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The Doctors' Health Fund

Flexible cover, choose and change to suit your needs

 

Hospital Options

Extras Options

 

  Smart Starter Prime Choice Top Cover
Gap Cover

Benefits paid up to AHSA schedule fee

The medical benefits paid under the Access Gap scheme are equivalent to most funds' premium products. The Access Gap scheme has a record of paying benefits at or above the industry average.

 Benefits paid up to AHSA schedule fee

The medical benefits paid under the Access Gap scheme are equivalent to most funds' premium products. The Access Gap scheme has a record of paying benefits at or above the industry average.

 Benefits paid up to AMA list of fees and services

Our Top Cover is unique and pays medical benefits up to the AMA List fee. This is the highest medical gap scheme in Australia. Top Cover also provides complete freedom of choice of doctor in that your doctor does not have to agree to participate in the scheme for you to receive the benefits.

Included Services:
Pregnancy related services
including assisted reproductive
services, sterilisation and
reversal of sterilisation.
No
Yes
Yes
Hip and Knee replacements
and revisions.
No
Yes
Yes
Cataract and glaucoma
treatment.
No
Yes
Yes
Cardio-thoracic surgery.
Yes
Restricted
Cardio-thoracic surgery limited to delivery as a private patient in a public hospital. Plastic and reconstructive surgery benefits for hospital and medical costs are restricted to services eligible for Medicare benefits.
Yes
Yes
Renal dialysis for chronic
renal failure.
Yes
Restricted
Dialysis for chronic renal failure is limited to delivery as a private patient in a public hospital shared ward.
Yes
Yes
Psychiatric services and
rehabilitation services.
Yes
Restricted
Psychiatric services are limited to 10 days per annum in a private hospital with benefits for any further days limited to delivery as a private patient in a public hospital shared ward. Rehabilitation services following cardio thoracic, psychiatric, hip and knee replacement and revisions is limited to delivery as a private patient in a public hospital shared ward.
Yes
Yes
Gastric banding and obesity surgery.
No
Yes
Yes
Plastic and reconstructive
surgery.
No
Yes
Yes

 

 

  Essential Extras Total Extras

Included Services:
General Dental
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
  $600 100% paid for ten general check up items up to two times per year, so long as the charges are within the range of usual, customary and reasonable charges. Fixed benefits paid for all other items No annual limits 100% paid for ten general check up items up to two times per year, so long as the charges are within the range of usual, customary and reasonable charges. Fixed benefits paid for all other items 
Major Dental
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
Inlays, onlays, facings Not covered Not covered $700 Fixed benefits paid per item
Endodontic/periodontic Fixed benefits paid per item Fixed benefits paid per item $800
Crowns & bridges Not covered Not covered $1,000
Dentures & prosthodontics Not covered Not covered $800
Orthodontics Orthodontic services are included in the general dental limit, up to $250 per year of membership with a lifetime limit of $1,250 Fixed benefits paid per item Up to $500 per year of membership with a lifetime limit of $2,500
Physiotherapy and remedial massage
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
  $500 $30 per visit with limit of $500 per year $600 $35 per visit
Psychology
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
  $500 $100 per visit $600 $100 per visit
Occupational therapy, Speech therapy, Orthoptics, Podiatry, Dietics & Midwifery services*
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
  $900 $30 per visit with calendar year sublimits per therapy type $1,000 $35 per visit with calendar year sublimits per therapy type
Home Nursing
No
Yes
  Limits Benefits Paid Limits Benefits Paid
  Not covered Not covered $600 $30 per visit of up to 6 hours
$60 per visit exceeding 6 hours
Aids & applicances
Yes
Yes
  Limits Benefits Paid Limits Benefits Paid
Single hearing aid One set of hearing aids every 3 calendar years $200 One set of hearing aids every 3 calendar years $400
Two hearing aids $400 $800
Hearing aid repairs   $50   $50
Audiology Test Not covered Not covered One visit per year $40