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

 

Treatments Covered
Treatment for injuries sustained in an accident Yes
Prosthesis Yes
Appendicitis treatment Yes
Removal of Appendix Yes
Obesity Surgery Yes
Removal of tonsils and adenoids Yes
Joint reconstruction and investigations Yes
Surgical removal of wisdom teeth (hospital charge only) Yes
Colonoscopy/Gastroscopy 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
Joint replacements Yes
Surgery on broken bones Yes
Renal dialysis Yes
Cosmetic surgery covered by Medicare Yes
Cosmetic surgery (not covered by Medicare) Excluded
Psychiatric services Yes
Rehabilitation Yes
Palliative care Yes
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.

 

Nil Excess 

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

Hospital

  • 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

Fund Rules

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.