Great-fitting health cover that costs you less

We know how important price is to young people and families when it comes to health cover.

So we’ve managed to lower the cost of our new Budget cover by stripping out the things you’re unlikely to need.

Leaving in all the things you do need.

Like... dental. Optical. Physio. Chiro. Remedial massage. Acupuncture. Accident-related hospital treatment, and much more.

Plus, you’ll have access to HCF’s huge range of health support services. Everything from health coaching to weight loss and stress management programs.

Pregnancy services?

No!

Hearing aids?

Don’t think so!

Hip replacements?

Definitely not!

Service

Annual limitsAnnual limits are per person unless otherwise specified. They are also not indications of the benefits you’ll receive for individual treatments.

Waiting periods

Dental

Diagnostic and preventative

2 check-ups, 2 scale and clean, x-rays and 1 fluoride treatment per year.
Other service and item limits apply.

2 months

Restorative (e.g. Fillings)

$400

Oral surgery (e.g. Tooth extractions)

$300

12 months

Endodontic services (e.g. Root canal)

Periodontic services (e.g. Gum treatment)

-

Orthodontics (by an Orthodontist)

$250 - $1,500

Dentures

-

Crowns, bridges and implants

-

Optical

Spectacles and Contacts

$180

2 months

Therapies

Physiotherapy, group physiotherapy and hydrotherapy

$500
Sublimit of $250 each for chiropractic, osteopathy and exercise physiology. $200 combined for speech pathology and occupational therapy

2 months

Chiropractic, osteopathy and exercise physiology

Occupational therapy

Speech pathology

Audiology

-

Dietetics

-

Podiatry consultation

-

Psychology (After Medicare exhausted)

-

Acupuncture and Chinese herbal medicine consultation

$100
(Within $500 overall limit for therapies)

Remedial massage and myotherapy

Naturopathy and nutrition consultation

-

Alexander technique

-

Homoeopathy

-

Others

Pharmacy (HCF approved, non-PBS)

$500

2 months

HCF approved health management programs (e.g. Weight management course)

-

6 months

School accident cover (Approved services)

$400

2-12 months

Hearing aids

-

24 months

Travel and accommodation

-

2 months

Artificial aids (Approved appliances e.g. CPAP machine)

-

12 months

What's covered

What's not covered

What's covered to a limited extent

Minimal benefits

If you choose a product which has Minimal Benefits for some procedures (such as pregnancy and birth- related services), then you’ll be covered in a public hospital shared room, but your private hospital costs won’t be fully covered.

This means you may face significant personal expenses if you have any of these procedures in a private hospital.

For procedures attracting Minimal Benefits in a private hospital, HCF would:

  • Pay a small amount towards your accommodation;
  • Pay for government approved prosthesis list items; but
  • Not pay operating theatre expenses, or labour ward charges.

In addition, there are some services where doctor’s charges are not payable (for example, elective cosmetic surgery and surgery by an accredited podiatric surgeon). For these, HCF will only pay a very small amount towards the total cost of the procedure (and no doctor’s charges). This only applies to services which do not attract a benefit from Medicare.

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These things are covered in a public or HCF Participating Private Hospital:

  • Accommodation
  • Operating theatre, intensive care
  • Prosthesis for covered services100% cover for Government approved Prostheses for covered services. There are a small number of prostheses that will attract a personal expense to you.
  • Physiotherapy100% for HCF participating private hospitals or $20 up to $500 per year for non-participating private hospitals.
  • Pharmaceuticals in hospitalsDirectly associated with the reason for admission, excluding experimental and high cost non-PBS drugs.
  • Ambulance100% cover for emergency ambulance (State Government services) for road, air or snow ambulance, to the nearest hospital that can provide you with the care you need.
  • All other services
    (unless shown on the right)

The following exclusions apply on this level of cover:

  • Heart surgery1
  • Cataract and other lens related surgery
  • Dialysis for chronic renal failure
  • Gastric banding & obesity surgery
  • Total hip and knee joint replacement surgery
  • Pregnancy and birth related services
  • Assisted reproductive services (e.g. IVF, GIFT)
  • Spinal fusion, spinal scoliosis and disc replacement surgery
  • Cochlear implant surgery and bone anchored hearing devices2
  • Insulin pump treatments3
  • Psychiatric services
  • Rehabilitation services
  • Palliative care

Exclusions

The following services are excluded on this level of cover:

  • Heart surgery1
  • Cataract and other lens related surgery
  • Dialysis for chronic renal failure
  • Gastric banding & obesity surgery
  • Total hip and knee joint replacement surgery
  • Obstetric services, i.e. Pregnancy and birth related services
  • Assisted reproductive services (e.g. IVF, GIFT)
  • Spinal fusion, spinal scoliosis and disc replacement surgery
  • Cochlear implant surgery and bone anchored hearing devices2
  • Insulin pump treatments3
  • Elective cosmetic surgery and podiatric surgery




This means if you need treatment for any procedures listed above, you will not receive any benefits from HCF towards your hospital and medical costs and you may have significant out-of pocket expense. Please ensure you have reviewed the exclusions list before purchasing this product.

If a service is not covered by Medicare there will be no benefit payable on your hospital cover so you should always check with us to see if you’re covered before receiving treatment.