Police Health Review
Overview
Police Health was established over 80 years ago to cater to the medical needs of police employees and their families.
What began as a small fund with just under 400 members is now a modern and highly competitive health insurer with over 57,000 members.
Police Health is part of Members Own, a group of 19 like-minded, mutual health funds that invest their dividends back into their members through higher benefits and paid claims.
Police Health Key Facts
Founded: 1935
For-Profit or Not-For-Profit?: Mutual/Not-For-Profit
Private Hospital Agreements Nationwide: 282
Day Hospital Agreements Nationwide: 267
Headquarters: Adelaide, SA
Health Deal Represented?: No
Police Health Hospital Cover
Police Health has one specialised hospital policy; the hospital cover currently available is listed below.
- Gold Hospital
Police Health Extras Cover
Extras Cover takes care of the everyday healthcare service expenses that are not generally covered under Medicare such as dental services, prescription glasses, and physiotherapy.
Police Health offers one unique extras policy that covers an extensive range of general ancillary services that allows a rollover of unused Annual Maximum benefits from one calendar year to the next.
- Rolling Extras
Police Health Combined Cover
Police Health has one combined policy called:
- Gold Combined
Police Health Waiting Periods
Police Health recognises the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:
Hospital waiting periods
- Ambulance services: 2 months
- Accidental Injury: None
- New Conditions: 2 Months
- Pregnancy and birth-related services: 12 months
- Pre-existing conditions: 12 months
- Rehabilitation & Palliative care: 2 months
- Weight Loss Surgery: 12 months
How Do You Claim Extras With Police Health?
Claiming Extras with Police Health is a quick and easy process. Here are some of the ways that you can do this:
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
App: Submit a claim by sending a photograph of your receipts to your registered account on the Police Health Mobile Claiming App.
Online: You can make a claim by going onto their website and providing the details on your receipt.
By Mail: You can lodge your claim by posting relevant accounts and receipts to:
Police Health
Reply Paid 611
Adelaide SA 5000
Police Health Gap Cover
Police Health’s gap cover is called Access Gap Cover. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense. Access Gap can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.
Gap Cover Ratings By State
To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme.
Medical Services with No Gaps — The percentage of claims that were fully refunded.
Medical Services with No or Known Gaps — The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.
The information below outlines the percentages of services covered under no-gap and known-gap.
Police Health medical services with No Gap: 80.5%
Industry Average: 79.1%
Police Health medical Services with No or Known Gap: 96.5%
Industry Average: 90.5%
Police Health medical services with No Gap: 87.7%
Industry Average: 89.5%
Police Health medical Services with No or Known Gap: 95.3%
Industry Average: 95.7%
Police Health medical services with No Gap: 86.7%
Industry Average: 86.7%
Police Health medical Services with No or Known Gap: 97.2%
Industry Average: 95.1%
Police Health medical services with No Gap: 88.8%
Industry Average: 89.2%
Police Health medical Services with No or Known Gap: 96.5%
Industry Average: 94.5%
Police Health medical services with No Gap: 90.9%
Industry Average: 89.5%
Police Health medical Services with No or Known Gap: 99.4%
Industry Average: 96.6%
Police Health medical services with No Gap: 81.7%
Industry Average: 84.4%
Police Health medical Services with No or Known Gap: 94.4%
Industry Average: 96.2%
Police Health medical services with No Gap: 89.2%
Industry Average: 90.2%
Police Health medical Services with No or Known Gap: 98.5%
Industry Average: 96.7%
Police Health medical services with No Gap: 83.3%
Industry Average: 84.2%
Police Health medical Services with No or Known Gap: 94.7%
Industry Average: 93.8%
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