While anyone can join open health funds, restricted membership funds, as the name implies, are not open to all. But they could be more open than you may think – especially if you're a family member of an employee or a former employee of the organisation associated with the fund. 

We looked at three of the largest restricted membership health insurance funds: Teachers HealthDefence Health and CBHS (Commonwealth Bank of Australia group employees); plus competitor funds Teachers Union Health (TUH) and Navy Health.

We found they were open to many more people than direct employees of their associated industries. For example, 

  • Linda from NSW was able to join Teachers Health because her daughter is a teacher.
  • Jen from Victoria was able to get a membership at Defence Health because her late father served for Australia in the Second World War.
  • Ann from NSW re-joined CBHS as an ex-employee of the Commonwealth Bank after 18 years.

Our investigations also found that people eligible to join a restricted health fund could get cover as good as or better than our hospital CHOICE Buys and extra CHOICE Buys for open funds.

Performance check

Saving money isn't everything when it comes to your health, so we've made sure the restricted top-cover policies we've highlighted offer private hospital cover that's better than or equal to what's offered by our open-fund CHOICE Buys.

For a family or couple with top hospital insurance without an excess in NSW, for example, CBHS's premium is $480 less per year (before the government rebate) than Health Partners' (which we rated as this year's cheapest open-fund top insurance cover policy with $0 excess).

When we looked at top extras insurance for families or couples in NSW we found another example: Navy Health's premium was $108 less than St. Lukes', which we singled out this year as the cheapest open-fund extras cover in NSW.

How much you save will depend on the type of policy you're looking for, your age and your health circumstances, but restricted fund top-cover policies can save you some bucks.

Happy customers

Another good reason to join a restricted fund is strong evidence of a satisfied customer base. Surveys conducted by HIRMAA, the industry association for some community-based open funds and all restricted funds (excluding CBHS), have shown an average customer satisfaction score for restricted funds of 97% or above since 2006. And CBHS's satisfaction history is similar; it received a Roy Morgan Customer Satisfaction Award in 2014. We surveyed health insurance customers in 2012 and received similar results with regard to restricted funds.

Restricted membership health funds

For more information check our CHOICE Buys for five restricted funds or visit privatehealth.gov.au.