When shopping for a product as complex as health insurance it can be easy to get so overwhelmed by the details that you neglect to consider every available option. Many people might not even be aware that they qualify for one or more restricted membership health funds. These smaller funds provide products that often compare favourably to the big open funds in cost, level of cover, or both.
So who can qualify for a restricted fund?
Restricted funds cater to customers in specific industry groups, such as teachers, police, the military, or medicine. The Commonwealth Bank
Group also has a fund for its staff. Depending on the fund, you can become a customer even if you're no longer a member of the relevant profession.
Some of these funds are also generous with family memberships. For most funds, if you qualify for membership, then so do your parents, partner, children
(even if they're grown), children's partners, grandchildren, siblings, and siblings' partners and children.
Once you sign up, you're allowed to stay a member if your circumstances change. This means that the fund won't boot you even if your sibling quits being a
teacher, or your relationship with your doctor partner ends.
Restricted fund premiums – how do they compare?
If you can access a restricted fund, it's at least worth considering. Especially if you're interested in a Top Hospital policy as the restricted fund policies we recommend offer the same level of
cover as open funds, often at a lower premium.
Traditionally, restricted funds saw lower than average premium increases, although in the past few years this hasn't held true for all funds. Premiums at Defence Health and Teachers Health have increased about 17.5% since 2014, in line with the industry average. Over the last three years, members of RT Health (18.3%) and TUH (22.3%) have been feeling the sting of successive above-average price hikes.
Restricted fund premium increases 2015–2018
Doctors' Health Fund
Cumulative average premium increase: 9.9%
Reserve Bank Health Society
Cumulative average premium increase: 12.4%
Cumulative average premium increase: 13.3%
Cumulative average premium increase: 13.7%
Cumulative average premium increase: 14.2%
Cumulative average premium increase: 15%
Cumulative average premium increase: 15.1%
INDUSTRY WEIGHTED AVERAGE
Cumulative average premium increase: 15.1%
RT Health Fund
Cumulative average premium increase: 16.4%
Cumulative average premium increase: 17.9%
Cumulative average premium increase: 20%
When it comes to extras insurance, the restricted funds are less competitive. We weren't able to find a restricted policy that offered just the basics (dental, optical and physiotherapy) at a price that competed with the open funds.
Restricted funds tended to compete well with top-shelf, high-benefit policies: if you're likely to use your extras more, then it can be worth considering a restricted fund. See our tips to save on extras insurance.
The restricted membership health funds
- ACA Health Benefits Fund: Current or former Seventh-day Adventist Church employees (including SDA-affiliated companies)
- CBHS Health Fund: Current or former employees, contractors and franchisees of Commonwealth Bank Group
- Defence Health: Current or former members of the ADF, reservists, civilian employees of Department of Defence (or related departments), employees of Defence contractors
- Doctors' Health Fund: Current or former doctors and health practitioners, their employees, and medical students
- Emergency Services Health: Current or former employees or volunteers in fire, ambulance, medical, water, state emergency response and recovery services, and their related unions or associations.
- Navy Health: Current or former Australian Defence Force service personnel, civilian employees and contractors
- Nurses & Midwives Health: Current or former people in nursing and midwifery professions, including students and assistants, with membership in a nurses union.
- Police Health: Current or former federal, state and territory police or police union employees, and police employees who retired after 2000
- Reserve Bank Health Society: Current or former employees of the Reserve Bank of Australia or Note Printing Australia. (This fund declined to participate in our survey).
- RT Health: Current or former employees in the transport or energy sectors (including businesses that supply services to the sector)
- Teachers Health Fund and Unihealth: Current or former teachers and academics (primary to tertiary), teacher aides or non-teaching support staff, with membership in their relevant union
- TUH Health Fund: Current or former members of any union
The best restricted health fund policies
We've compared the restricted health funds and found the best policies for a range of circumstances. All the policies in the tables provide better or similar cover and premiums than the policies from open funds we recommended.
Read on below for our picks of the best restricted fund hospital insurance for budget cover, budget plus accident and emergency cover and top cover with nil or up to $500 excess, as well as the best extras policies for families looking for orthodontic cover and for seniors.