Phoenix Health Fund
Bronze Hospital 500 & Healthy Flex Extras 50
Phoenix Health Fund
How $304.07 is worked out
- Premium as filed - $400.72 a month (hospital share $251.00)
- Government rebate - 24.1% of the premium (never of the loading): -$96.65
- A month - $304.07
Go to insurer no commission on this policy
Hospital: what is covered
Covered (18)
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Diabetes management (excluding insulin pumps)
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Hernia and appendix
- Joint reconstructions
- Kidney and bladder
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Skin
- Tonsils, adenoids and grommets
Restricted (3)
- Hospital psychiatric services
- Palliative care
- Rehabilitation
Not covered (17)
- Assisted reproductive services
- Back, neck and spine
- Blood
- Cataracts
- Dental surgery
- Dialysis for chronic kidney failure
- Heart and vascular system
- Implantation of hearing devices
- Insulin pumps
- Joint replacements
- Lung and chest
- Pain management with device
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Sleep studies
- Weight loss surgery
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Bronze
- Hospital - Private hospital, or a shared room in a public hospital
- Excess - Capped per person and per policy per year. $500 per admission. $500 per person a year. $1,000 per policy a year. No excess for dependants.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Offered for 18 to 29 year olds
- Accident cover - Yes
- Travel and accommodation benefits - Yes
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: Phoenix Health Hospital Cover features include... *Access Gap – Where your Doctor agrees to participate in our Access Gap Program, you can eliminate or reduce your out-of-pocket costs that you may have otherwise incurred towards your hospital procedure. *Hospital Care Programs – supporting you beyond a hospitalisation, you have access to programs designed to support your health and wellbeing before and after a hospital admission. *Full Ambulance Cover – medically required emergency and non-emergency Ambulance treatment and transport is covered on all of our Hospital Covers, Australia-wide.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental * | 2 months | Check-up (item 012): 100% back; Scale and clean (item 114): 100% back; Fluoride treatment (item 121): 100% back | $700 per person a year |
| Major dental | 12 months | Tooth extraction (item 322): 50% back; Crown (item 615): 50% back | $700 per person a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): 50% back | $700 per person a year (shared with other services) |
| Glasses and contact lenses | 6 months | Single vision glasses: 50% back; Multifocal glasses: 50% back | $700 per person a year (shared with other services) |
| Physiotherapy | 2 months | First visit: 50% back; Follow-up visit: 50% back | $700 per person a year (shared with other services) |
| Chiropractic | 2 months | First visit: 50% back; Follow-up visit: 50% back | $700 per person a year (shared with other services) |
| Podiatry | 2 months | First visit: 50% back; Follow-up visit: 50% back | $700 per person a year (shared with other services) |
| Remedial massage | 2 months | First visit: 50% back; Follow-up visit: 50% back | $700 per person a year (shared with other services) |
Not covered: Braces, Prescriptions not on the PBS, Psychology, Acupuncture, Hearing aids, Blood glucose monitors, Audiology, Antenatal and postnatal, Chinese herbal medicine, Dietitian, Exercise physiology, Eye therapy (orthoptics), Health management programs, Home nursing, Occupational therapy, Orthotics, Osteopathy, Speech therapy, Vaccinations.
* 100% benefit available on preventative dental services– includes items 012, 013, 111, 114, 115, 121, 161. Claimable once per appointment, up to twice per person per calendar year up to General Dental limits.
Other services, as filed: $700 General Dental limit. $700 Flex Limit combined for Major Dental, Endodontics, Optical ($200 sublimit), Physiotherapy, Chiropractic, Podiatry, Remedial Massage ($200 sublimit).
Ambulance
Emergency and non-emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in Northern Territory
Phoenix Health Fund has agreements with 3 private hospitals here, as filed with the Ombudsman.
The list
- Darwin Day Surgery - Wanguri (day hospital)
- Darwin Private Hospital - Tiwi
- NT Medical Specialist - Wanguri (day hospital)
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
82.5% is the Commonwealth Ombudsman's figure for Phoenix in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement BHH5/WRLL2Y, filed by Phoenix Health Fund Limited, issued 1 Apr 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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