Phoenix Health Fund offers affordable, great value Private Health Insurance to meet the needs of people who don’t need full cover.
Bronze Plus YoungSavers 500 provides a combination of private and public hospital and medical cover along with offering a wide range of extras covering the services required by younger individuals.
This policy can be purchased as a Singles or Couples policy only.
What’s Included in Hospital Cover
|Assisted reproductive services||No|
|Back neck and spine||No|
|Bone, joint and muscle||Yes|
|Brain and nervous system||Yes|
|Breast surgery (medically necessary)||Yes|
|Chemotherapy, radiotherapy and immunotherapy for cancer||Yes|
|Diabetes management (excluding insulin pumps)||Yes|
|Dialysis for chronic kidney failure||No|
|Ear, nose and throat||Yes|
|Eye (not cataracts)||Yes|
|Heart and vascular system||No|
|Hernia and appendix||Yes|
|Hospital psychiatric services||Restricted|
|Implantation of hearing devices||Yes|
|Kidney and bladder||Yes|
|Lung and chest||Yes|
|Male reproductive system||Yes|
|Miscarriage and termination of pregnancy||Yes|
|Pain management with device||No|
|Plastic and reconstructive surgery (medically necessary)||Yes|
|Podiatric surgery (provided by a registered podiatric surgeon – limited benefits)||No|
|Pregnancy and birth||No|
|Tonsils, adenoids and grommets||Yes|
|Weight loss surgery||No|
For hospital services to which Phoenix Health Fund provides coverage, Bronze Plus YoungSavers 500 provides coverage for:
- private and public hospital services nationwide (after the up-front excess has been paid) with access to an extensive range of quality services and approved programs in private hospitals which have an agreement with Phoenix Health Fund.
- Public or Private Hospital bed – shared or private room (if available)
- Same day patient fees
- Theatre fees
- Intensive care
- In hospital pharmacy
- Prosthesis (Commonwealth Government approved)
- All other in-patient services where a Medicare benefit is payable (not listed as an exclusion in the table above)
Additional costs you may incur are:
- The amount the doctor charges above the Medicare schedule fee or “Access Gap” cover amount
- some drugs, pharmacy items and non-PBS drugs for personal use or on discharge; and possibly
- a co-payment for prostheses devices above the minimum benefit.
- There are a small number of public hospitals that do not have agreements with us. In these cases a personal payment may apply.
If you are to be admitted into a public or private hospital as an in-patient for a restricted service, you will need to be aware of how your fund will pay your benefits.
Be aware that if you are admitted with a restricted service, significant out of pocket expenses can apply.
|Service Category||Benefit Rules|
|Psychiatric, Rehabilitation, Palliative care||
If you are to be admitted into a public or private hospital as an in-patient for an excluded service on your policy, the fund will not pay a benefit.
If you are admitted to a hospital you will pay an up-front excess of hospital costs until you have reached your excess maximum of $500 per person within a calendar year (1st January through to 31st December).
The excess is applied as follows:
- An excess of $500 per adult applies to day or overnight admissions in a private or public hospital
- The maximum excess per family membership is $1000
- The excess is waived for all dependant children/adult on family/sole parent policies
Medical Gap Cover
Phoenix Health Fund, as a member of the Australian Health Service Alliance, has “Access Gap” arrangements with more than 15,000 doctors Australia-wide. These arrangements minimise or eliminate Members’ out-of-pocket expenses when our Members are treated as admitted hospital patients.
If your doctor participates in the “Access Gap” scheme, you will either have no out-of-pocket expenses to pay or will know exactly how much you will have to pay before treatment begins. Your doctor can bill Phoenix Health Fund direct, so in most cases you will not be required to lodge a claim with us, making it easier for you.
To check whether your doctor participates in “Access Gap”, use our Doctor Search facility, or ask your doctor.
Inclusions in the extras cover
Unless otherwise stated, benefit limits apply per person per calendar year.
Please also note that this page does not include the full detail of all services covered, and that sublimits apply for some services. It is recommended that you either check your Online Member Services or contact us before your treatment to check exactly what you are covered for.
|Treatment||Example of Benefit||Annual Limit|
121- Fluoride Treatment – $24.00
022- Bitewing X-ray – $28.00
Full crown veneered – $800.00
Filling of one root canal – $170.00
Excluded: Sunglasses, where no sight correction is needed
|80% of the charge||$240|
|Non PBS Pharmaceuticals
Excluded: contraceptives and items purchased over the counter
|Per eligible prescription – $70.00 (Paid after General PBS copayment has been paid)||$250|
|Chiropractic / Osteopathic
*Acupuncture benefits paid for approved alternative therapy associations only.
|Chiro/Osteo Initial visit – $40.00
Chiro/Osteo Subsequent visit – $30.00 Acupuncture visits- $25.00
|Physiotherapy / Myotherapy Initial visit – $50.00
Physiotherapy / Myotherapy Subsequent visit – $37.00
Exercise Physiology Initial visit – $40.00
Exercise Physiology Subsequent visit – $30.00
Remedial Massage Initial visit – $32.00
Remedial Massage Subsequent visit – $25.00
|$100 sublimit applies for Exercise Physiology and Remedial Massage Overall Therapy Limit of $400 per person|
|Orthoptic, Occupational and Speech Therapy||Orthoptic Therapy Initial visit – $45.00
Orthoptic Therapy Subsequent visit – $44.00
Occupational Therapy Initial visit – $60.00
Occupational Therapy Subsequent visit – $40.00
Speech Therapy Initial visit – $85.00
Speech Therapy Subsequent visit – $45.00
|$200 sublimit applies for Speech, Orthoptic and Occupational Therapies
Overall Therapy Limit of $300 per person
* Benefits paid for registered DAA Dieticians only)
|Initial visit – $60.00
Subsequent visit – $40.00
|Podiatry||Initial visit – $44.00
Subsequent visit – $34.00
Podiatric devices – 80% of cost
* Benefits paid for registered clinical psychologists only)
* Benefits paid for registered clinical hypnotherapists only)
|Psychology visits – $75.00
Hypnotherapy visit – $50.00
|Healthy Lifestyle Program
(Approved Health Education, Health Screening, Health Management programs. Please contact the fund before you make a claim to check that the service provided is an approved program. Click here for more information
|80% of charge||$100|
|Aids and Appliances||80% of charge
(after $20 copayment is made)
|Travel||benefit is equivalent of economy rail fare for distance travelled or 10c per kilometre. Combined benefit patient and attendant.||$60|
Phoenix Health Fund covers all medically necessary transport from a State Emergency Ambulance service. This also includes when an Ambulance is called to attend to you, but you do not subsequently need to be taken to hospital. Coverage is not offered when it is not medically necessary for you to be transported by an Ambulance.
Bronze Plus YoungSavers 500 waiting periods
- 12 month waiting periods for pre-existing conditions
- 2 month waiting periods for all other hospital items covered
- 2 month waits for General Dental and Endodontic dental procedures/claims
- 12 month waits for Major Dental procedures/claims
- 6 month waits for Optical claims
- 2 month waits for all other extras items
For the complete description of the Fund rules, relating this product, please refer to the General Information section on our website.
Please ensure you have read and retained the information relating to your policy of choice before applying for membership.