Top Cover Gold & Essential Extras
A Gold hospital and extras policy from Doctors' Health Fund.
- Doctors' Health Fund only takes medical and allied health professionals, their families, medical students and AMA employees.
Premiums for every state, cover type and excess this policy is sold with, and what it covers, from the statement Doctors' Health Fund files with the government. Monthly, before the rebate and any Lifetime Health Cover loading.
From
Single, NT, $750 excess, before the rebate.
- Medicare levy surcharge
- Exempts you
- Excess options
- None, $750
- Ambulance
- Emergency and non-emergency, call-out fees included, no limit
- Who can join
- Restricted
The Private Health Information Statement for this price, on PrivateHealth.gov.au.
Doctors' Health Fund's page for this policyAgainst every other Gold hospital and extras policy in NSW & ACT
Single cover, each policy at its cheapest excess, corporate and restricted policies included.
- Gold84 policies$473.6347th cheapest of 84
Monthly premium by state and cover type
NSW prices also apply in the ACT. Each price in the tables opens its official Private Health Information Statement on PrivateHealth.gov.au, with a PDF to download.
Single premium in each state
To the nearest dollar, a month before the rebate. The tables below have every price to the cent.
What a higher excess saves
Single cover in NSW & ACT, a month. The excess is what you pay towards a hospital stay before the policy pays.
- No excess$513.71
- $750 excess$40.08 less than no excess$473.63
No excess
| State | Single | Couple | Family | Single parent | Extended family | Extended single parent |
|---|---|---|---|---|---|---|
| NSW & ACT | $513.71 | $1,027.42 | $1,027.42 | $881.68 | $1,284.26 | $1,102.09 |
| VIC | $548.16 | $1,096.31 | $1,096.31 | $941.11 | $1,370.39 | $1,176.37 |
| QLD | $553.00 | $1,105.99 | $1,105.99 | $949.46 | $1,382.49 | $1,186.81 |
| SA | $545.73 | $1,091.47 | $1,091.47 | $936.93 | $1,364.33 | $1,171.15 |
| WA | $496.20 | $992.41 | $992.41 | $851.47 | $1,240.50 | $1,064.33 |
| TAS | $555.23 | $1,110.45 | $1,110.45 | $953.30 | $1,388.06 | $1,191.62 |
| NT | $478.55 | $957.09 | $957.09 | $821.01 | $1,196.36 | $1,026.25 |
$750 excessat most $1,500 a year for couples and families
| State | Single | Couple | Family | Single parent | Extended family | Extended single parent |
|---|---|---|---|---|---|---|
| NSW & ACT | $473.63 | $947.27 | $947.27 | $821.59 | $1,184.08 | $1,026.98 |
| VIC | $508.25 | $1,016.49 | $1,016.49 | $882.13 | $1,270.61 | $1,102.66 |
| QLD | $513.11 | $1,026.22 | $1,026.22 | $890.64 | $1,282.77 | $1,113.29 |
| SA | $506.73 | $1,013.46 | $1,013.46 | $879.47 | $1,266.81 | $1,099.34 |
| WA | $456.06 | $912.12 | $912.12 | $790.84 | $1,140.15 | $988.55 |
| TAS | $515.35 | $1,030.70 | $1,030.70 | $894.56 | $1,288.37 | $1,118.20 |
| NT | $438.58 | $877.16 | $877.16 | $760.27 | $1,096.45 | $950.33 |
All 38 clinical categories covered in full
- Covered in full38
Covered 38
- Assisted reproductive services
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Dialysis for chronic kidney failure
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Heart and vascular system
- Hernia and appendix
- Hospital psychiatric services
- Implantation of hearing devices
- Insulin pumps
- Joint reconstructions
- Joint replacements
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Pain management with device
- Palliative care
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Rehabilitation
- Skin
- Sleep studies
- Tonsils, adenoids and grommets
- Weight loss surgery
Waiting periods
- Pre-existing conditions
- 12 months
- Pregnancy and birth
- 12 months
- Psychiatric, rehabilitation and palliative care
- 2 months
- All other hospital treatment
- 2 months
Excess and other costs
Excess options: none, $750, paid when you are admitted.
Offers the age-based discount for people who join between 18 and 29.
From the insurer: Top Cover Gold is a unique hospital cover that pays a medical gap benefit up to the Australian Medical Associations (AMA) list of medical services and fees. It does not require participation from your doctors and out-of-pocket expenses only occur when the doctor charges above AMA fee. This cover offers the highest level of hospital cover for the full range of inpatient services eligible for Medicare benefits.
Pays towards 22 of 27 standard services
Yearly limits, per person, against the typical policy
- General dentalshared with major dental, endodontic (root canals), orthodontics$1,600typical policy $800
- Major dentalshared with general dental, endodontic (root canals), orthodontics$1,600typical policy $1,000
- Optical$500typical policy $220
- Physiotherapyshared with 10 other services$900typical policy $450
- Psychologyshared with 10 other services$900typical policy $400
What it pays on common claims, against the typical policy
- Periodic oral exam (item 012)100% of the feetypical policy $35.20
- Scale and clean (item 114)100% of the feetypical policy $66.85
- Full crown, veneered (item 615)$765.00typical policy $773.80
- Single vision lenses and frames100% of the feetypical policy $220.00
- Physiotherapy, first visit$50.00typical policy $42.00
- Psychology, first visit$100.00typical policy $75.00
| Service | Waiting period | Yearly limit, per person | Per policy | Example benefits (all states) |
|---|---|---|---|---|
| General dental | 2 months | $1,600shared with major dental, endodontic (root canals), orthodontics | - | Periodic oral exam (item 012): 100%Scale and clean (item 114): 100%Fluoride treatment (item 121): 100%Simple extraction (item 322): $153.00 |
| Major dental | 12 months | $1,600shared with general dental, endodontic (root canals), orthodontics | - | Full crown, veneered (item 615): $765.00 |
| Endodontic (root canals) | 12 months | $1,600shared with general dental, major dental, orthodontics | - | Root canal filling (item 417): $131.75 |
| Orthodonticsconditions apply | 12 months | $1,600shared with general dental, major dental, endodontic (root canals) | - | Braces, upper and lower, with retainer (item 881): 100% |
| Opticalconditions apply | 2 months | $500 | - | Multifocal lenses and frames: 100%Single vision lenses and frames: 100% |
| Non-PBS medicines | 2 months | $300shared with vaccinations | - | Non-PBS prescription: 85% |
| Physiotherapyconditions apply | 2 months | $900shared with 10 other services | - | Physiotherapy, first visit: $50.00Physiotherapy, later visit: $35.00 |
| Podiatry | 2 months | $900shared with 10 other services | - | Podiatry, first visit: $50.00Podiatry, later visit: $35.00 |
| Psychology | 2 months | $900shared with 10 other services | - | Psychology, first visit: $100.00Psychology, later visit: $100.00 |
| Acupunctureconditions apply | 2 months | $200shared with health management programs | $400 | Acupuncture, first visit: 75%Acupuncture, later visit: 75% |
| Remedial massage | 2 months | $900shared with 10 other services | - | Remedial massage, first visit: $40.00Remedial massage, later visit: $30.00 |
| Hearing aids | 24 months | $800, 1 every 5 years | - | Hearing aid: $400.00 |
| Blood glucose monitors | 12 months | $500, $250 a visit, 1 every 2 years | - | Blood glucose monitor: 75% |
| Antenatal and postnatal | 2 months | $900shared with 10 other services | - | Antenatal and postnatal, first visit: $50.00Antenatal and postnatal, later visit: $30.00 |
| Dietetics | 2 months | $900shared with 10 other services | - | Dietetics, first visit: $50.00Dietetics, later visit: $35.00 |
| Exercise physiology | 2 months | $900shared with 10 other services | - | Exercise physiology, first visit: $30.00Exercise physiology, later visit: $30.00 |
| Orthoptics | 2 months | $900shared with 10 other services | - | Orthoptics, first visit: $50.00Orthoptics, later visit: $35.00 |
| Health management programs | 2 months | $200shared with acupuncture | $400 | Health management program: 75% |
| Occupational therapy | 2 months | $900shared with 10 other services | - | Occupational therapy, first visit: $50.00Occupational therapy, later visit: $40.00 |
| Orthotics | 12 months | $900shared with 10 other services | - | Orthotics: $150.00 |
| Speech therapy | 2 months | $900shared with 10 other services | - | Speech therapy, first visit: $50.00Speech therapy, later visit: $40.00 |
| Vaccinations | 2 months | $300shared with non-pbs medicines | - | Vaccination: 85% |
Not covered: chiropractic, audiology, chinese herbal medicine, home nursing, osteopathy.
Other services: Major dental paid at fixed benefits per item. Combined annual limit of $900 for physiotherapy, exercise physiology, dietetics, occupational therapy, speech therapy, podiatry, massage and more (sub-limits of $700 for mental health and $500 for other therapies). Group physiotherapy and hydrotherapy $20 per session. Benefit of $400 each for one left and one right hearing aid every 5 years. Pharmacy benefits paid at 85% of charge above the PBS co-payment to a maximum of $40 per prescription (sub-limit applies for weight loss medications).
From the insurer: Superior mid-range extras cover with substantial benefits including major dental and high-level optical cover. 100% back for 2 dental checkups per year (fixed benefits thereafter) at the provider of your choice. No sub-limits on optical benefits – use the full $500 limit on contact lenses or frames fitted with prescription lenses. Claim up to $700 per year (as part of the $900 overall limit for therapies) for mental health services. Health management includes services such as acupuncture, weight loss classes and class physiotherapy for the treatment of a specific diagnosed condition.
Orthodontic services accrue to a lifetime limit of $1,600 at $320 per year of membership. $500 optical limit every 2 years. Individual and group physiotherapy and hydrotherapy claimable under physiotherapy. Class physiotherapy and acupuncture claimable through health management when prescribed by your medical practitioner.
Example benefits are what the policy pays for that item at a provider without a special arrangement with the insurer; a percentage is of the fee charged. The typical policy is the middle one of the 708 extras policies on the market that aren't sold only through employers.
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Source: PrivateHealth.gov.au data (Private Health Insurance Ombudsman) via data.gov.au, licensed CC BY 3.0 AU. Normalised by The Finance Algorithm from the extract dated 1 Oct 2026, read on 23 Oct 2026.
Premiums are monthly and shown before the Australian Government rebate and any Lifetime Health Cover loading or age-based discount. Confirm the price and the cover with the insurer before you buy; the official statement for every policy is on PrivateHealth.gov.au. This is general information, not advice, and no insurer pays to be listed or ranked here.