Restricted funds are a closed club - only people in specific industries can join.
They sometimes offer better value for money than open funds, but not always.
All restricted funds are run as not-for-profit health funds.
List of restricted funds in Australia
The table below lays out the current restricted funds in Australia and their joining rules.
Fund
Conditions
Open to members of the Seventh-day Adventist Church and present and past employees of affiliated companies, along with the partners/spouses, dependents, siblings, parents and grandchildren of those mentioned previously.
Open to employees, contractors and franchisees of Commonwealth Bank of Australia Group as well as their partners and family members, including dependent and non-dependent children, siblings, parents and grandchildren.
Open to reservists and past members* of the Australian Defence Force, employees of the Department of Defence and Defence suppliers. Extended family as well as the ex-partner/spouse of those previously mentioned are also eligible to join.
Open to registered Medical Practitioners and Health Practitioners (in an eligible category), their employees, extended family and much more. The eligibility criteria for this fund is wide and you can view the full list via the More Info button.
Available to current and former members of the emergency services such as fire response and recovery sectors, ambulance and medical response and recovery sectors, water response and recovery sectors, and state emergency response and recovery sectors.
Open to current and former members, reservists and cadets of the ADF, employees of the DoD, Defence suppliers and more. Extended family as well as the ex-partner/spouse of those previously mentioned are also eligible to join.
Open to current and former nurses and midwifes and their family. Nurses & Midwives is operated by Teachers Health.
Open to current or former (if retired or resigned after 1 Jan 2001) employees of state, territory and federal police departments/police unions including their partners/spouses, dependants and adult children plus their immediate family.
Open to current or former employees of the Reserve Bank of Australia and Note Printing Australia, as well as their current or ex-partner or spouse and their dependant or adult children.
Open to current or former members and administrative staff of approved education unions and organisations, along with their extended family. Use the More Info button to the right to view the eligible unions and organisations.
Open to current or former union members of any industry along with their current or ex partner/spouse, dependent children, adult children (plus their partner), siblings (plus their partners and dependent children), parents and grandchildren.
UniHealth is open to those in the higher education community and their families. It's operated by Teachers Health.
Union Health is open to all current or former Australian union members and their family. About 1 in 8 Aussies are in a union, so a lot of Australians are eligible to join. Union Health is operated by TUH health fund.
Are restricted funds worth it?
Maybe, but not always. Like all not for profit health funds, restricted funds are run solely for the benefit of members, so all profits are returned to the fund in the form of lower premiums.
Despite that, premiums aren't always the cheapest in the market. The for-profit companies have big marketing and member acquisition budgets, so they can often justify more generous prices and sign-up offers.
Of course, there are other reasons to join a fund that's associated with a particular industry or union. The fund may be able to offer specific benefits that make sense for your specific lifestyle, as well as offer more back on certain extras or hospital treatments. You also might just be ideologically inclined to go with a not-for-profit, restricted fund.
The pros and cons of a restricted health fund
Pros of restricted health funds
They're run for members. All profits are returned to the fund, usually in the form of cheaper premiums or better policies with more benefits.
Terms and conditions can be more flexible. For example, with Navy Health, waiting period and pre-existing health condition rules are waived if you join within 90 days of being discharged from the ADF.
Family members can join too. Restricted health funds are generally open to your family members as well.
Cons of restricted health funds
Because they're generally smaller, restricted health funds sometimes have a narrower range of policies.
They may not have as many arrangements with Doctors and Allied Health professionals to reduce the gap for members.
There's not blanket rule that restricted funds will be cheaper.
Final things you might want to know
Some points to bear in mind when comparing restricted and open funds:
Most restricted funds are open to family members, but this may be limited to immediate family (spouse and dependent children)
Previous employment in an industry can encompass a number of years (you may still be eligible to join restricted funds, even though you have not worked in an industry for some time)
Belonging to a restricted health fund may also give you access to other member only benefits such as industry super and life insurance
Price should not be the only consideration when looking at restricted funds. It is also important to ensure that the level of cover being offered is adequate for your needs
Frequently asked questions
Restricted health funds aren't always cheaper than open funds. The big for-profit funds can often offer cheaper premiums and generous sign-up discounts, for example. However, there are other reasons to join a restricted fund.
Nope, CBHS Corporate Health isn't a restricted fund. It's an open health insurance fund available to everyone, not just specific groups. It's a bit confusing though - CBHS Corporate Health is distinct from CBHS Health Fund, which is a restricted not-for-profit health fund for current and former employees of the Commonwealth Bank Group and their families.
RT Health used to be a restricted fund, one of Australia's oldest in fact. However, after it merged with HCF in 2021, RT Health converrted to an open fund. It still operates as a sub-brand of HCF with its own policies, but anyone can join.
In Australia, all restricted health funds operate on a not-for-profit model. This means they reinvest any surplus funds into improving member benefits, lowering premiums, or enhancing services. Theoretically this doesn't have to be the case, but on one seems to be trying ot make a profit with a restricted fund right now.
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