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Compare Covers

Choose from options designed to suit the needs of people at different stages in their lives.

The Australian Government requires all private health insurance policies to be classified as basic, bronze, silver or gold. This categorisation helps you to better understand your level of cover.

Inclusions Restrictions2 Exclusions

Smart Starter

Bronze Plus

$110.03monthly1

$750 excess

Entry-level hospital cover with more inclusions than bronze level cover, designed for young singles, couples and families who aren’t looking for higher cover at this stage of their life.

Access Gap Cover
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Most popular

Prime Choice

Gold

$208.91monthly1

$750 excess

Ideal for families and those wanting full cover, with three excess options to choose from.

Access Gap Cover
More details

Top Cover

Gold

$284.19monthly1

$750 excess

Unique premium hospital cover that pays a medical gap benefit based on the AMA list of medical services and fees.

AMA benefit
More details
Ambulance transport

National cover for emergency and medically-necessary ambulance services, including when an ambulance is called but you are not subsequently taken to hospital, it is medically necessary for you to be transported by an ambulance to be admitted to hospital, you need immediate medical attention at a hospital or other approved facility or you are an admitted patient and need to be transferred to another hospital.

Covered
Covered
Covered
Basic tier inclusions

Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.

For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.

Restricted
Covered
Covered

Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.

Covered
Covered
Covered

Hospital treatment for physical rehabilitation for a patient related to surgery or illness.

For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.

Restricted
Covered
Covered
Bronze tier inclusions

Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

Covered
Covered
Covered

Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Covered
Covered
Covered

Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Covered
Covered
Covered

Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Covered
Covered
Covered

Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.

Covered
Covered
Covered

Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Covered
Covered
Covered

Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.

Covered
Covered
Covered
Silver tier inclusions

Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

For example: sciatica, prolapsed or herniated disc, and spine curvature disorders such as scoliosis, kyphosis and lordosis.

Not covered
Covered
Covered

Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

Covered
Covered
Covered

Hospital accommodation and anaesthetist costs for surgery to the teeth and gums (dental surgeon costs are covered by either Essential Extras or Total Extras).

For example: surgery to remove wisdom teeth, and dental implant surgery.

Covered
Covered
Covered

Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Not covered
Covered
Covered

Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Not covered
Covered
Covered

Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Covered
Covered
Covered

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Covered
Covered
Covered

Limited benefits for hospital accommodation costs (equivalent to a shared ward in a public hospital) and medical devices and human tissue products for the investigation and treatment of conditions affecting the foot and/or ankle. There is no cover for theatre costs or the costs of the podiatric surgeon or anaesthetist.

Covered
Covered
Covered
Gold tier inclusions

Medically necessary hospital treatment for infertility, for example, retrieval of eggs or sperm, in vitro fertilisation (IVF), and gamete intra-fallopian transfer (GIFT).

Not covered
Covered
Covered

Hospital treatment for surgery to remove a cataract and replace with an artificial lens.

Not covered
Covered
Covered

Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.

Not covered
Covered
Covered

Hospital treatment for the provision of an insulin pump for the treatment of diabetes. The cost of an insulin pump is not automatically covered where hospitalisation is not required.

Not covered
Covered
Covered

Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of medical devices and human tissue products.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint, spinal disc replacement.

Not covered
Covered
Covered

Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Not covered
Covered
Covered

Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Not covered
Covered
Covered

Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.

Covered
Covered
Covered

Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy.

Not covered
Covered
Covered

Why Doctors' Health Fund?

Health insurance made for doctors and your families. Enjoy better value Gold hospital cover, with Prime Choice Gold costing less than Gold hospital cover from the big health funds in most states and territories.3

  • Owned by doctors and part of Avant. The only health fund that can also support doctors professionally.

  • Top Cover Gold pays up to the AMA List, helping reduce out-of-pocket costs and support fairer fees for doctors.

  • Medical gap cover that is among the best in the industry.4

  • No preferred providers means you choose who treats you for your extras.5

Get a quoteWhy join?

Important notes

  1. Back to footnote 1

    Premium for a single in NSW including the base tier Australian Government rebate for under 65s.

  2. Back to footnote 2

    Services limited to delivery as a private patient in a public hospital in a shared room.

  3. Back to footnote 3

    Based on a $750 excess. Comparison based on publicly available information for open Gold hospital policies of Doctors' Health Fund and Bupa, Medibank and HCF as at 1 April 2026. Premiums rounded up to nearest dollar and don’t include any applicable rebates or loadings.

  4. Back to footnote 4

    Private Health Insurance Ombudsman, State of the Health Funds Report 2025, Ombudsman’s website.

  5. Back to footnote 5

    Treatment must be delivered by a recognised provider.