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Access Gap Cover
Access Gap Cover
Access Gap Cover (when admitted to hospital)
Under Emergency Services Health Access Gap Cover you may never have to pay a doctor’s bill.
Accident and Emergency Facility Fee
Am I covered for all ambulance services?
Emergency Services Health - Unlimited Ambulance Cover Australia-wide
Annual Maximum
Annual Maximum
An Annual Maximum is the maximum benefit payable for services received during any calendar year for particular services or groups of services.
Are there any Benefit limitation periods?
Other funds may apply benefit limitations which pay reduced benefits on one or more services for a set period of time that is no longer than normal
Australian Government Rebate
Benefit
Benefit Statements
Just received a benefit statement from us and want to know more? Take a look at these frequently asked questions.
Benefits limit for Extras
Private health insurers generally calculate an average charge for services and set their benefits based on those amounts.
Calendar Year
Can I buy glasses online from overseas and claim them on my extras cover?
I found a great pair of spectacles from an overseas online retailer. Can I claim them on my extras cover?
Can I suspend my membership?
Claim
Co-payment
Co-payment
Complaints/ Dispute Resolution
At Emergency Services Health, we're constantly trying to improve the quality of our products, processes and services.
Complementary Therapies
Emergency Services Health provides benefits for a range of recognised Complementary Therapies within extras cover.
Contracted and Recognised Hospitals
Contracted and Recognised Hospitals
Contributor
Dependent
Eligibility
Excess
Excesses
Extras Cover
Extras/Ancillary Cover
FAQ about Tax Statements
FAQ about Tax Statements
FAQ: Premium Increase
Premiums have been reviewed by the Minister for Health and will be increasing as of 1 April 2019.
FAQ: Why don't you offer different levels of cover?
The nature of health insurance is that you never know what health service you might need or when you might need it.
Fund Rules
Gap
Hospital Accommodation
How can I pay my premiums?
Premiums can be automatically paid fortnightly, monthly or quarterly by direct debit from your financial institution account.
How health insurance works in Australia
The Australian Government provides certain incentives to encourage all Australians to take out private health insurance.
How to make a claim
Lodging claims with Emergency Services Health is easy.
I lost my membership card, what can I do?
If your membership card is lost or stolen please notify us immediately so that it can be cancelled and replaced.
I need to travel long distances to access specialist medical services, am I covered?
Important Information
Before taking out private health insurance with Emergency Services Health, there is some important information you need to be aware of.
In-patient
IVF and other Assisted Reproductive Services
Emergency Services Health's Gold Hospital and Gold Combined includes cover for in-hospital services relating to In vitro fertilis
Lifetime Health Cover (LHC) Loading
Lifetime Limit
Medicare Benefits Schedule (MBS)
A list of medical services and fees recognised by the Australian Government.
Medicare Levy Surcharge (MLS)
Medicare Levy Surcharge (MLS) is a levy you should be aware of. Most Australian taxpayers are charged a 2% Medicare Levy.
Member
Membership Arrears
Membership Conditions
This website does not contain all Emergency Services Health benefit details or conditions of membership.
Non-recognised hospitals
Regrettably following negotiations, Emergency Services Health through the AHSA have been unable to reach agreement with Toowong Private Hospital on
Not-for-profit
Emergency Services Health operates on a not-for-profit basis.
Out-of-pocket Expenses
The portion of charges you incur that is not covered by Medicare or health fund benefits.
Out-patient
A person receiving treatment at a hospital but not admitted to hospital.
Palliative Care
Specialised health care to support and comfort people with life-limiting illnesses.
Pharmaceutical benefits
Under extras cover you’re eligible to receive pharmaceutical benefits towards prescription items that are not eligible for subsidy under the Govern
Pharmaceutical Benefits Scheme (PBS)
An Australian Government subsidy scheme that lowers the cost of prescription medicine.
PHIS (Private Health Information Statement)
Policies, Brochures & Forms
Access Emergency Services Health Policies, Brochures & Forms:
Policy Holder
Emergency Services Health’s reference to a policy holder refers to the contributor of the policy (not everyone covered under the policy).
Policy/Product
Pre-existing Condition
Where signs or symptoms of an ailment, illness or condition (in the opinion of a medical practitioner appointed by us) existed at any time during t
Pre-existing conditions
If a new member has a pre-existing condition before joining Emergency Services Health, they may need to serve a 12-month waiting period under the t
Pregnancy and private health insurance
If you’re thinking of starting a family, now’s a great time to review your health insurance to make sure you’re happy with, and understand, your co
Premium
Private Health Information Statement (PHIS)
All Australian health funds are required by law to provide Private Health Information Statement (PHIS) for each product they offer.
Prostheses
Prostheses include screws and plates, intraocular lenses, replacement joints, cardiac stents, defibrillators and other devices that are surgically
Provider
An individual or institution that provides preventive, curative, palliative or rehabilitative health care services to individuals, families or comm
Reasons to join
We believe we’re the best health insurer for emergency services employees, volunteers and their families because;
Recognised health providers
Recognised health providers are those who are in private practice in Australia and recognised by us.
Restricted Membership Access
Rollover Benefit
State of Residence
The state or territory where the Contributor of
the policy lives.
Suspension of Private Health Cover
Under certain circumstances, such as travelling overseas, members may suspend the payment of their premiums for an agreed period of time (condition
The Australian Government Rebate
The Australian Government Rebate on private health insurance (Rebate) is an incentive whereby you’re offered a Rebate on your private health insura
Thinking about having a baby?
Then it’s a good time for you to review your health insurance and make sure you understand what your policy does and doesn’t cover.
Understanding Medicare
How much does Medicare cover for out hospital services?
Waiting Periods
Waiting periods
Like all private health funds, Emergency Services Health has waiting periods for new members, including people transferring from another insurer wh
What do I need to know if my child needs braces?
What does 'Members Own' mean?
Whenever you see the Members Own symbol next to a health fund logo, you're looking at a fund that values members over profits and works hard to del
What does no excess or co-payments mean?
Other funds may charge an excess (an excess is the amount you agree to pay towards the cost of hospital treatment).
What does no exclusions and restrictions mean?
Other funds may apply exclusions (you agree not to be covered at all for certain treatments).
Will you pay benefits towards my Pilates treatment?
Your choice of doctor
We give you freedom to choose.