Doctors' Health Fund (AMA)

Doctors' Health Fund is a private health insurer serving the medical community. The Fund offers a service that protects members from the impact of health care incidents in their lives. We offer convenience and flexibility with a choice of hospital and extras cover. Our top hospital cover offers the best gap cover in Australia. It delivers unrestricted choice of doctor and greater benefits which are based on the AMA List of Services and Fees.

This information is provided by the insurer

Doctors' Health Fund provide further information regarding:

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 see Agreement Hospitals for this insurer and further details are available from the insurer.

Business Structure

This insurer operates on a for-profit basis and is owned by the Avant Mutual Group, a group that operates on a not-for-profit basis.

Doctors' Health Fund operates in all states and territories.

Membership restrictions

To be eligible to be a member of Doctors' Health Fund you must be: o A registered medical practitioner. o A registered health practitioner from the following list: medical, medical radiation, optometry, dental, occupational therapy, physiotherapy or psychology. o A person studying to become a medical practitioner or listed registered health practitioner, at an Australian educational institution. o An overseas qualified doctor who is registered for the AMC exams. o The spouse, child or grandchild of a medical practitioner or a listed registered health practitioner. o An employee of a medical practitioner or a listed registered health practitioner or an officer or employee of an incorporated practice of a medical practitioner or a listed registered health practitioner. o Employed in any role by an association, college or organisation whose members are medical practitioners or listed registered health practitioners. o The spouse or child of a member of the Fund or former member of the Doctors' Health Fund or the AMA Health Fund, or o Have been covered by Doctors' Health Fund or AMA Health Fund in the past either as a member or as the dependent of a member. Please contact us on 1800 226 126 if you would like help in determining your eligibility.


This table compares this health insurer's performance on a range of factors. Some of this information has previously been published in the Private Health Insurance Ombudsman's State of the Health Funds report, available from the Ombudsman's website ( Please note information is not provided for some insurers in some states, as there are insufficient numbers reported for states in which the insurer does not have a large membership.

Ombudsman complaints compared to market share
All complaints 0.2% 0.5% market share
Investigated complaints 0%
Health Insurer Retention and Finances Industry result
Member retention (hospital cover) 90.2% 86.5%
Benefits as % of contributions 80.4% 81.1%
Management expenses % of contribution income 13.1% 10.8%
Management expenses per average policy $605 $413
Coverage ACT NSW VIC QLD SA WA TAS NT Australia
Hospital Related Charges Covered 86.7% 90.7% 91.6% 90.8% 92.1% 88.2% 85.7% 84.2% 90.8%
Industry Result 81.8% 88.7% 90.5% 88.9% 92.6% 92.4% 92.4% 88.6% 89.9%
Medical Services with No Gaps 88.8% 92.6% 93.0% 94.0% 94.5% 90.0% 89.8% 91.5% 93.0%
Industry Result 75.6% 89.3% 87.3% 87.8% 89.0% 88.9% 91.2% 86.7% 88.3%
Medical Services with No or Known Gaps 94.9% 97.3% 98.2% 98.3% 98.9% 96.9% 93.4% 95.5% 97.8%
Industry Result 91.2% 96.4% 97.8% 96.8% 99.3% 98.0% 98.8% 95.9% 97.2%
General Treatment (extras) Covered 53.6% 52.3% 53.4% 54.2% 56.7% 53.5% 51.9% 59.2% 53.2%
Industry Result 46.4% 48.4% 50.5% 51.4% 55.2% 55.9% 51.8% 57.7% 51.1%
Private Hospital Agreements 6 87 69 50 18 21 8 1 -
Industry Maximum 8 98 72 58 24 24 8 2 -
Day Hospital Agreements 8 87 69 44 23 20 4 2 -
Industry Maximum 9 104 79 54 30 29 9 2 -
PO Box Q1749
Queen Victoria Building
NSW 1230