What do I need to know before I claim?
- Make sure your contributions are paid up to the date of service
- You must have served the relevant waiting period – for example there is a twelve month waiting period before you can claim for a pre-existing condition
- You can't lodge a claim before the service has been provided
- Claims must be lodged within 2 years of the date of service
- The Policyholder's or nominated partner's signature must appear on the claim form
- An HCF recognised health practitioner must provide the service
- Claims for artificial appliances approved by HCF may need a letter of authorisation
from the practitioner, stating the condition being treated. If you would like to
claim for an artificial appliance please call us on 13 13 34
to find out if you need a letter from your practitioner
- Submit original accounts (not photocopies) detailing the date of service, the item
number, the description of service and the cost
- Claims relating to school accident cover must be made within 12 months of the date
of the accident.
Doctor and Specialist claims during hospital admission
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.
If you are admitted into 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.
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 your excess and any gap payment directly to the hospital.This usually
occurs at the time of departure, however, check with your hospital to make sure.
Please check with the hospital whether you have to pay this upon admission or if
they bill you.
If your doctor or specialist treated you under the HCF Medicover agreement, they will send the bills directly to HCF.
If your doctor or specialist sends the bills to you, please take it to Medicare and complete a Medicare Two-Way form and drop into an HCF branch and complete a Medicare
claim form and an HCF claim form.
Did your doctor or specialist treat you under the HCF Medicover agreement?
- Yes - Then there's no need to visit Medicare. They will send the bill directly to
- No - Just take your bill to either Medicare or HCF and complete a Medicare Two Way
form and a Medicare form.
Here are the ways to claim payments for extras:
1. On the spot
This is your most convenient way to claim for some services such as visiting your
optometrist, dentist(claims for orthodontic treatment must be submitted by mail
or at a branch), physiotherapist, chiropractor, osteopath, speech pathologist, occupational
therapist, dietician or podiatrist. Using 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. Photo claiming with the HCF app
Download the HCF app to your personal device to submit a claim with a photo of your
3. Claim by post
You can pick up a claim form from any branch,
download one or call Self Service on 13 13 34 and
we’ll post or email one to you.
- Complete and sign the claim form and, attach the original receipts (the receipts
must have the name and address of the provider printed or stamped on them, not handwritten)
- Post the form to HCF at GPO BOX 4242, Sydney, NSW, 2001
- We will post you a cheque, or credit your nominated bank account if the receipt
you’ve attached shows that you’ve paid the provider. If there is no receipt attached
to the claim form, and only an account, a cheque will be drawn to the person or
organisation that provided the service.
- We'll also send you statement for your records.
4. Claim in person
You can make a claim at any HCF branch by presenting your membership card and original
receipts. The name and address of the health care provider must be printed or stamped
on the receipt, not handwritten. We will credit to your nominated
bank account, and give you a statement for your records.
5. Claim online
You can claim online for popular Extras like general dental, dietetics, occupational
therapy, podiatry, podiatry, homeopathy, speech pathology, remedial massage, naturopathy
To claim these online follow these steps:
- If you are a first time user of the HCF Member Section, please select the ‘Register
now’ link on the login page.
- If you currently have access to the HCF Member Section, you will need to log in
and select the 'Make an online claim' link.
When you have completed your online claim, please ensure that you post the original
receipts, otherwise future claims may be delayed.
Medicare doesn’t cover the cost of an ambulance and these services can be very expensive.
HCF hospital and extras products include cover for State Government emergency ambulance services.
Plus, on selected levels of cover, you may also be able to claim up to $5,000 per person, per year for non-emergency,
medically necessary State Government ambulance transport i.e. where your doctor requests ambulance transport because
your condition requires medical monitoring and support in transit.
Ambulance transport is to the nearest appropriate hospital able to provide the level of care you need. There is a waiting
period of one day for emergency ambulance cover, 2 months for non-emergency ambulance cover and 12 months for pre-existing
ailments or conditions.
NSW and ACT members
If you live in New South Wales or Australian Capital Territory, a levy is included in the hospital component of your private health cover.
This levy entitles you to free ambulance transport under the State Government ambulance transport schemes. So, if you receive an invoice for
ambulance transport, just send it to us; we will endorse the account and send it to the appropriate ambulance transport scheme for settlement.
Members with pension or social security entitlements in NSW or the ACT just need to complete that section on the back of the ambulance account
and return it to the ambulance service.
If you fall outside the state based arrangement for ambulance services and aren’t otherwise covered, you can claim under your HCF product for State
Government provided emergency ambulance services.
QLD and TAS members
If you live in Queensland or Tasmania, you’re covered under your state ambulance service scheme. If you fall outside your state based arrangement and aren’t
otherwise covered for emergency ambulance services, you can claim under your HCF product for State Government provided emergency ambulance services.
VIC, SA, NT and WA members
If you live in Victoria, South Australia, the Northern Territory or Western Australia and you don’t have an ambulance subscription with your state ambulance
service and aren’t otherwise covered (including under other state based arrangement e.g. where the State Government has made a provision for free ambulance
services for aged pensioners) you can claim under your HCF product for State Government provided emergency ambulance services.
How do I claim for doctor and specialists’ medical accounts when I have been in hospital?
How do I make an online claim?
Log into online member services and select ‘Make an online claim’.
What can I claim online for?
You can claim online for:
- Diagnostic Dental
Pharmaceutical (non-PBS, limited items available)
Peak Flow Meter
Where can I find information on More for you program providers?
You will need to take your account to Medicare and complete a Medicare Two Way claim form.
For more information and to download a Two Way claim form, go to http://www.humanservices.gov.au
You can search for recognised ancillary (extras) providers in your local area by logging into member section the
member section and following the
links to Find a Health Professional. Here you can search for specialist doctors, More for Muscles program physiotherapists,
More for Backs program chiropractors or osteopaths, More for Teeth program dentists, More for Eyes program optical providers,
More for Feet program podiatrists and online optical providers.
Alternatively you can call HCF on 13 13 34.