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A Health Insurance Review of The Doctors Health Fund

A private health insurance company specifically designed to protect the health of medical professionals and their families.
Fact Checked

Updated: 22 May 2024

This private health insurer offers clinical independence and freedom of choice by placing no restrictions on your preferred provider networks for your general treatment services.

If you’re a current or past licensed medical or health practitioner or a student studying to become one, you might be eligible to join the Dr’s health fund.

ComparingExpert does not currently have access to this provider. Visit www.doctorshealthfund.com.au to request a quote and compare their price and benefits to the Australian private health insurance companies we have access to.

About the
Doctor’s
Health Fund

The Australian Doctors Health Fund was established over 40 years ago, created by doctors to provide quality private health insurance for doctors and the medical community of Australia.

This private health insurance company changed its name to the Doctors Health Fund in 2005 reflecting its separation from AMA (the Australian Medical Association).

In 2012, the fund was acquired by the Avant group, Australia’s largest Medical Defence Organisation, with the aim of increasing its client base, averaging a 10% per year growth since joining. As part of Avant Mutual, the fund is owned by doctors only and not shareholders.

Who can join?

To gain Doctors Health Fund eligibility, you generally need to qualify as one of the below:

Once you’re a member, you can continue your membership even when you’ve switched jobs or your relationship status has changed.

Your Doctors Health Fund review

If you’re part of the medical community, you can choose to buy any of the 3 Hospital or 2 Extras health insurance options available or combine Hospital and Extras into a combo package.

In 2018 the Drs Health Fund had the lowest premium increase of all health funds, and when you pay annually in advance, you can receive 2.5% off your premiums. Furthermore, as a member, you’ll also usually receive a 30% discount on QBE’s travel insurance products.

Hospital cover

When logged into the fund’s members’ portal, you can quickly find and choose one of the many hospitals that the fund has an existing agreement with by using their Contracted Hospital Search. There are 3 Hospital only cover options to choose from; Smart Starter, Prime Choice and Top Hospital and all 3 options cover you for ambulance services nationwide.

Smart Starter
Prime Choice
Top Hospital
Entry-level cover, designed for singles and couples on a tight budget.
Comprehensive hospital coverage that provides for a wide range of services.
Premium cover that pays a medical gap benefit up to the AMA list of medical services and fees.
$115.95
$201.92 to $230.27
$307.73
$500 Excess
$500 or $0 Excess
Zero Excess

The main difference between Prime Choice and Top Hospital is that the Top Hospital cover requires no Excess and your doctors’ services, as an in-patient, is covered by the Unique Premium Gap Cover. Meaning, the fund pays the rest of the benefits Medicare does not include, up to the AMA list.

Source: www.privatehealth.gov.au
Prices above are based on a single adult, without an LHC loading, living in NSW, November 2018 (excludes the Government Rebate).

Hospital waiting periods

Doctors Health Fund extras

The private health fund offers you the choice of 2 Extras options; Essential and Total. While each option has a different benefit limit, they both exclude non-medically proven therapies (chiropractic and natural therapies) and include:

General treatment & Waiting periods
Essential Extras Annual benefit
Total Extras Annual benefit
Monthly premium
$69.11
$113.47
General dental: 2 month waiting period
$1,600 per policy Sub-limits apply
No annual limit
Major dental: 12 month waiting period
$500 over 2 years
$3,200 per policy
Optical: 2 month waiting period
$900 per policy. Sub-limits apply
$600 over 2 years
Physiotherapy: 2 month waiting period
$900 per policy. Sub-limits apply
$700 per policy. Sub-limits apply
Remedial massage: 2 month waiting period
$900 per policy. Sub-limits apply
$700 per policy. Sub-limits apply
Podiatry: 2 month waiting period
$900 per policy. Sub-limits apply
$600 per policy
Hearing aids: 24 month waiting period
$500 per policy. 1 Appliance every 3 years.
$1000 per policy
Blood glucose monitors: 12-month waiting periods
$500 per policy. 1 Appliance every 3 years.
$1000 per policy. 1 Appliance very 5 years.
Non-PBS pharmaceuticals: 2 month waiting period
$300 per policy
75% of charge per monitor.

The Total Extras option also includes access to the fund’s Health Management Programs and home nursing services. Their Health Management Programs are designed to help you manage specific health conditions, like high Body Mass Index (BMI), arthritis and asthma.

Source: www.privatehealth.gov.au
Prices above are based on a single adult, without the LHC loading, living in NSW, November 2018 (excluding the Government Rebate).

Cover combos