Police health insurance: what cover options are available?

What kind of cover does Police Health offer?

In short

Police Health offers 3 types of cover – hospital, extras and combined (hospital + extras)*, all of which have unique advantages over other health funds’ cover.

What kind of cover does Police Health Insurance (Police Health) offer?

Police Health keeps it simple by offering only 3 carefully designed cover options*;

Gold Hospital helps with the costs of treatment as a private patient in hospital.

Rolling Extras helps with the cost of out-of-hospital health services that Medicare does not cover (eg dental, physio, optical).

Gold Combined has everything covered under Gold Hospital and Rolling Extras.

This suits police and their families because it's easier to plan your health cover needs when you know what's included and can avoid fewer unexpected costs.

What is hospital cover?

Hospital cover can help pay for hospital treatment, which is typically defined across 38 clinical categories. whether you’re treated as a private patient in a private or public hospital anywhere in Australia.

Clinical categories are the standard groups health funds use to classify different types of hospital treatment and services, helping you see what’s included in a policy.

Depending on your policy, your hospital cover will pay for a range of costs including:

Theatre fees/labour ward
Hospital accommodation
Drugs supplied
Doctor’s fees for hospital treatment (At a minimum, we will cover the difference between the Medicare rebate and the Medicare Benefits Schedule (MBS) Fee)

Waiting periods and other terms and conditions apply to hospital cover. You can read more information in our hospital cover guide.

Common scenarios that hospital cover help with include;

Surgeries - e.g. joint replacements
Treatment – e.g. chemotherapy, radiotherapy and immunotherapy for cancer
Pregnancy – giving birth at a hospital

The price of hospital cover depends on many factors including which state or territory you live in. If you want to know more, call us on 1800 603 603.

Police Health's Gold Hospital cover

The good news is that Police Health's Gold Hospital covers all 38 clinical categories.

It's made like this to give you and your family peace of mind. It means you're covered for the maximum number of clinical categories available

In the 2024-2025 financial year, these were the top 10 clinical categories paid by Police Health (total benefits paid);

Heart and vascular system
Joint replacements
Digestive system
Hospital psychiatric services
Gastrointestinal endoscopy
Pregnancy and birth
Brain and nervous system
Bone, joint and muscle
Gynaecology
Joint reconstruction

Click here to see the full clinical category

More reasons to get Police Health's Gold Hospital cover

Our Gold Hospital cover also gives you peace of mind by having no excess, no exclusions and no restrictions.

An excess is the amount you agree to pay towards the cost of hospital treatment.

While some funds don’t offer any lower than $750 Excess, we don't impose any excess (subject to waiting periods, other terms and conditions apply).

An exclusion is when you agree not to be covered at all for certain treatments, while a restriction is when you agree to receive very limited benefits for certain treatments.

We don’t think you should have to predict what health needs you or your family will have in the future.

You wouldn’t insure just half of your house or car, so why insure just part of your health?

Ambulance cover

Our Gold Hospital cover also has 100% Ambulance cover for emergency transport, clinically required non-emergency transport and treatment not requiring transport (Subject to waiting periods and other conditions).

This means you can save around $900, depending on your state or territory.

Pregnancy cover

At a minimum we recommend you take out Gold Hospital cover if you’d like to have your baby in the private system.

However, if you want more support during your pregnancy, we recommend our Gold Combined cover, which includes both Gold Hospital and Rolling Extras.

For more information about pregnancy and birth cover, read our pregnancy guide.

Aids and appliances

Gold Hospital also covers aids and appliances, including but not limited to;

Continuous positive air pressure (CPAP) machines

Non-surgically implanted itemaids and appliances such as insulin pumps, prosthetic eye (non-implant), external breast prothesis, pressure Garments, ankle or knee brace, custom-made footwear.

This is important for police families because it can help cover essential equipment used to manage ongoing conditions like sleep apnoea (CPAP) and diabetes (insulin pumps), reducing out-of-pocket costs for long-term care.

Waiting periods and pre-existing conditions

It’s important to be aware that waiting periods and pre-existing condition rules may apply, so you may not be able to claim straight away for some treatments or services.

You can read more about these here.

Extras health cover and Police Health

Police Health offers an extras product too, Rolling Extras. Like all extras health insurance, it's used for preventative and maintenance services that Medicare doesn't cover.

Common examples that are most helpful for families are dental, optical (glasses and contact lenses), and physio.

Most extras are easy to claim. For example, after a dental clean and scale you can claim on the spot at the provider when you pay.

There are service limits and annual maximums are the set dollar amounts you can claim back for each type of service, and the total you can claim in a year under your policy.

However, this is where Police Health has a big advantage over health funds.

Extras that roll over

Our Rollover Benefit lets you roll over unclaimed Annual Maximum from one calendar year to the next on most Rolling Extras services, up to the Rollover Maximum.

This means that if you don’t use the full amount of your Rolling Extras services within a year, you won’t lose out on those benefits.

This is particularly helpful for services you may not need every year, such as major dental or optical.

It allows you to build up your available benefits for when you need them most.

How it works

Let’s use the example of Stacey, who joined Police Health on 1 January 2022.

She goes through the whole calendar year without claiming Optical benefits (such as new prescription glasses and/or contact lenses).

Then on 1 January 2023, the rollover kicks in and her $350 Annual Maximum becomes $700 (subject to Waiting Periods).

After that, her rollover will kick in on 1 January every year.

For Major Dental, Stacey will have to wait two years before her $1,500 Annual Maximum rolls over to $3,000.

Better dental cover for families

Another bonus is that root canal, simple and surgical extractions and periodontic treatment are covered under General Dental, with no annual limit, rather than major dental like most other funds.

This means you and your family's major dental category is not exhausted by these services and is available if you need more complex dental services.

Discounts on optical cover

While members can access our optical benefits at any optical provider of their choice, we have arrangements with the following leading providers to give extra discounts to members, on top of our generous benefits;

OPSM
Laubman & Pank
Specsavers
Bailey Nelson

You can read more about how these arrangements work on our optical benefits guide.

Choose where you go

We also don’t have a preferred provider network. As long as the provider is recognised by us, on most Extras you will get up to 80% back, up to the item limit.

This makes booking dentist or optometrist appointments much easier for families by giving you more choice.

It's important to note that there are waiting periods for extras. We encourage you to read our guide to waiting periods to get better understanding.

Combined cover – hospital and extras

Our Gold Combined cover brings together our Gold Hospital and Rolling Extras at a reduced premium.

It's great for families because it makes complete peace of mind even more affordable.

Hospital cover vs extras cover – how to choose

A clear example is pregnancy. If you want to be covered for being admitted to a private or public hospital as a private patient to give birth, you need hospital cover.

If you want to see a physio to help with pregnancy related pain, you need extras.

This is why we always recommend you take out Gold Combined. It has both, at a reduced premium.

Want to know more?

Read more about our cover on our dedicated health cover pages.

Our products

*All benefits may be subject to Waiting Periods, Limits and other conditions. Rollover applies once you’ve completed your first 12 months membership (2 years for Major Dental). Providers must be recognised by us. Review the cover tables on the Combined, Hospital and Extras pages, and your State Premium and Benefit Guide or contact us for more information. ^IPSOS Healthcare and Insurance Australia Report 2023 — independent research conducted every 2 years.