Emergency Services Health (ESH)
We’re Emergency Services Health – a health fund established in response to a need, and requests, for emergency services personnel of all disciplines to have access to the type of quality, tailored health cover previously only available through our sister fund Police Health.
We’ve been looking after those on the front line, and their families too, for over 80 years – and we’re proud of the reputation we’ve built by putting our members first.
We only offer the best – because we believe anything less would be a disservice to you. We’re about value for money, unparalleled benefits, exceptional service and ultimate peace of mind.
Let us prove it to you.
Emergency Services Health 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 is a mutual organisation that operates on a not-for-profit basis.
Emergency Services Health operates in all states and territories.
Membership restrictions
If you work or volunteer — or you’ve ever worked or volunteered — for one of Australia’s emergency services, you can take out your health insurance cover with us. What’s more, membership is also open to your close relations. That means your parents and grandparents, as well as your brothers and sisters and their partners and children can all benefit from the quality of our cover. We provide cover for singles, couples, single parent families and families. Check our website for full details.
Performance
The Private Health Insurance Ombudsman prepares an annual report on the service delivery and performance of Australian health insurers. The following is a selection of statistics about this health insurer - the full report and an explanation of these figures is available from the Ombudsman's website. Please note information is not provided for some insurers in some states, as there are insufficient numbers reported to APRA for states in which the insurer does not have a large membership.
| Performance | Insurer | Industry |
|---|---|---|
| Benefits as a % of contributions | 98.4% | 86% |
| Management expenses (% cont) | 0% | 9.1% |
| Management expenses (average policy) | $0 | $350 |
| Surplus | 0% | 4.9% |
| Member retention (%) | 0% | 82% |
| Coverage | ACT | NSW | VIC | QLD | SA | WA | TAS | NT |
|---|---|---|---|---|---|---|---|---|
| Hospital Related Charges Covered | 82.7% | 95.9% | 95.8% | 91.2% | 96.5% | 95.3% | 100% | 88.7% |
| Industry Result | 83.8% | 90.4% | 92.2% | 90.8% | 94.6% | 93.0% | 93.9% | 90.2% |
| Medical Services with No Gaps | 76.7% | 90.7% | 87.5% | 88.7% | 91.8% | 80.8% | 100% | 62.1% |
| Industry Result | 78.5% | 88.9% | 85.6% | 88.4% | 87.3% | 85.0% | 88.6% | 84.2% |
| Medical Services with No or Known Gaps | 86.7% | 96.5% | 97.8% | 96.2% | 98.7% | 89.5% | 100% | 89.7% |
| Industry Result | 91.0% | 95.5% | 94.7% | 94.5% | 95.1% | 96.4% | 96.0% | 94.0% |
| General Treatment (extras) Covered | 65.5% | 62.3% | 64.3% | 65.6% | 67.1% | 65.3% | 61.8% | 67.2% |
| Industry Result | 48.1% | 50.7% | 52.4% | 54.3% | 57.4% | 57.5% | 54.3% | 59.1% |
| Private Hospital Agreements | 5 | 96 | 77 | 50 | 24 | 21 | 8 | 2 |
| Industry Maximum | 9 | 110 | 83 | 61 | 33 | 31 | 8 | 2 |
| Day Hospital Agreements | 8 | 92 | 72 | 51 | 28 | 23 | 4 | 1 |
| Industry Maximum | 6 | 98 | 78 | 57 | 29 | 23 | 5 | 2 |
| Share of PHIO complaints | Compared to insurer's market share | |
|---|---|---|
| Benefit Complaints | - | <0.5% |
| Service Complaints | - | |
| All Complaints | 0.1% | |
| Investigations | 0.3% |
Adelaide
SA 5000