Membership conditions

This website does not contain all Police Health benefit details or conditions of membership. These conditions are contained in the Fund Rules. In the event of any inconsistency between anything on the website and the Fund Rules, it is the Fund Rules which apply in all cases.

You can obtain a copy of the Fund Rules (excluding schedules)  through the secure member login section on this website or you can view the Fund Rules  at 320 King William Street, Adelaide. Alternatively we can post a copy to any adult covered under a Police Health policy following their written request.

Waiting periods

Like all private health funds, Police Health has waiting periods for new members, including people transferring from another insurer when taking out a higher level of cover. Waiting periods also apply to current members upgrading their cover.

Waiting periods are designed to protect the interest of our members. Without them it would be easy for people to join only at the times when they need cover and to receive benefits. This would lead to higher premiums for all fund members.

At Police Health the waiting periods are:

Hospital benefits of Top Hospital, Platinum Health and Platinum Plus:

  • 2 months membership for all benefits, excluding accidents
  • 12 months membership for obstetric treatment
  • 12 months membership for pre- existing conditions, excluding psychiatric care, rehabilitation or palliative care.
  • 12 months membership for aids & appliances.

Extras benefits for SureCover Extras, Platinum Health and Platinum Plus:

  • 2 months membership for all benefits, excluding accidents
  • 12 months membership for major dental (like crowns and dentures) and orthodontics, hearing aids, nebulisers, blood glucose & blood pressure monitors, blood coagulation monitor and for pre-existing conditions
  • 12 month membership for Rollover Benefit (2 years Major Dental).

Platinum Health and Platinum Plus:

  • 3 years membership for corrective laser eye surgery.

It is important to note that if you are transferring from another insurer, waiting periods only apply to the level of cover that is greater the previously held.

For instance if you previously had a top hospital cover with the previous insurer but with an excess, the waiting period only applies to the excess when joining Police Health.

A government leaflet containing further information is available by clicking here

Pre-existing conditions

If a new member has a pre-existing condition before joining Police Health, they may need to serve a 12-month waiting period under the terms of our policy before benefits are payable for the particular condition. This does not apply for psychiatric care, rehabilitation or palliative care.

A pre-existing condition is one where signs or symptoms of your ailment, illness or condition existed at any time during the six months preceding the day on which you purchased your  insurance or upgraded to a higher level of cover.

A medical practitioner appointed by Police Health (not your own doctor) is the only person authorised to decide that a condition is pre-existing. The practitioner must, however, consider any information regarding signs and symptoms provided by your own treating doctor or specialist.

A government leaflet containing further information is available by clicking here

Standard Information Statements (SIS)

All Australian health funds are required by law to provide Standard Information Statements (SIS) for each product they offer. SIS's are important tools to aid the consumers of health insurance to review their existing policy or compare private health insurance products when making a purchasing decision.

There are three types of Standard Information Statements:

  • Hospital - describes the features and limitations of hospital cover, including the type of accommodation, which medical services are covered in full, part or not covered, waiting periods and additional payments (excesses, co-payments and gaps),
  • General Treatment - describes the features and limitations of general treatment cover, including which services are covered, waiting periods, benefit limits and example benefits for each type of service, and
  • Combined - describes the features and limitations of a combined hospital and general treatment cover, with details as above.

A Standard Information Statement gives a summary of the key product features only, it is a description of your cover.

You should not fully rely on the dollar amounts of premiums on the Statement as they are there for comparison purposes only, but are indicative. The actual premium may vary depending on your circumstances, for example, your age and your age when you first got health insurance. Benefits will vary depending on the details of your policy, the treatments you are having, the health service provider and the payment option you choose.

A government leaflet containing further information is available by clicking on the below pdf downloads

Government Brochures