Essential Euthanasia | Covered (up to the sub-limit) | Covered (up to the sub-limit) | Covered (up to the sub-limit) |
| ✈️ Travelling in New Zealand | Not covered | Covered (up to the sub-limit) | Covered (up to the sub-limit) |
| 🔖 Waiting Period (Accidental Injury) | 0 days | 0 days | 0 days |
| 🏷️ Waiting Period (Illness) | 30 days | 30 days | 30 days |
| ⏰ Waiting Period (Cruciate Ligament) | 6 months | 6 months | 6 months |
| ❌ Exclusions | Pre-existing conditions, some dental issues, elective treatments, routine care, breeding | Pre-existing conditions, dental issues, elective treatments, routine care, breeding | Pre-existing conditions, dental issues, elective treatments, routine care, breeding |
| 📉 Pre-existing Conditions | Not covered | Not covered | Not covered |
| 📈 Claims Process | Pre-approval required | Pre-approval required | Pre-approval required |
| 📊 Cover for Older Pets | Available for pets under 9 years old | Available for pets under 9 years old | Available for pets under 9 years old |
| 💹 Cooling-Off Period | 21 days | 21 days | 21 days |
RT Health Travel Insurance
RT Health offers travel insurance policies in partnership with HCF Travel Insurance+ to cover the following:
- Cover for evacuation in a medical emergency or natural disaster.
- Compensation for accommodation and meal expenses during unexpected travel delays.
- Covers emergency medical treatment, hospital stays, and evacuation costs.
- Covers rental vehicle damage or theft, subject to policy conditions.
- 24/7 access to Allianz Global Assistance for emergency support.
- Reimbursement for non-refundable expenses due to cancellations.
Moreover, Compensation for lost, stolen, or damaged baggage and personal belongings are offered.
RT Health Regulation
The Australian Prudential Regulation Authority (APRA) monitors the financial health of health funds like RT Health to ensure they’re stable and can fulfill their commitments to policyholders.
The Department of Health and Aged Care is responsible for shaping health policy and overseeing private health insurance in Australia. It ensures policies align with the population’s needs and offers information on eligibility, health insurance programs, and government initiatives.
The Commonwealth Ombudsman is an independent agency that helps consumers with problems concerning private health insurance. It provides resources such as the State of the Health Funds Report and Individual Health Fund Report Cards to assist consumers in comparing and evaluating health funds. The Ombudsman oversees the website privatehealth.gov.au, making it simple to compare different policies.
RT Health Awards and Recognition
RT Health has been recognized for its outstanding performance and customer satisfaction. RT Health has won the following awards in recent years:
| 🔎 Award | 📌 Year | 📍 Category | 🚩 Significance |
| 🅰️ ProductReview.com.au Health Insurance of the Year | 2024 | Health Insurance | Awarded for exceptional customer service and value for money, with a 4.8/5 rating from members |
| 🅱️ ProductReview.com.au Health Insurance of the Year | 2023 | Health Insurance | Recognized for consistent member satisfaction and strong service delivery |
RT Health Customer Support and Contact Details
RT Health provides these channels for members to access support:
- Phone: 1300 886 123 (Available Monday – Friday from 8:30 am to 5 pm).
- Email: [email protected]
- Mailing Address: Feedback and Resolutions Team, PO Box 545, Strawberry Hills NSW 2012.
RT Health Rebates and Discounts
Government Incentives and Rebates
Lifetime Health Cover (LHC)
The LHC loading applies to Australians who don’t have private hospital insurance before their 31st birthday. The loading increases your premiums by 2% for each year you delay, with a maximum of 70% for a ten-year delay.
The Medicare Levy Surcharge (MLS)
The Medicare Levy Surcharge (MLS) applies to high-income Australians who don’t have private health coverage. The fee is up to 1.5% of your salary and applies to persons earning more than $97,000 (singles) or $194,000 (couples/families).
Moreover, the Australian government offers a rebate to lower private health insurance payments. The rebate is income-tested and can pay up to 32.812% of premiums, with yearly modifications. It can be used to reduce premiums or as a tax deduction.
Eligibility Criteria
| 🔎 Incentive | 📌 Eligibility Criteria |
| 📉 Lifetime Health Cover (LHC) | Australians over the age of 31 who have not applied for private hospital cover by 1 July after their 31st birthday |
| 📈 Medicare Levy Surcharge (MLS) | This applies to singles earning above $97,000 and couples/families earning above $194,000 (as of 1 July 2024) without private hospital cover |
| 📊 Australian Government Rebate | Available to anyone with private health insurance, income-tested based on income, age, and number of dependents. The rebate percentage decreases with higher income |
RT Health Additional Health Services and Products
RT Health offers several additional health services and products to Australians. These services include unique offerings like the Hospital at Home program, corporate health plans, and individual services such as lifestyle health checks.
Hospital at Home
The Hospital at Home program gives participants access to hospital-equivalent care at home. After completing the waiting periods, members can access different therapies and post-procedure assistance in their own homes, with the approval of their doctor and the hospital.
Corporate Health Plans
RT Health also offers specialized business health plans to improve staff health and productivity. These programs are accessible to enterprises in rail, transportation, electricity, and energy sectors where RT Health has extensive experience.
Branch2U and Lifestyle Health Check
This offers members the ability to find health services in a familiar setting. One prominent service is the Lifestyle Health Check, which is a 30-minute assessment performed by a certified nurse.
This health check assesses important risk factors for heart disease, such as blood pressure, cholesterol, BMI, heart rate, resting metabolism, and blood sugar levels, helping members manage their health.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Available for individuals, families, and corporate members | Pre-existing conditions are not covered under most plans |
| Hospital at Home services for eligible members | Some waiting periods apply, especially for upgrades in cover |
| Offers corporate health plans for organisations in specific industries | Restrictions on cover for certain elective treatments and cosmetic procedures |
| Not-for-profit status prioritising members over shareholders | Limited flexibility in cover for members outside of the rail and transport sectors |
| 24/7 access to HCF Travel Insurance+ for travel insurance cover | Some members report issues with the usability of the mobile app |
In Conclusion
RT Health is a trusted Australian health insurer with over 100 years of experience, offering tailored health plans for individuals and families. They provide five hospital-only and three extra plans, along with services like the Hospital at Home program and corporate health plans. As a not-for-profit organization, RT Health prioritizes member benefits over shareholder profits.
However, some areas, like their mobile app, could improve, and there are exclusions such as pre-existing conditions and certain elective treatments. While open to all Australians, RT Health is primarily focused on the rail and transport sectors, which may not suit everyone.
Overall, RT Health offers reliable, member-focused coverage, with a strong history and valuable benefits, despite a few limitations.
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Frequently Asked Questions
What health cover does RT Health provide?
RT Health offers hospital and extra coverage and a combination of the two.
Who can join RT Health?
RT Health is available to all Australian citizens with full Medicare coverage. While it has a history of supporting specialized sectors, it currently accepts Australians from all sectors.
Does RT Health provide family cover?
Yes, RT Health has family cover options. Dependents under the age of 22 are covered at no additional expense, and full-time students under the age of 31 are also eligible.
Are there any exclusions in RT Health policy?
Exclusions include pre-existing conditions, some elective treatments, and others, depending on the plan chosen.
