Bronze Plus Essentials 500 & Kick Start Extras 50

Hospital: what is covered

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 Plus
• 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

Not covered: Major dental, Root canal, Braces, Glasses and contact lenses, Podiatry, Psychology, Hearing aids, Blood glucose monitors, Audiology, Antenatal and postnatal, Chinese herbal medicine, Dietitian, Eye therapy (orthoptics), Health management programs, Home nursing, Occupational therapy, Orthotics, Speech therapy.

* 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: *$200 sublimit for Physiotherapy/ Myotherapy & Exercise Physiology; $200 sublimit for Chiropractic, Osteopathy & Remedial Massage; up to overall combined limit of $400. *Non PBS Pharmaceuticals benefit applies after PBS co-payment is applied.

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.

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 SSE5/TNDE2Y, filed by Phoenix Health Fund Limited, issued 1 Apr 2026.