What are Restricted Health Funds?

What are Restricted Health Funds?

Restricted health funds offer private health insurance cover for people in certain industries, including the Australian Defence Force. They are not for profit and are usually provided by industry or employment groups. This contrasts with open health funds, which offer health insurance cover to anyone and are for profit.

Restricted health funds are run solely for the benefit of their members. They are also available to immediate and extended family members as well. One also does not have to be currently working in the industry to be a member of the fund.

What are the benefits of restricted health funds?

You can enjoy several advantages by joining a restricted health fund.

  1. They are run solely for their members’ benefit, so all profits are returned to the fund. Because of this, members can take advantage of lower premiums, better policies and greater benefits.
  2. You can enjoy more flexible terms and conditions. For example, in the case of Navy Health, the pre-existing medical condition rules and waiting period are waived if you join within 90 days of being discharged from the Australian Defence Force (ADF).
  3. Like most not-for-profit funds, restricted health funds often return a higher percentage of premiums to their members.
  4. As a restricted health fund member, you can also have access to other member-only benefits, including industry super and life insurance.

Who are providers of restricted health funds in Australia?

Here is a list of restricted health fund insurers and their conditions on how to become a member.

  • ACA Health Benefits Fund – This is restricted to current and former Seventh-day Adventist Church employees and Local Church Officers. Their spouses or partners, children, grandchildren, parents and siblings are also eligible to join the fund.
  • CBHS Health Fund Limited – This is available to current and former employees of Commonwealth Bank Group. Contractors, franchisees and their extended families are also eligible to join the fund.
  • Defence Health Limited – This is available to current and past members of the Australian Defence Force. Fund membership is open to their immediate and extended families as well.
  • Doctors’ Health Fund – This is open to medical and allied health practitioners, medical students, employees of the Australian Medical Association (AMA), as well as their families.
  • Navy Health Ltd – Provides cover for current and former cadets, reservists and members of the ADF, employees of the Department of Defence (DoD), as well as ADF contractors and suppliers. Their extended families are also eligible to join.
  • Nurses & Midwives Health – This is available to nurses and midwives and their families.
  • Police Health – This is open to members of Australia’s police and emergency services community, as well as their families.
  • Railway and Transport Health Fund Limited – This provides health cover for transport and energy employees and their families.
  • Reserve Bank Health Society Ltd – Current and former Reserve Bank employees are eligible to join this fund.
  • Teachers Health – This restricted health fund is open to education union members and their families.
  • TUH Health Fund – This is open to current and former education-related professionals, such as academics, admin and support staff, who are union members. Their families are also eligible to join.

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