If you’re looking to cover all the if’s and maybe’s in hospital, look no further than Phoenix’s Top Hospital policy. Providing the full range of coverage in both private and public hospitals across the country, this policy gives you the most comprehensive hospital coverage available, leaving you with complete peace of mind.
What’s Included in Hospital Cover
|Treatment for injuries sustained in an accident||Yes|
|Removal of Appendix||Yes|
|Removal of tonsils and adenoids||Yes|
|Joint reconstruction and investigations||Yes|
|Surgical removal of wisdom teeth (hospital charge only)||Yes|
|Pregnancy and birth related services||Yes|
|Fertility treatment (e.g IVF & GIFT programs)||Yes|
|Heart related services||Yes|
|Major eye surgery (including cataract and eye lens services)||Yes|
|Surgery on broken bones||Yes|
|Cosmetic surgery covered by Medicare||Yes|
|Cosmetic surgery (not covered by Medicare)||Excluded|
|All other in-patient services where a Medicare benefit is payable||Yes|
Emergency Ambulance Coverage
Phoenix Health Fund covers all medically necessary emergency transport from a State Emergency Ambulance service. This also includes when an Ambulance is called to attend to you, but you do not subsequently need to be taken to hospital. Coverage is not offered when it is not medically necessary for you to be transported by an Ambulance.
Important Hospital Information
For hospital services to which Phoenix Health Fund provides coverage, Top Hospital provides coverage for:
- Private and public hospital services nationwide (after the up-front excess has been paid) with access to an extensive range of quality services and approved programs in private hospitals which have an agreement with Phoenix Health Fund.
- Public or Private Hospital bed – shared or private room (if available)
- Same day patient fees
- Theatre fees
- Intensive care
- Labour ward
- In hospital pharmacy
- Prosthesis (Commonwealth Government approved)
- All other in-patient services where a Medicare benefit is payable (not listed as an exclusion in the table above)
Additional costs you may incur are:
- The amount the doctor charges above the Medicare schedule fee or “Access Gap” cover amount
- some drugs, pharmacy items and non-PBS drugs for personal use or on discharge; and possibly
- a co-payment for prostheses devices above the minimum benefit.
- There are a small number of public hospitals that do not have agreements with us. In these cases a personal payment may apply.
Phoenix’s Top Hospital policy does not have an excess. This means if you are admitted into hospital, an excess payment will not apply.
Medical Gap cover
Phoenix Health Fund, as a member of the Australian Health Service Alliance, has “Access Gap” arrangements with more than 15,000 doctors Australia-wide. These arrangements minimise or eliminate Members’ out-of-pocket expenses when our Members are treated as admitted hospital patients.
If your doctor participates in the “Access Gap” scheme, you will either have no out-of-pocket expenses to pay or will know exactly how much you will have to pay before treatment begins. Your doctor can bill Phoenix Health Fund direct, so in most cases you will not be required to lodge a claim with us, making it easier for you.
To check whether your doctor participates in “Access Gap”, use our Doctor Search facility, or ask your doctor.
Top Hospital waiting periods
- 12 month waits for Pregnancy and birth related services
- 12 month waits for assisted reproductive services
- 12 month waiting periods for pre-existing conditions
- 2 month waiting periods for all other hospital items
For the complete description of the Fund rules, relating this product, please refer to the General Information section on our website.
Please ensure you have read and retained the information relating to your policy of choice before applying for membership.