Phoenix Health Fund

What Phoenix Health Fund does

Phoenix Health Fund Limited is an Australian not-for-profit, member-owned private health insurer headquartered in Newcastle, New South Wales. Founded in 1953 originally for employees of the Australian Steel Industry, the fund is now open to all Australians and operates under the regulatory framework of the Private Health Insurance Act, as a signatory to the Private Health Insurance Code of Conduct. The company is a founder member of the Members Health Fund Alliance (MHFA) and a member of Private Healthcare Australia (PHA), positioning it within the collective of smaller not-for-profit health funds in the Australian market.

The product portfolio comprises six hospital cover tiers (Basic Accident Only, Bronze, Bronze Plus Essentials, Silver Plus Support, Silver Plus Family, and Silver Plus Advantage) and four extras cover tiers (Kick Start Extras 50, Healthy Flex Extras 50, Value Extras 60, and Active Extras 60), sold separately or in combination. All hospital covers bundle unlimited Australia-wide ambulance cover, and an Accident Cover add-on waives waiting periods for accident-related injuries. Underlying infrastructure includes the Phoenix Health mobile application on iOS and Android, an online member services portal, and a 5-minute web-based quote tool. Service delivery is supplemented by a suite of Health Support Programs (Hospital at Home, Rehab in the Home, Mental Health Connect, Bumps & Bubs, Cancer Care Complete via Spectrum.Life, Diabetes Support, Spinal Care via Kieser, Osteoarthritis Care, Short Stay Joint Replacement), giving the fund clinical-care adjacencies beyond pure claims administration. Network reach is achieved through ASHA membership, providing access to 480+ private hospitals and 36,000 Access Gap Doctors nationwide.

Phoenix Health operates a direct-to-consumer distribution model - phone (1800 028 817), website quote tool, and Australia-based service team - with no broker or aggregator intermediaries. Revenue is generated entirely through recurring monthly and annual member premiums, with profits reinvested in member benefits under the mutual structure rather than distributed as dividends. Marketing is delivered through content (Phoenix Learning Hub), email (HealthLinks newsletter), social channels, a Refer a Friend program, and a 4.9/5 ProductReview.com.au rating across 404 verified member reviews. Customer service performance is publicly cited as 85% of phone calls answered within 30 seconds. The company reports 11-50 employees and discloses no financial figures.

Name

Phoenix Health Fund

Legal name

Phoenix Health Fund Limited

Website

https://phoenixhealthfund.com.au

Company type

Private

Founded year

1953

Operating status

Operating

Headcount range

11–50 employees

Short description

Phoenix Health Fund is a not-for-profit, member-owned Australian private health insurer offering six hospital cover tiers and four extras cover tiers to individuals, couples, families and single parents across Australia, with network access via ASHA membership and a Health Support Programs portfolio delivered through clinical partnerships.

Ownership category

akta.pro rank

Product category

Private Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Accident & Health Insurance (6321)

akta.pro primary industry

Small Group Health Insurance (2–50/100) (FSAIAFAD)

akta.pro secondary industry

Individual Supplemental Health (Hospital Indemnity, Critical Illness, Accident) (FSAIAEAD)

Keywords

• Private health insurance
• Hospital cover
• Extras cover
• Member-owned fund
• Ambulance cover

Headquarters

HQ city

Newcastle

HQ country

Australia

HQ region

Oceania

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Revenue model

1. Health Insurance Premiums (Subscription): Phoenix Health generates revenue through monthly and annual health insurance premiums paid by members for Hospital Cover, Extras Cover, or combined policies. As a not-for-profit, member-owned fund, premiums are reinvested into member benefits and services rather than distributed to shareholders.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Phoenix Health Fund is a not-for-profit, member-owned private health insurer headquartered in Newcastle, NSW, Australia, operating since 1953. The fund sells Hospital Cover, Extras Cover, Ambulance Cover, and combined Hospital & Extras policies directly to Australian consumers via phone and online, and complements these products with Health Support Programs such as chronic condition management, mental health support, weight management, and healthy eating. As a mutual, any surplus is returned to members rather than distributed to shareholders.

Product overview

Phoenix Health Fund is a not-for-profit, member-owned health insurer offering a comprehensive portfolio of private health insurance products. The core product line consists of six hospital cover tiers (Basic Accident Only, Bronze, Bronze Plus Essentials, Silver Plus Support, Silver Plus Family, and Silver Plus Advantage) and four extras covers (Kick Start Extras 50, Healthy Flex Extras 50, Value Extras 60, and Active Extras 60), which can be combined or purchased separately. All hospital covers include comprehensive ambulance cover, and Accident Cover add-on is available to waive waiting periods for accident-related injuries. The company also provides digital services including the Phoenix Health App and Online Member Services portal. Health Support Programs include Hospital at Home, Rehab in the Home, Mental Health Connect, Bumps & Bubs, Diabetes Support, Cancer Care Complete, and various musculoskeletal programs. Member perks include Phoenix Health Rewards and Travel Insurance. The company serves singles, couples, families, and single parents across Australia.

Differentiator

Problem solved

Functional benefit

Brands

• Phoenix Health Rewards: Member rewards program offering travel insurance and other member perks.
• Phoenix Health App
• Mental Health Connect
• Hospital at Home (HITH)
• Rehab in the Home (RITH)
• Bumps & Bubs
• Cancer Care Complete
• Diabetes Support Program
• Spinal Care Plan
• Short Stay Joint Replacement Program
• Osteoarthritis Care Programs

Products and services

• Hospital Cover
• Extras Cover Ancillary cover that provides benefits for out-of-hospital services including dental, optical, physiotherapy, chiropractic, podiatry, hearing aids, and other allied health services. Sold to Australian consumers as a stand-alone product or combined with Hospital Cover.
• Ambulance Cover Coverage for emergency ambulance transport and related ambulance services. Sold to Australian consumers, particularly in states where ambulance services are not fully covered by government schemes.
• Combined Hospital & Extras Cover Combined policy bundling Hospital Cover and Extras Cover into a single membership, often at a lower combined premium than purchasing each product separately. Targeted at Australian individuals, couples, and families seeking comprehensive cover through a single policy.
• Health Support Programs A suite of member wellness and condition-management programs covering chronic condition management, mental health support, weight management, healthy eating, and related health-education services. Available to Phoenix Health Fund members as part of their cover.

Quantifiable outcome

• 85% of phone calls answered in under 30 seconds
• +2 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature5 records

Partnerships

Six partnerships are on record, tiered core and minor.

• Australian Health Services Alliance (ASHA)coreTechnology or IntegrationPhoenix Health is a proud member of the Australian Health Services Alliance (ASHA), which provides access to a network of over 480 private hospitals and 36,000 Access Gap Doctors across Australia. This partnership is foundational to Phoenix Health's value proposition of providing members with broad hospital choice and reduced out-of-pocket costs through the Access Gap Cover Scheme.
• Private Healthcare Australia (PHA)coreStrategic or Co-development PartnerPhoenix Health is a member of Private Healthcare Australia, the peak industry body representing the private health insurance sector in Australia. Membership demonstrates commitment to high industry standards, collaboration, and advocacy for member-first value.
• Members Health Fund Alliance (MHFA)coreStrategic or Co-development PartnerPhoenix Health is a member and founder of the Members Health Fund Alliance (MHFA), an alliance representing smaller not-for-profit health funds. The alliance's purpose is to collectively represent not-for-profit health funds, support the reduction of member expenses, and maximise member benefits across the industry.
• Spectrum.LifecoreStrategic or Co-development PartnerPhoenix Health has partnered with Spectrum.Life to deliver the Cancer Care Complete program, supporting members through the side effects of chemotherapy and radiotherapy so they can maintain their quality of life and return to activities they enjoy.
• KieserminorStrategic or Co-development PartnerPhoenix Health has partnered with Kieser to deliver the Spinal Care Plan, helping members manage severe back pain and improve symptoms through a structured care program delivered by Kieser's physiotherapists.
• Smith Brothers MediaminorImplementation/ SI/ Consulting PartnerSmith Brothers Media is the agency responsible for the design and development of the Phoenix Health Fund website.

Scale indicators7 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• GMHBA: Australian regional not-for-profit mutual health insurer headquartered in Geelong, offering hospital and extras cover to individuals and families in a not-for-profit member-owned structure. Closely comparable to Phoenix Health in mutual status, product offering and D2C distribution model.
• CBHS Health Fund: Not-for-profit restricted-membership private health insurer that has opened to the public, providing hospital and extras cover. Peer on mutual structure and product set, with comparable tiered cover offerings and D2C sales channels competing in the same Australian PHI market as Phoenix Health.
• HCF (Hospitals Contribution Fund of Australia): Australia's largest not-for-profit private health insurer, also member-owned and mutual. HCF operates the same direct-to-consumer model offering Hospital and Extras cover to individuals, couples and families nationally, with comparable product tiering and a member-first value proposition. Most directly comparable peer to Phoenix Health.
• Australian Unity Health: Australian mutual providing private health insurance alongside broader wellbeing services. Competes with Phoenix Health in the same individual/family hospital and extras segments using a similar mutual/member-owned structure and complementary health programs.
• Defence Health: Not-for-profit private health insurer serving the defence and broader community. Offers hospital and extras cover with member-owned governance and alliance-based hospital network access, structurally similar to Phoenix Health's model and competitive overlap.
• Teachers Health Fund: Australian not-for-profit health fund providing hospital and extras cover primarily to education sector members but now open to the public. Operates as a smaller mutual PHI with comparable product architecture, hospital network access via alliance partnerships, and member-owned economics directly relevant to Phoenix Health.

Broad incumbents

• Medibank Private: Australia's largest private health insurer and former government-owned entity, providing hospital and extras cover to a national member base. Dominant incumbent competitor to Phoenix Health across all segments; useful for understanding market dynamics, regulatory exposure and competitive context.
• Bupa Australia: Major international health insurer's Australian arm, one of the largest PHIs in the country. Offers comprehensive hospital and extras cover and competes with Phoenix Health across the same D2C and family segments at significant scale.
• NIB Holdings: ASX-listed Australian private health insurer with national hospital and extras cover offerings. Competes directly with Phoenix Health in the D2C individual/family market but operates a much larger, publicly-listed for-profit model - relevant for benchmarking scale, product breadth and pricing.

Regional players

• HBF Health: Western Australia-focused not-for-profit private health insurer offering hospital and extras cover with member-owned governance. Comparable in mutual structure and product philosophy to Phoenix Health, but serves a different primary geography and therefore not a direct in-territory competitor.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/@phoenixhealthfund3183
• Facebookfacebook.com/Phoenixhealthfund
• LinkedInlinkedin.com/company/phoenix-health-fund
• Xx.com/phoenixhealth4u

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Phoenix Health Fund