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You can join:
At HCF, we are dedicated to helping members choose the right cover. If you would like assistance with choosing your health cover you can:
Your cover will start as soon as you have paid us all premiums due at the time that you apply, and have fully completed our application process. Waiting Periods may apply so make sure you check out how this affects your membership before you join.
Yes. You will receive a 100% refund on your Hospital and Extras cover if you change your mind or cancel your policy within 30 days, and you haven't made a claim.
Yes. Upon joining, all HCF members receive a membership card that lists the membership number and the names of those covered. You will receive your card within 10 working days of joining. You can use your membership card to make 'on the spot' claims at branches or through HICAPS.
Switching to HCF is easy. Use our product finder to choose your cover and receive a quote. Then, fill out your application and the Interfund Transfer online. We'll do the rest for you (including contacting your previous fund). Alternatively, print, and fill out an HCF application form including the Interfund Transfer section, and post it to HCF, GPO Box 4242, Sydney 2001, or take it to your nearest branch or representative. You can also join by phone, and then fill in an application form later. Call HCF on 13 13 34. You will receive continuity on similar benefits when you're switching from comparable cover with another Australian registered health fund within 30 days. In some instances, your existing health fund may send your Interfund Transfer / Clearance Certificate to you (and not HCF). You will need to forward this certificate to HCF which confirms your Lifetime Health Cover details and ensures you receive continuous cover. If you are switching and wish to upgrade your cover, you will need to serve the necessary waiting periods for the higher benefit entitlements.
An excess is an amount members nominate to pay per calendar year when admitted to hospital. Choosing an excess option can reduce your premium and is only payable if you are admitted to hospital.
If hospitalised, the total excess amount will only apply once per person in a calendar year, and dependant children are exempt. You'll find you save even more as you won't pay any excess for accidents and same day surgery (unlike most other funds).
Waiting periods must be served before benefits are paid. They apply to:
Waiting periods vary according to the type of treatment or service and are as follows: Hospital Waiting Periods
Extras Waiting Periods
If you join under a waiver, waiting periods are only waived for services with waiting periods equal to or less than the waiver. All other waiting periods in excess of the waiver apply.
The type and level of health insurance you take out. There are two types of covers: hospital & extras. The level of health insurance differs depending on the services for which you want to be covered and you wish to pay.
Private hospital cover helps reduce the costs associated with treatment in hospital (e.g. doctors fees, accommodation, operating theatre, intensive care, and pharmaceuticals in hospital). Having private hospital cover also allows you to choose your own doctor (such as your own obstetrician), and choose when you have treatment for elective surgery. Hospital Advanced Savings and Hospital Savings provide 'minimum benefits' for some hospital services. This means you would experience additional out-of-pocket expenses if you were treated for those services in a private hospital. If you are planning treatment for any services with 'minimum benefits', you should consider a higher level of cover to help reduce your out-of-pocket expenses. All HCF hospital covers exclude:
Extras cover helps reduce the out-of-pocket expenses associated with managing or improving your health. Examples of 'Extras' services include dental, optical, physiotherapy and chiropractic. You can claim for the following expenses depending on your level of cover:
If you choose Level 2, 4, 5 or 6 cover, you will be covered for a benefit of $10,000 if you are permanently and totally disabled in an accident that occurred after your cover commenced. Cover is provided by a group policy issued by HCF Life and copies are available on request.
Did you know that Medicare does not cover you for the cost of using an ambulance? If you have an accident you could be up for a very expensive ride, especially if you live in a rural or remote area. Fortunately, you can take out HCF Ambulance cover. It provides you with 100% cover for emergency ambulance (state government services) for road or air ambulance, to the nearest hospital that can provide you with the care you need. You'll also be covered for non-emergency ambulance by state government services, up to $5,000 per person per calendar year. Please note: This cover is not available to residents of Western Australia, Tasmania and Queensland. Pre-existing conditions will not be covered for 12 months, otherwise a 1-day waiting period applies for emergency and two months for non-emergency cover.
Please make certain you understand who is covered under your policy. Review your policy at least once a year to identify changes in your circumstances that could affect your health cover needs. If your family situation changes, let us know so that we can suggest appropriate adjustments to your cover. Family cover
Dependant students must be registered as a Student Dependant at the start of each academic year. If they cease study, they are no longer covered as dependant students. Let us know if this is the case so that we can discuss other options with you, such as Extended Family cover. All new dependants must serve waiting periods, unless they are transferring from another membership or another private health insurer where they have already completed the relevant waiting periods. In this case they will need to request an Interfund Transfer Certificate from their previous fund, which is provided to HCF when joining. Cover for your dependants Single Parent Family cover As per Family cover, excluding the contributor's nominated partner. Couples cover The contributor and the contributor's nominated partner' Singles cover The contributor only
Be aware of these circumstances, which will prevent payment of a claim:
HCF health insurance does not cover
In addition, HCF hospital cover does not include:
In addition, HCF Extras cover does not include:
These are services that are directly related to the hospitalisation for pregnancy and childbirth. They include things like complications of pregnancy, delivery itself and post-natal care of the mother.
All HCF hospital covers include pregnancy but only minimum benefits are paid on the lower levels of cover. You would be fully covered on Top Plus Cover and Hospital Savings. However, please be aware that a 12-month waiting period applies for pregnancy and birth related services.
It's important to take out a family membership before your child is born so that the child doesn't have to serve any waiting periods. To cover your baby from birth, just transfer your single membership to a family membership two months or more before they're born.
There is a 12 month waiting period for the extraction of wisdom teeth. If you are planning to have your wisdom teeth removed by your dentist in private practice, the extras cover that offers general dental benefits will cover it. If you are to be admitted to a hospital for the removal of your wisdom teeth, an extras cover that offers general dental benefits would cover the dentist's account for the extractions. The hospital cover would cover hospital costs such as accommodation.
A pre-existing ailment or condition is an ailment or illness or a condition where the signs or symptoms existed any time during the six months before a member joined or upgraded to a higher level of cover, even though a diagnosis may not have been made.
If you're sure you won't need specific services in a private hospital then insurance with these services at a Minimum benefit level can save you money. Minimum benefits only cover the cost of staying in a public hospital shared room.
Reduced Benefits mean where no medical benefits (doctor's charges) are payable and only a proportion of hospital benefits are covered.
Ezipay (direct debit from a bank, building or credit union).
Arrange for your bank, building society or credit union to make your payments automatically by direct debit from your nominated account. Download Ezipay authorisation form
Ezipay (direct debit from a bank, building or credit union).
Arrange for your bank, building society or credit union to make your payments automatically by direct debit from your nominated account. Download Credit Card authorisation form You can choose any direct debit date with the exception of the 28th, 29th, 30th and 31st day of a month, and you can pay your premiums yearly, half yearly, quarterly or monthly. We will advise you if your payment is not made, and what you need to do to keep your membership up to date. Please note: If your account becomes overdrawn, some financial institutions may charge you a fee. We guarantee to abide by a Direct Debit Customer Service Agreement so that we can maintain a trusting relationship with you. If you're not sure whether your company has such a scheme, just ask your personnel or finance manager, or give us a call on 13 14 39. Online You can make a secure payment with your credit card online. Just log in to the member section and select Make a Payment. BPAY With BPAY, you can make your HCF payments any time over the phone, or via internet banking. We have put together instructions on how to use BPAY By phone We accept American Express, MasterCard and VISA. Just call 13 13 34. By mail You can mail a cheque to us at: HCF, GPO Box 4242, Note: Please remember to write your membership number on the back of your cheque, and we can't accept cash through the mail. HCF Branch You can also pay at any HCF branch.
Log into our member section where you can change your address, phone numbers, and email address. Alternatively call HCF on 13 13 34, email
Log into our member section, go to 'Your personal details' and click on 'Edit' for an existing member, or the 'add a new member' button to add someone new. Alternatively call HCF on 13 13 34, email
Congratulations!
Step 1: change your name with Medicare Step 2: send us a copy of your marriage certificate Step 3: we will re-order a new card
Use the Application form available on the website. Make the relevant changes on the form and send it to us by mail or through visiting a branch. You will be advised the difference in the premium you will be required to pay.
Knowing what you're entitled to claim for when in hospital can become very confusing. That's why we try to make it as clear as possible for you. Please log into our member section or call 13 13 34 to find out what you're entitled to under your current policy. Assuming you're in a participating private hospital, the hospital will send a bill to HCF on your behalf. All you need to do is read the claim form carefully, answer the questions and sign it before being discharged. Too easy! Also non-participating private hospitals and public hospitals will send bills to HCF on member's behalf. If your policy requires you to pay an excess or you have restricted cover, you will need to pay this directly to the hospital. Please check with the hospital whether you have to pay this upon admission or if they bill you.
Did your doctor or specialist treat you under the HCF Medicover agreement?
There are four ways to claim payments for extras as follows: 1. On the spot
This is your most convenient way to claim for some services such as visiting your optometrist, dentist, physiotherapist, chiropractor, osteopath or podiatrist. Done via our electronic claims and payment system, you just need to pay the difference between the cost and benefit once the claim is approved electronically. 2. Claim online for popular Extra items
3. Claim by mail
Pick up a claim form from a branch, download one or call 13 13 34 to have one mailed to you. 4. Claim in person
Claims can be made at any HCF branch. There is no need to complete a claims form; just bring your membership card and original receipts and we will pay you in cash or credit your nominated bank account. You will receive a detailed statement for your records.
* All other dependants presenting a claim require a claim form signed by the contributor/spouse before the claim can be paid. Those claims will be paid by cheque made payable to the contributor.
If you've taken a ride in an ambulance, send the unpaid account to us. We'll look after the payment directly with the Ambulance Service on your behalf.
You will need to take your account to Medicare and complete a two-way claim form. For more information and to download a two-way claim form, go to http://www.medicareaustralia.gov.au/public/files/ma_0543_medicare_two_way_form.pdf
As long as they are listed on your policy, your children are automatically covered under your family cover until the day before they turn 22. If they are full-time students, simply register them as Student Dependants, and they'll be covered for no extra cost until the day before they turn 25.
If your children aren't full-time students, you can also continue to cover them until they turn 25 with Extended Family cover. As long as they're not married or in a de facto relationship, you can take out this cover for a surcharge of about 25% of your existing premium - even if your children are living away from home.
Extended Family cover is available with either Top Plus or Hospital Savings, and applies to your extras cover when taken with these hospital products.
If you're under 22 years of age, you don't need to do anything. You're covered under your family's membership.
If you are under 25 years, you can be covered under "Extended Family cover" at an additional cost of 25% of the existing premium on your families' membership.
If you are single, aged less than 25 years and studying full time, you can continue to be covered under your parent's family membership as a student dependant.
We recommend taking out Travel insurance whenever you travel overseas. As an HCF member, you're entitled to a 10% discount on travel insurance
When you travel overseas, it's wise to carry travel insurance if medical or emergency assistance is required. Remember, your HCF hospital, extras or more protection insurance only applies when you're in Australia. If all members on the HCF policy are overseas for more than 30 days, you may be able to suspend your policy for this period. Think seriously before you suspend or cancel your HCF policy as individuals and families who do not have adequate private patient hospital cover may be liable to pay an additional 1% Medicare Levy Surcharge (MLS).
There is nothing in the tax legislation that requires you to suspend or cancel your policy if you go overseas. It is your choice but there may be MLS implications if you do suspend or cancel your policy.
Not necessarily. You should contact your accountant or tax agent for advice.
Travel insurance is not private patient hospital cover for MLS purposes. Hence, you are considered to have no private patient hospital cover during the period of suspension or cancellation.
Private patient hospital cover does not include cover provided by an overseas fund. Hence, you are considered to have no private patient hospital cover during the period of suspension or cancellation.
Individuals on a policy cannot be suspended. In family situations, this means everyone on your policy must be suspended. You and your dependants need to have private patient hospital cover to avoid paying the MLS. Cancelling or suspending cover for yourself will mean that you and your spouse may each still be liable for the MLS if your taxable income exceeds the relevant threshold.
HCF is committed to best practice privacy protection and will do our best to protect your personal information from the moment you share it with us. How HCF collects, uses and keeps secure your personal information is described in the HCF Privacy Policy
Log in to the member section of the HCF website and search for your closest
Many people are apprehensive about going into hospital. However, being well prepared can reduce your worry. We have put together a brochure that tells you all about what you need to know before going into hospital. Download brochure.
Our 'participating hospitals' and 'recognised provider' network includes most private hospitals, and all public hospitals throughout Australia. You're fully covered (except for any excess and conditions relating to your hospital cover which still apply) in every one of them for the following in-hospital expenses:
A private hospital that we don't have an agreement with. If you go to a non-participating private hospital, we may not be able to cover the cost of your stay.
Public hospitals
Private hospitals
Sounds simple? It's not.
Prostheses are surgical implants such as pacemakers, defibrillators, cardiac stents, joint replacements, intraocular lenses and other devices. They are used in surgery to replace or augment a part of the body. From 31 October 2005, the Government has issued a new Prostheses List, which will be updated twice a year. You and your doctor will be able to choose from a selection of prostheses that will be fully covered by HCF for every Medicare Benefit Schedule (MBS) procedure, provided it is an in-hospital service. 98.8% of items on the Prostheses List will be fully covered by HCF. A limited number of prostheses will attract a 'gap', which you may be required to pay. The gap amount is the difference between the prostheses chosen by you and your doctor and the no-gap alternative. Gap payments apply only where there is a choice of other effective clinically similar products available at no-gap. Before surgery 1. Check that your HCF product covers you. 2. If your surgery requires a prosthesis, ask your doctor which prosthesis will be the best one for you and which no-gap prostheses are available. If the doctor recommends a prosthesis for which a gap is payable, ask why this one is being recommended. You will only have to pay part of the prosthesis cost if you agree to have one of these devices. 3. Ask the doctor to explain the costs of the surgery including any medical gap, the prosthesis gap payment (if any) and any other expenses involved. If there are any gaps for you to pay ask for a written cost estimate. 4. Then either call HCF on 13 13 34 or log into the member section of the website to access the Prostheses List online, with the prosthesis code to confirm if your surgery will result in any gap payments.
Submit your receipts together with a completed claim form. Your receipts must contain the following for HCF to process your claim:
The HCF Health Management program offers a range of benefits to help members lead a fit and healthy life; address health issues such as stress, smoking and weight; and help you to manage specific medical conditions. This is because we believe staying healthy is a top priority for you and your family. Exercise regimes and gym membership fees HCF Exercise & Gym benefits authorisation form. A program provided by a childbirth educator or qualified health professional (such as a midwife or nurse). Diabetes Association membership fees
First Aid Course For a course that is Workcover approved. (The Workcover Number for your State is required.) Learn to Swim For lessons conducted by swim instructors holding AUSTSWIM qualifications, who are senior first aid accredited and who hold indemnity insurance. (Excludes squad and recreational swimming). Stress Management and Quit Smoking For stress management and quit smoking programs conducted by a registered psychologist. Your GP or psychologist is required to fill out a Psychology benefits authorisation form. For information on stress and anxiety, you can visit www.beyondblue.org.au. To quit smoking, contact the Quitline Service on 13 78 48 or visit www.quitnow.info.au Weight Management For HCF approved programs that include a consultation with a dietician and conducted by a qualified health professional.
Lactation consultant You can claim towards the services of a lactation consultant who is certified by the International Board of Lactation Consultant Examiners and recognised by us. My Health Guardian A new and unique preventative health program to help you better manage your health, wellbeing and chronic illness.
Go to the member section of the website and click on the 'forgot your password?' link (located under the login boxes). Follow the prompts to reset your password. If you are having difficulties, please call us on 13 13 34.
Yes, you can make one-off credit card payments online. Log into the member section and select 'make a payment'. Making a payment online is totally secure. Please note that making a payment online will not change your regular method payment.
Go to the member section of the website and click on the 'change your password' link (located under the login boxes). Follow the prompts to reset your password. If you are having difficulties, please call us on 13 13 34.
Register for the member section, choosing the 'online claims' registration option. Once you've logged in, click 'Make an online claim'.
When you've completed your online claim, your benefit will be paid straight into your direct credit account (if you have not advised HCF of the details please call 13 13 34).
You will need to print out, or take note of the information provided at the completion of your claim (i.e. the Claim Reference Number). Attach it to your original itemised receipt and then send it to our free postal address: HCF Online Claiming, Reply Paid 77010, Locked bag 4100, QUEEN VICTORIA BUILDING NSW 1229.
All original itemised receipts should show the following:
Once we've received your receipts, we will adjust your online claimable balance.
If you have any queries, please email onlineclaims@hcf.com.au or call 13 13 34.
Please note that the following list is not exhaustive (i.e. each category may not contain every item number available). If in doubt, please call us on 13 13 34.
Private health insurance is about having choice and access, and being in control of your situation. It's the only affordable way to choose your own hospital, your own doctor and your own timeframe. Just as extras cover is the only option if you want to pay less for dental, physiotherapy, optical, chiropractic and all the other every day health services not covered by Medicare. Currently almost 8 million Australians (40%) have private health cover.
Doctor of your choice You get to choose your doctor, which means peace of mind.
Avoid waiting lists You can access the HCF network of Participating Private or Public hospitals.
If you need an urgent operation or medical treatment, you won't need to go on a waiting list. Our hospital cover will quickly get you into a private hospital so you can spend your time getting better, not waiting for surgery and a bed.
Our generous benefit limits for extras like dental, optical, chiropractic and physiotherapy services will keep more money in your pocket and help you to achieve a better level of health.
Take advantage of government incentives You can avoid having to pay the Lifetime Health Cover loading if you take out cover before you turn 31. Loading adds an additional 2% to the cost of your hospital premiums for every year after you turn 31.
In addition, the Government pays a minimum of 30% towards your health insurance premium known as the 'Federal Government Rebate'.
Reduce your tax Reduce your tax by taking out private hospital cover and not having to pay the Medicare Levy Surcharge (an extra 1% tax). Go to www.ato.gov.au for full details.
The Private Health Insurance Ombudsman produces an annual State of the Health Funds Report to assist consumers in assessing the relative performance and service delivery of each of the health funds. This report can be accessed at www.phio.org.au. The Ombudsman can also be reached on 1800 640 695, or by writing to Suite 2202, 580 George St, Sydney NSW 2000
HCF supports the Private Health Insurance Code of Conduct ensuring:
A full copy of the code is available at www.privatehealth.com.au/codeofconduct
HCF supports the Private Patients Hospital Charter, which outlines what members can expect from doctors, hospitals and their health fund. Copies of the Charter are available by phoning 13 13 34 or at www.phiac.gov.au
If you are single and earn more than $77,000 a year or a family or couple earning more than $154,000 a year (increasing by $1,500 for each dependent child after the first), avoid the additional 1% Medicare Levy Surcharge simply by having HCF hospital cover.
The Pharmaceutical Benefits Scheme (PBS) is a Government scheme which helps pay for pharmaceutical items. Non-PBS drugs are those that are not listed under the scheme. If your doctor prescribes drugs that are not covered by the PBS but are approved by the Therapeutic Goods Administration (TGA) and are on the HCF approved list, you can claim a benefit for the difference between the actual cost of the item and the maximum PBS specified charge.
HCF has an extensive network of service providers and private hospitals throughout Medical Gap The Australian Government subsidises medical services listed on the Medicare Benefit Schedule (MBS). However, when a doctor charges a fee higher than the MBS, it's referred to as the 'medical gap'. HCF has negotiated 'no gap' or 'known gap' services with thousands of doctors across Participating Hospital An HCF participating hospital is a private hospital where specific charges have been negotiated by HCF for accommodation and other services, so you will not have any additional charges for these services. Per night excesses, co-payments and conditions relating to your hospital cover will still apply in any HCF participating hospital. However, you may still have to pay for doctor's bills if the doctor does not participate in a Gap scheme. Example You may be charged $110 for a procedure in a non-participating hospital in SA. The average charge in NSW is $100. Therefore, HCF would pay the Member $100, meaning you are $10 out-of-pocket.
Many doctors who charge above the MBS fee are now participating in HCF's no medical gap arrangements. This means you will not have to pay any gaps for the in-hospital medical services they provide for you which could save you thousands of dollars. The easiest way to find out if you can benefit from this arrangement is to ask your doctor(s) in advance whether they participate in the HCF no medical gap arrangement. As an HCF member you also have the right to choose the doctor who treats you. HCF provides details of the doctors who participate in our no gap arrangements. If you choose a doctor who doesn't participate in the no medical gap arrangement, then there may be a medical gap payment that you may have to pay for.
Should any problem arise concerning your HCF membership, contact us directly so that it can be resolved as quickly as possible. An Internal Dispute Resolution officer has been appointed to independently review complaints. If your complaint is not dealt with satisfactorily, you can contact the Private Health Insurance Ombudsman, an independent body formed to help resolve complaints and provide advice and information. The Ombudsman can be reached on 1800 640 695, or by writing to Suite 2202, 580 George St, Sydney NSW 2000. HCF also supports the Private Patients Hospital Charter, which outlines what members can expect from doctors, hospitals and health funds. Copies of the Charter are available by phoning 13 13 34.
Medicare is Australia's public health system. It covers all Australian citizens and permanent residents. Medicare is partly funded by a levy on taxable income. It covers public hospital treatment and doctor services.
You'll often find public hospitals have long waiting lists - especially for non-urgent operations. In addition, as a Medicare patient you cannot choose the doctor you want. A doctor chosen by the public hospital you attend will treat you. Medicare does not cover ambulance costs.
While Medicare is acknowledged as one of the world's best public health systems, it only covers things like:
There are circumstances where you may be entitled to an increased Government Rebate. The Savings Provision Entitlement ensures that people remaining on a policy that has been eligible for the 35% or 40% Government Rebate do not have their rebate amount reduced to 30% when the person aged 65 years or over leaves or cancels the policy. The Savings Provision Entitlement only applies when the person 65 years or over leaves or cancels the policy after 1 April 2005. Anyone who is aged under 18 or a full-time student under the age of 25 at the time the person leaves the membership cannot inherit the 35% or 40% Rebate.
The Federal Government Rebate helps make private health cover more affordable by subsidising your premium. Rebates are 30% for people under 65, 35% for people aged 65-69 and 40% for those 70 and over. You can take this rebate as a discount on your premium, as a tax return or as a cash rebate from a Medicare office.
The Federal Government's Rebate is available to everyone who is eligible for Medicare and has private health insurance.
You can claim the Government Rebate as a reduction on your premium paid to HCF (this requires a completed Government Rebate Application form), as a refund from a Medicare office (on presentation of a HCF contribution receipt), or as a rebate through your annual tax return.
According to the Lifetime Health Cover initiative those who take out Hospital cover before the age of 31 and keep it can maintain lower premiums. From 1 July following your 31st birthday, you will pay 2% more for each year you don't have hospital cover. If you're already over 31, take out hospital cover as early as possible to avoid paying any extra.
Statements are generally mailed out to members during the first two weeks of July.
If you are an existing member, or have held private health insurance with HCF during the last financial year, we will automatically mail you a Tax Statement.
Tax Statements include details of all payments processed by HCF up to and including 30 June. This means that we cannot begin processing them until after that date. Also, as you can well imagine, it takes some time to process all statements. However, rest assured that we endeavour to get Statements out to all members as quickly as possible. We will mail it to you by mid-July.
You may need it to complete your Tax Return. Your Tax Statement will have details of the number of days you have been covered by an appropriate level of patient hospital cover during the last financial year. If you did not have an appropriate level of private patient hospital cover for the full financial year and you fall within certain income brackets, you may be liable for the Medicare Levy Surcharge. Your statement will also outline premium reductions you have received due to the Federal Government's Rebate on Private Health Insurance as well as details of any additional rebate you may be able to claim as part of your Tax Return.
If you are an existing member, you will also get a Summary of Cover. This statement provides a summary of your current Lifetime Health Cover status as well as an overview of your current level of cover.
No. The Summary of Cover is for your personal records only.
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