Phoenix Health Fund

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About Phoenix Health Fund

What is Phoenix Health Fund?

Phoenix Health Fund is a private health insurer that operates as an open health fund. 

Background

Phoenix Health Fund was established in 1953 in Newcastle to provide hospital cover for employees of Stewarts and Lloyds, a steel tube manufacturer.

As part of the Tubemakers of Australia group, the fund soon expanded to offer insurance to all employees working for the group.

Eventually, Phoenix Health Fund evolved from a restricted to an open fund.

Who can join Phoenix Health Fund?

As Phoenix is now an open fund, anyone can join.

What products does Phoenix Health Fund offer?

Phoenix Health Fund offers:

• Hospital Cover
• Extras Cover.

Does Phoenix Health Fund offer corporate policies?

Yes. Phoenix Health Fund provides corporate policies to certain organisations. Search your organisation’s website or intranet to find out whether a corporate health insurance policy is available to you, and what conditions apply.

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Do Phoenix Health Fund policies include Ambulance Cover?

Phoenix Health Fund includes ‘medically necessary’ Ambulance Cover with:

• Hospital Cover
• Extras Cover
• Combined Hospital and Extras Cover.

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Is Phoenix Health Fund a not-for-profit health insurer?

Yes. Phoenix is a not-for-profit health insurer.

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Does Phoenix Health Fund operate in all Australian states and territories?

Yes. Phoenix Health Fund operates in all Australian states and territories.

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How does Phoenix Health Fund Hospital Cover compare with other insurers?

Benchmarks	Phoenix	Industry average
Member retention for Hospital Cover	85.0%	86.9%
% hospital-related charges covered	90.5%	89.9%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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Does Phoenix Health Fund have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. Phoenix Health Fund has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

Location	Number of private Agreement Hospitals	Industry maximum
ACT	5	6
NSW	95	98
NT	2	2
QLD	49	60
SA	19	23
TAS	8	9
VIC	73	76
WA	21	24

Phoenix also has agreements with a number of day hospitals so it can provide services at low cost or with no out-of-pocket costs:

Location	Number of day Agreement Hospitals	Industry maximum
ACT	8	9
NSW	84	103
NT	1	2
QLD	48	57
SA	24	30
TAS	4	8
VIC	69	79
WA	20	24

Source: Phoenix Health Fund: performance

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How does Phoenix Health Fund Extras Cover compare with other insurers?

Benchmark	Phoenix	Industry average
% Extras Cover charges covered	54.1%	51.1%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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How does Phoenix Health Fund compare with other private health insurers?

Benchmarks	Phoenix	Industry average
Market share	0.2%	–
% services with no gap	91.4%	88.3%
% services with no gap or where known gap payment made	98.3%	97.2%
Market share of complaints to the PHIO	0.1%	3.1%
% complaints investigated by the PHIO	0.0%	3.1%
Benefits as a % of contributions	77.7%	80.5%
Management expenses as a % of contribution income	10.0%	13.1%
Management expenses per average policy	$484	$592

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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Is Phoenix Health Fund a member of any industry organisations?

Yes. Phoenix Health Fund is a member of Private Healthcare Australia (PHA), a body that represents 20 registered health insurers and 97% of people covered by private health insurance.

It is also a member of the Members Health Fund Alliance, an alliance of not-for-profit, member-owned, regional or community-based health insurers.

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Does Phoenix Health Fund let me claim online or via an app?

Yes. Phoenix Health Fund allows you to make a claim online through Online Member Services or with the Phoenix Health App.

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How to contact Phoenix Health Fund

Phone:

1800 028 817

Website:

https://www.phoenixhealthfund.com.au

Email:

enquiries@phoenixhealthfund.com.au

Address:

Suite 1
4 Honeysuckle Drive
NEWCASTLE NSW 2300

Postal address:

PO Box 156
NEWCASTLE NSW 2300

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