Silver Plus Advantage Hospital is a Phoenix Health Fund product that gives you a choice of excess options to help manage your premium costs without compromising your level of cover. It includes a broad range of covered treatment categories, restricted services, and access to the Access Gap scheme for in-hospital procedures.
Silver Plus Advantage Hospital & Everyday Extras 60 – FAQ
Everything you need to know about your cover, your excess, in-hospital costs, dental benefits, and how to claim — all in one place.
Silver Plus Advantage Hospital
Everyday Extras 60
Everyday Extras 60 is a Phoenix Health Fund extras product that provides a 60% set benefit across a range of everyday health services. It includes Gap Free Dental — 100% back on two preventative check-ups per year — plus general dental, and more. Please note: this product is closed and is no longer available to purchase.
About Your Excess
An excess is an amount you agree to pay when you are admitted to hospital. Choosing a higher excess reduces the cost of your premiums without compromising your level of cover.
With Silver Plus Advantage Hospital you have the choice between three excess options. Selecting a higher excess option will reduce the cost of your premiums.
The excess is payable on admission to hospital once per adult, per calendar year — regardless of how many times you need to go to hospital during that year.
Yes. Selecting a higher excess option is a way to reduce the cost of your premiums without compromising your level of cover.
Hospital Cover: Included, Excluded & Restricted Services
The following treatment categories are fully included (✔) in your Silver Plus Advantage Hospital cover:
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
Yes. Hospital Psychiatric Services are listed as a restricted (R) service under Silver Plus Advantage Hospital. Restricted services are covered, but at a limited benefit level.
The complete list of included (✔), excluded (✘) and restricted (R) treatment categories is set out in your Silver Plus Advantage Hospital product document. Contact Phoenix Health Fund on 1800 028 817 or at enquiries@phoenixhealthfund.com.au if you need a copy.
Access Gap & In-Hospital Costs
For every Medicare-recognised in-hospital procedure, Medicare sets out a schedule of fees called the Medicare Benefits Schedule (MBS). The Access Gap scheme is designed to help cover the difference between what Medicare pays and what your doctor charges, reducing or eliminating out-of-pocket costs for in-hospital procedures.
Yes. Phoenix Health Fund offers Access Gap cover for Medicare-recognised in-hospital procedures. For full details of how Access Gap applies to your cover, contact Phoenix Health Fund directly.
If your doctor charges above the MBS fee, there may be an out-of-pocket cost (a gap). The Access Gap scheme aims to reduce or eliminate this gap. Phoenix Health Fund is here to help — contact them on 1800 028 817 so you can focus on what's important.
Everyday Extras 60: Dental & Extras Benefits
Everyone on your membership gets 100% back on select preventative dental services — including a check-up and scale and clean — twice per calendar year, at the dentist of your choice.
Everyday Extras 60 provides a 60% set benefit for a range of included health services. This means Phoenix Health Fund pays 60% of the set benefit amount for those services.
General dental services covered include fillings, some extractions, x-rays, and more. Benefits are paid at the 60% set benefit rate (except Gap Free Dental, which is 100%).
No. Everyday Extras 60 is a closed product and is no longer available to purchase. Existing members already on this product continue to be covered under its terms.
Claiming: How to Claim, Limits & Benefit Resets
Unless otherwise specified, limits are per person, per year and reset on the 1st of January each year.
Everyone on your membership can claim Gap Free Dental (100% back on select services such as a check-up and clean) twice per calendar year.
Unless otherwise specified, limits under Everyday Extras 60 are per person, per year.
Full claiming information is set out in your Everyday Extras 60 product document. Phoenix Health Fund recommends checking the claiming details page of your product document to make sure you have all the information you need before submitting a claim. You can also contact the fund directly on 1800 028 817 or at enquiries@phoenixhealthfund.com.au.