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. Many of the nil-excess Top Hospital policies we recommend offer the same level of
cover as open funds, 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: click here for an accessible text-only version of this infographic.
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.
To learn more about your health insurance options, check out our private health insurance buying guide. Our hospital insurance buying guide and extras health insurance buying guide will give you more detail.
The restricted membership health funds
Two new restricted funds were established in 2016: Emergency Services Health (owned by Police Health) and Nurses & Midwives Health (owned by Teachers Health fund).
- ACA Health Benefits Fund: Seventh-day Adventist Church employees (including SDA-affiliated companies)
- CBHS Health Fund: employees, contractors and franchisees of Commonwealth Bank Group
- Defence Health: members of the ADF, reservists, civilian employees of Department of Defence (or related departments), employees of Defence contractors
- Doctors' Health Fund: doctors and health practitioners, their employees, and medical students
- Emergency Services Health: employees or volunteers in fire, ambulance, medical, water, state emergency response and recovery services, and their related unions or associations
- Navy Health: Australian Defence Force service personnel, civilian employees and contractors
- Nurses & Midwives Health: people in nursing and midwifery professions, including students and assistants, with membership in a nurses union.
- Police Health: federal, state and territory police or police union employees, and police employees who retired after 2000
- Reserve Bank Health Society: employees of the Reserve Bank of Australia (this fund declined to participate in our survey).
- RT Health: employees in the transport or energy sectors (including businesses that supply services to the sector)
- Teachers Health Fund: teachers (primary to tertiary), teacher aides or non-teaching support staff, with membership in their relevant union
- TUH Health Fund: 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 basic cover and with nil, $500 and $1000 excess, as well as the best extras policies for families looking for orthodontic cover, for older people, and for people wanting natural health therapies.