Frequently-Asked Questions
Am I eligible to join?
Current and former employees of Tubemakers, OneSteel, Bradken, BHP and associated companies can join. Immediate family members of current and former employees can also join. Employees of contractors to the above companies and Phoenix Health Fund can also join.
I have not had private health cover before. Will I have to wait before I can make a claim?
Waiting periods do apply for some types of claims.
I have not had private hospital cover before. Will it cost me more?
The Commonwealth Government’s Lifetime Health Cover (LHC) legislation says that if you are over 30 and taking out private hospital cover for the first time, you may have to pay an extra 2% for each year over 30. Contact our office for details.
I am already in another fund. How do I transfer to Phoenix Health Fund?
Phoenix can arrange the transfer on your behalf, you do not need to contact your other fund directly. If you apply online, the application process will ask you about your other fund. If you prefer to print and mail your application forms, make sure you complete the “Transfer from another Fund” form. Your other fund will send a clearance certificate to Phoenix showing your type of cover and the length of time you’ve been a member.
I am transferring from another fund. Will I have to wait before I can make a claim?
You can claim immediately (once contributions have commenced) if you are taking out a similar level of cover, and have served the relevant Phoenix waiting periods with your previous fund. If taking a higher level of cover with Phoenix, applicable waiting periods must be served for the higher cover only.
If I take out Top Hospital cover will I have any gaps to pay if I go to a private hospital?
Phoenix, as part of the Australian Health Service Alliance (AHSA) has agreements with over 480 private hospitals throughout Australia. With Top Hospital cover your hospital charges are fully covered in these agreement hospitals.
Phoenix also has AHSA agreements in place with over 155,000 doctors where your medical charges are either fully covered or you will be advised of any gaps. You should always ask your doctor before hospital treatment if they participate in our Access Gap Cover scheme, and if they will be charging a gap.
If I take out YoungSavers cover will I have any gaps to pay for hospital treatment?
With YoungSavers cover you pay an excess of $250 for same day hospital treatment, and $500 for overnight. If you go into hospital for one of the restricted conditions you could have quite considerable gaps. YoungSavers is covered by the same AHSA agreements with doctors and hospitals as Top Hospital cover.
Am I covered for ambulance?
Ambulance cover varies from state to state. In NSW and ACT you are covered if you have hospital cover. In all other states you should join your State Ambulance Scheme, and claim the membership cost from Phoenix if you have Ancillary cover.
How can I claim for ancillary services?
For a wide range of ancillary services your membership card can be swiped at participating HICAPS providers. The fund pays the benefit directly to the provider, and you pay the difference between the charge and the benefit. You can also claim by sending in a Claim Form with your receipts/accounts to the fund. Claims are paid by cheque or directly into your account on the day they are received at the fund.
How do I pay my contributions?
Contributions can be paid by monthly direct debit (debit accounts only), quarterly account by BPay, credit card or cheque, or by payroll deductions from participating employers.
Will membership of Phoenix Health Fund exempt me from the Medicare Levy Surcharge?
All Phoenix products with hospital cover will exempt the member from the Medicare Levy Surcharge. The cover must be held for the full tax year for full exemption.
How long can my children stay on my family membership?
Children can remain on your membership until their 21st birthday as long as they are not married. After their 21st birthday they can remain on your membership until they turn 25 as long as they are full time students and a Student Declaration form is signed. Once your child is no longer a dependant they are welcome to take out their own membership.
If I leave the company can I stay in Phoenix Health Fund?
Yes
What should I do if I have a complaint?
If you have a complaint concerning your membership, contact the Fund in the first instance so that it can be resolved as quickly as possible. Your complaint will be dealt with in accordance with our Complaints Policy.
If you are unable to resolve your complaint with the Fund, the independent Private Health Insurance Ombudsman has been established to assist with inquiries and complaints about any aspect of private health insurance. Complaints can be lodged with the Ombudsman online or by telephone on 1800 640 695.
