Who is Phoenix Health Fund?
Phoenix Health Fund is a mutual nonprofit private health insurer. Established in 1953, originally for the needs of the Australian steel industry, today it has just over 15,000 members. It belongs to Members Health, an alliance of nonprofit and mutual health funds.
Phone: 1800 028 817
Website: phoenixhealthfund.com.au
Does Phoenix Health Fund get many complaints from members?
Phoenix Health Fund has a Medium complaints rating.
When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don’t get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.
How good is Phoenix Health Fund’s gap cover?
A medical gap is the difference between Medicare’s recommended fee and what your doctor actually charges for a treatment or service.
Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called ‘no gap agreements’, or part of that gap, which are called ‘known gap agreements’ (these will have lower out-of-pocket costs, usually less than $500).
Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.
Rating scale
- Well above average
- Above average
- Average
- Below average
- Well below average
Australian Capital Territory
Below average.
New South Wales
Above average.
Northern Territory
Well below average.
Queensland
Above average.
South Australia
Average.
Tasmania
Average.
Victoria
Average.
Western Australia
Above average.
How many hospital agreements does Phoenix Health Fund have in each state?
The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you’re treated.
The table below shows how many hospital agreements Phoenix Health Fund has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don’t have agreements with specific funds and are generally treated as though they’re agreement hospitals.
Phoenix Health Fund hospital agreements
In the Australian Capital Territory this fund has…
5 private hospital agreements out of an industry maximum of 6.
8 day hospital agreements out of an industry maximum of 9.
In New South Wales this fund has…
89 private hospital agreements out of an industry maximum of 92.
89 day hospital agreements out of an industry maximum of 105.
In the Northern Territory this fund has…
1 private hospital agreement out of an industry maximum of 1.
2 day hospital agreements out of an industry maximum of 2.
In Queensland this fund has…
50 private hospital agreements out of an industry maximum of 58.
46 day hospital agreements out of an industry maximum of 54.
In South Australia this fund has…
18 private hospital agreements out of an industry maximum of 20.
25 day hospital agreements out of an industry maximum of 31.
In Tasmania this fund has…
8 private hospital agreements out of an industry maximum of 8.
4 day hospital agreements out of an industry maximum of 9.
In Victoria this fund has…
69 private hospital agreements out of an industry maximum of 71.
71 day hospital agreements out of an industry maximum of 80.
In Western Australia this fund has…
21 private hospital agreements out of an industry maximum of 23.
20 day hospital agreements out of an industry maximum of 29.
Does Phoenix Health Fund offer any discounts?
None While there are no discounts for direct debit or prepaying your annual premium, youth discounts are offered on all policies.
Does Phoenix Health Fund offer ambulance cover?
All Phoenix Health extras, hospital and combined policies have emergency ambulance cover.
Depending on where you live, you may not need a policy with ambulance cover.
- Queensland and Tasmania: Emergency ambulance services are covered by the state government.
- New South Wales and the Australian Capital Territory: All hospital policies come with emergency ambulance cover – so you’ll be covered with any hospital or combined policy you select.
- South Australia, Victoria and the Northern Territory: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover.
- Rural Western Australia: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover.
- Metropolitan Western Australia: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.
Does Phoenix Health Fund offer family policies that cover adult children?
- Adult children are covered on family policies for free until they turn 21.
- Full-time students are covered on family policies for free until they turn 25.
- Adult children younger than 25 can be covered on extended family policies for an extra cost.
Does Phoenix Health Fund let you claim online or in-app?
All services can be claimed via email or the fund’s app (iOS and Android).
