Doctors' Health Fund
fund code AMA · Restricted membership: Medical and allied health professionals, their families, medical students and AMA employees.
Health insurance
Doctors' Health Fund sells 1,204 open policies with hospital cover (392 hospital-only, 812 combined with extras, counting one per state and household type) in all states, grouped below into 23 products. Premiums are monthly, before the government rebate; the table shows each product's range across the states and households it is sold to, and choosing a state and household narrows it to the exact premium.
Products
SCFP = sold to singles · couples · families · single parents
| Policy | Tier | Type | Excess / person | Co-pay | Covered | Restricted | Under-30 discount | States | S C F P | Monthly premium | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Prime Choice Gold | Gold | Hospital | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $289.30 – $885.05 | |
| Prime Choice Gold $500 Excess | Gold | Hospital | $500 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $260.67 – $813.72 | |
| Prime Choice Gold $750 Excess | Gold | Hospital | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $244.22 – $772.25 | |
| Top Cover Gold | Gold | Hospital | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $379.44 – $1,140.29 | |
| Top Cover Gold $750 Excess | Gold | Hospital | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $339.47 – $1,040.60 | |
| Prime Choice Gold $500 Excess & Essential Extras | Gold | Combined | $500 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $359.78 – $1,061.49 | |
| Prime Choice Gold $500 Excess & Total Extras | Gold | Combined | $500 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $422.72 – $1,218.85 | |
| Prime Choice Gold $750 Excess & Essential Extras | Gold | Combined | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $343.33 – $1,020.02 | |
| Prime Choice Gold $750 Excess & Total Extras | Gold | Combined | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $406.27 – $1,177.38 | |
| Prime Choice Gold & Essential Extras | Gold | Combined | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $388.41 – $1,132.82 | |
| Prime Choice Gold & Total Extras | Gold | Combined | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $451.35 – $1,290.18 | |
| Top Cover Gold $750 Excess & Essential Extras | Gold | Combined | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $438.58 – $1,288.37 | |
| Top Cover Gold $750 Excess & Total Extras | Gold | Combined | $750 | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $501.52 – $1,445.73 | |
| Top Cover Gold & Essential Extras | Gold | Combined | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $478.55 – $1,388.06 | |
| Top Cover Gold & Total Extras | Gold | Combined | — | None | 38 | 0 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $541.49 – $1,545.42 | |
| Smart Starter Bronze Plus $500 Excess | Bronze Plus | Hospital | $500 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $138.69 – $443.00 | |
| Smart Starter Bronze Plus $750 Excess | Bronze Plus | Hospital | $750 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $128.17 – $416.20 | |
| Smart Starter Bronze Plus $500 Excess & Essential Extras | Bronze Plus | Combined | $500 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $237.80 – $690.77 | |
| Smart Starter Bronze Plus $500 Excess & Starter Extras | Bronze Plus | Combined | $500 | None | 25 | 2 | Yes | All states | SCSingle, Couple | $190.73 – $458.47 | |
| Smart Starter Bronze Plus $500 Excess & Total Extras | Bronze Plus | Combined | $500 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $300.74 – $848.13 | |
| Smart Starter Bronze Plus $750 Excess & Essential Extras | Bronze Plus | Combined | $750 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $227.28 – $663.97 | |
| Smart Starter Bronze Plus $750 Excess & Starter Extras | Bronze Plus | Combined | $750 | None | 25 | 2 | Yes | All states | SCSingle, Couple | $180.21 – $437.03 | |
| Smart Starter Bronze Plus $750 Excess & Total Extras | Bronze Plus | Combined | $750 | None | 25 | 2 | Yes | All states | SCFPSingle, Couple, Family, Single parent | $290.22 – $821.33 |
A policy name opens the fund's own page for it where the fund publishes one. "Covered" links to the cover profile listing the clinical categories. Where a range remains after choosing a state and household, the fund sells several variants of the product there (for example with and without adult dependants) and the per-fund JSON has each.
Hospital cover profiles
Every product's hospital cover is one of these profiles over the 38 clinical categories. Restricted categories are paid at the minimum benefit only.
Cover profile 1 · 25 of 38 categories covered, 2 restricted, 11 not covered
Covered Blood, Bone, joint and muscle, Brain and nervous system, Breast surgery (medically necessary), Chemotherapy, radiotherapy and immunotherapy for cancer, Dental surgery, 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, Lung and chest, Male reproductive system, Miscarriage and termination of pregnancy, Pain management, Palliative care, Plastic and reconstructive surgery (medically necessary), Podiatric surgery (provided by a registered podiatric surgeon), Skin, Sleep studies, Tonsils, adenoids and grommets
Restricted Hospital psychiatric services, Rehabilitation
Not covered Assisted reproductive services, Back, neck and spine, Cataracts, Dialysis for chronic kidney failure, Heart and vascular system, Implantation of hearing devices, Insulin pumps, Joint replacements, Pain management with device, Pregnancy and birth, Weight loss surgery
Products Smart Starter Bronze Plus $500 Excess (Bronze Plus, hospital); Smart Starter Bronze Plus $750 Excess (Bronze Plus, hospital); Smart Starter Bronze Plus $500 Excess & Essential Extras (Bronze Plus, combined); Smart Starter Bronze Plus $500 Excess & Starter Extras (Bronze Plus, combined); Smart Starter Bronze Plus $500 Excess & Total Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Essential Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Starter Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Total Extras (Bronze Plus, combined)
Cover profile 2 · 38 of 38 categories covered, 0 restricted, 0 not covered
Covered Assisted reproductive services, Back, neck and spine, Blood, Bone, joint and muscle, Brain and nervous system, Breast surgery (medically necessary), Cataracts, Chemotherapy, radiotherapy and immunotherapy for cancer, Dental surgery, Diabetes management (excluding insulin pumps), Dialysis for chronic kidney failure, Digestive system, Ear, nose and throat, Eye (not cataracts), Gastrointestinal endoscopy, Gynaecology, Heart and vascular system, Hernia and appendix, Hospital psychiatric services, Implantation of hearing devices, Insulin pumps, Joint reconstructions, Joint replacements, Kidney and bladder, Lung and chest, Male reproductive system, Miscarriage and termination of pregnancy, Pain management, Pain management with device, Palliative care, Plastic and reconstructive surgery (medically necessary), Podiatric surgery (provided by a registered podiatric surgeon), Pregnancy and birth, Rehabilitation, Skin, Sleep studies, Tonsils, adenoids and grommets, Weight loss surgery
Products Prime Choice Gold (Gold, hospital); Prime Choice Gold $500 Excess (Gold, hospital); Prime Choice Gold $750 Excess (Gold, hospital); Top Cover Gold (Gold, hospital); Top Cover Gold $750 Excess (Gold, hospital); Prime Choice Gold $500 Excess & Essential Extras (Gold, combined); Prime Choice Gold $500 Excess & Total Extras (Gold, combined); Prime Choice Gold $750 Excess & Essential Extras (Gold, combined); Prime Choice Gold $750 Excess & Total Extras (Gold, combined); Prime Choice Gold & Essential Extras (Gold, combined); Prime Choice Gold & Total Extras (Gold, combined); Top Cover Gold $750 Excess & Essential Extras (Gold, combined) and 3 more
Extras profiles
Extras profile 1 · 17 services
Services Acupuncture, General dental, Dietetics, Exercise physiology, Glucose monitors, Health management programs, Non-PBS pharmaceuticals, Occupational therapy, Optical, Orthoptics, Orthotics, Physiotherapy, Podiatry, Psychology, Remedial massage, Speech therapy, Vaccinations
Products Smart Starter Bronze Plus $500 Excess & Starter Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Starter Extras (Bronze Plus, combined)
Extras profile 2 · 22 services
Services Acupuncture, Antenatal and postnatal, General dental, Major dental, Dietetics, Endodontic, Exercise physiology, Glucose monitors, Health management programs, Hearing aids, Non-PBS pharmaceuticals, Occupational therapy, Optical, Orthodontic, Orthoptics, Orthotics, Physiotherapy, Podiatry, Psychology, Remedial massage, Speech therapy, Vaccinations
Products Prime Choice Gold $500 Excess & Essential Extras (Gold, combined); Prime Choice Gold $750 Excess & Essential Extras (Gold, combined); Prime Choice Gold & Essential Extras (Gold, combined); Top Cover Gold $750 Excess & Essential Extras (Gold, combined); Top Cover Gold & Essential Extras (Gold, combined); Smart Starter Bronze Plus $500 Excess & Essential Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Essential Extras (Bronze Plus, combined)
Extras profile 3 · 24 services
Services Acupuncture, Antenatal and postnatal, Audiology, General dental, Major dental, Dietetics, Endodontic, Exercise physiology, Glucose monitors, Health management programs, Hearing aids, Home nursing, Non-PBS pharmaceuticals, Occupational therapy, Optical, Orthodontic, Orthoptics, Orthotics, Physiotherapy, Podiatry, Psychology, Remedial massage, Speech therapy, Vaccinations
Products Prime Choice Gold $500 Excess & Total Extras (Gold, combined); Prime Choice Gold $750 Excess & Total Extras (Gold, combined); Prime Choice Gold & Total Extras (Gold, combined); Top Cover Gold $750 Excess & Total Extras (Gold, combined); Top Cover Gold & Total Extras (Gold, combined); Smart Starter Bronze Plus $500 Excess & Total Extras (Bronze Plus, combined); Smart Starter Bronze Plus $750 Excess & Total Extras (Bronze Plus, combined)
Waiting periods
- Waiting profile 1: pre-existing conditions 12 months, sub-acute care 2 months, other 2 months (8 products)
- Waiting profile 2: pre-existing conditions 12 months, pregnancy and birth 12 months, sub-acute care 2 months, other 2 months (15 products)
Data
This section is built from the Private Health Insurance Ombudsman's monthly policy data release. The same records are published as JSON, each row naming the release file it came from:
/au/insurance/health/v1/funds/doctors-health-fund.json: this fund, every policy row and the cover, waiting-period and extras profiles./au/insurance/health/v1/policies/<STATE>.json: every fund's policies sold in a state (NSW, VIC, QLD, SA, WA, TAS, NT)./au/insurance/health/v1/cheapest.json: the cheapest policies per state, household and tier./au/insurance/health/v1/index.json: dataset index, including every per-fund file.
Deep Almanac is a secondary source and this page is provided for general information and reference. It is not financial, investment, legal, valuation, educational or other professional advice, and it is not a substitute for checking the original source. Premiums change without notice, usually on 1 April each year, and insurers apply waiting periods, exclusions and eligibility rules not fully captured here. You are responsible for any decision you or your software makes in reliance on this page. See our terms of use.