Changes to hospitals in your area
Effective from Saturday the 4th of January 2025, Phoenix Health will no longer have an agreement in place with the Gastro Medicine & Endoscopy Group of Hospitals.
The following information is current as of 4 November 2024 and all information regarding claims refers to the level of Phoenix Health Hospital cover members held as at this date.
Why is the agreement ending?
To ensure that we’re able to provide you with the best cover, so you’ll receive the best treatment possible, we work with the Australian Health Service Alliance (AHSA) who negotiate agreements on our behalf, as well as on behalf of 29 other Australian Health Funds.
As a part of our commitment to providing you with access to quality and affordable health insurance, every now and then we, in conjunction with the AHSA, need to review the agreements with have with 550 private hospitals around Australia. When negotiating contracts with hospitals, we take into consideration the impact the loss of a hospital agreement has on our members and also the impact any fee increases with hospitals has on members premiums.
Unfortunately, on this occasion we’ve been unable to reach an agreement with the Gastro Medicine & Endoscopy Group on a fee increase that we see as both reasonable and fair.
What does this mean for me?
There are instances in which, after the 4th of January 2025, if you are admitted to a Gastro Medicine & Endoscopy Hospital, that you’ll still be covered:
*You’ll be covered at your level of Phoenix Health cover as at 4 November 2024, unless you downgrade your cover prior to your treatment date, in which case you’ll be covered at your level of cover as at your treatment date.
What Gastro Medicine & Endoscopy Group Hospitals are affected by these changes?
From Saturday the 4th of January 2025, Phoenix Health will no longer have an agreement in place with Gastro Medicine & Endoscopy Group Hospitals, including:
- Mornington Endoscopy, Mornington VIC 3931
- Rosebud Endoscopy, Rosebud VIC 3939
Can I still claim if I decide to be treated at a Gastro Medicine & Endoscopy Group Hospital in the future?
Yes, however you need to be aware that you may experience significant out of pocket costs for charges that were previously covered under the agreement.
If your Doctor or Specialist works from a Gastro Medicine & Endoscopy Group Hospital, speak to them to see if they can treat you at another hospital. If they can, you can use search tool to check if they are an agreement hospital.
What other hospitals can I go to in my area?
With agreements with over 500 hospitals Australia wide, there will always be one close by! To find an agreement hospital close to you, visit our Find a Provider search tool.
Still have questions?
We know health insurance and going to hospital can be confusing and we’re here to help so you can focus on what’s important – you! We understand the end of our agreement with the Gastro Medicine & Endoscopy Hospital Group may impact a number of members and we want you to feel confident in your cover and benefits.
As our member, your health and wellbeing are always our number one priority. As always, if you’re planning a hospital admission or have any questions about these changes and how they impact you, please reach out to our team on 1800 028 817 or email us at [email protected]