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Doctors’ Health Fund (Doctors’ Health) is a private health insurer that operates as a restricted health fund.
Background
Doctors’ Health was established by the NSW branch of the Australian Medical Association (AMA) in 1977 to serve the medical community.
There used to be a convention that doctors did not charge colleagues or their colleagues’ families. When Medibank was set up in 1976, doctors began to charge their colleagues the amount of the Medibank rebate. Doctors’ Health was set up to solve the discomfort associated with doctors charging their colleagues fees.
Avant Mutual, Australia’s largest medical defence organisation, bought Doctors’ Health in 2012. It now has more than 32,000 members.
Who can join Doctors’ Health?
You can join Doctors’ Health if you are a:
current or former (including retired) registered medical practitioner (including overseas trained doctor registered for the Australian Medical Council exams)
current or former:
optometrist
physiotherapist
psychologist
occupational therapist
dentist, dental therapist, dental hygienist, dental prosthetist and oral health therapist.
medical radiation practitioner, diagnostic radiographer, medical imaging technologist, radiographer, nuclear medicine scientist, nuclear medicine technologist or radiation therapist.
student studying to become a medical practitioner or eligible health practitioner
employee of a medical practitioner or eligible health practitioner (including practice managers and receptionists)
employee of any member associations for medical practitioners or eligible health practitioners, such as the Australian Medical Association.
member of the extended family (parent, children, grandchildren, spouse/partner (including former), sibling or niece/nephew.
The insurer’s Top Hospital Cover is unique because it pays a gap based on the AMA’s list of medical services and fees rather than the Medicare Benefits Schedule (MBS) fee.
Do Doctors’ Health policies include Ambulance Cover?
Doctors’ Health includes Ambulance Cover with Hospital Cover and Combined Hospital and Extras Cover.
Under these policies, Ambulance Cover is not restricted to emergencies or limited to a number of services per year.
Does Doctors’ Health offer corporate policies?
Yes. Doctors’ Health provides corporate policies to certain organisations. Search your organisation’s website or intranet to find out whether a corporate health insurance policy is available to you, and what conditions apply.
Is Doctors’ Health a not-for-profit health insurer?
Does Doctors’ Health have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?
Yes. Doctors’ Health has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:
Location
Number of private Agreement Hospitals
Industry maximum
ACT
6
6
NSW
91
98
NT
2
2
QLD
49
60
SA
19
23
TAS
8
9
VIC
73
76
WA
21
24
Doctors’ Health alsohasagreements with a number of day hospitals so it can provide services at low cost or with no out-of-pocket costs:
Is Doctors’ Health a member of any industry associations?
Yes. Doctors’ Health is a member of the Members Health Fund Alliance, an alliance of not-for-profit, member-owned, regional or community-based health insurers.
Does Doctors’ Health let me claim online or via an app?
Yes. Doctors’ Health allows you to make a claim online using the member portal or the mobile app.
