Emergency Services Health (ESH)

Emergency Services Health is Australia’s only not-for-profit private health insurer exclusively for the emergency services community. It’s vision and the reason it was created is to enhance the physical and mental health and wellbeing of Australia’s emergency services community.

It does this by providing easy to understand quality health insurance products designed for life, as well as support, information and services specifically for the needs of its community.

The fund is backed by Police Health, extending the quality cover, previously only police officers and their families could access, to their colleagues in the Emergency Services with their own dedicated health fund.
This information is provided by the fund

Emergency Services Health provide further information regarding Gap cover doctors and Agreement hospitals .

Agreement Hospitals

This fund has agreements with some private hospitals or day surgeries to provide services at low or no out-of-pocket costs. You can view Agreement Hospitals for this fund in your region and further details are available from the fund.

Business Structure

This insurer is a mutual organisation that operates on a not-for-profit basis.

Emergency Services Health operates in all states and territories.

Membership restrictions

Emergency Services Health is a restricted access health insurer. Membership is open to employees and volunteers (past and present) and their families of organisations within the emergency response and recovery sector. This includes organisations within Fire, Ambulance, Medical, State Emergency and Water and Surf Lifesaving response and recovery. Additionally the parents, siblings and adult children of the eligible person can also join. Check the website for full details.

Performance

The Private Health Insurance Ombudsman prepares an annual report on the service delivery and performance of Australian health funds. The following is a selection of statistics about this health fund - the full report and an explanation of these figures is available from the Ombudsman's website. Please note information is not provided for some funds in some states, as there are insufficient numbers reported to APRA for states in which the fund does not have a large membership.

Performance Fund Industry
Benefits as a % of contributions 90.2% 87.1%
Management expenses (% cont) 7% 8.5%
Management expenses (average policy) $266 $276
Surplus 2.8% 4.4%
Member retention (%) 93.5% 84.8%
Coverage ACT NSW VIC QLD SA WA TAS NT
Hospital Related Charges Covered 83.3% 91.7% 93.6% 93.3% 94.9% 91.3% 94.1% 90.1%
Industry Result 82.4% 89.9% 93.0% 90.7% 95.1% 93.7% 93.8% 88.4%
Medical Services with No Gaps 78.5% 91.7% 95.0% 91.8% 94.0% 87.6% 92.4% 86.2%
Industry Result 77.6% 89.6% 89.5% 86.9% 90.8% 83.4% 89.3% 77.5%
Medical Services with No or Known Gaps 91.1% 95.2% 98.5% 95.8% 99.3% 93.6% 98.0% 94.4%
Industry Result 84.8% 91.7% 94.0% 90.2% 95.9% 94.2% 94.1% 87.9%
General Treatment (extras) Covered 43.9% 50.3% 51.7% 50.5% 49.6% 50.2% 50.1% 47%
Industry Result 47.5% 51.2% 52.5% 54.4% 56.1% 56.1% 53.5% 56.3%
Private Hospital Agreements 6 97 76 51 26 20 5 2
Industry Maximum 6 97 78 53 29 21 6 2
Day Hospital Agreements 7 86 73 42 24 24 3 1
Industry Maximum 9 91 73 47 25 24 7 1
Share of PHIO complaints Compared to fund's market share
Benefit Complaints 1.6% 2%
Service Complaints 0.7%
All Complaints 1.2%
Investigations 0.5%
Address
320 King William Street
Adelaide
SA  5000


Phone: 1300 703 703
Email: enquiries@eshealth.com.au
Website: http://www.eshealth.com.au

To view a list of Emergency Services Health products, please complete the following:

Policies

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