• For a lower level of cover, you will be entitled to the benefits applicable under your new level of cover immediately.
• For a higher level of cover, you will be entitled to the benefits applicable under your old level of cover for the first 12 months. You will need to serve the necessary waiting periods for higher benefit entitlements.

Log into our member section where you can change your address, phone numbers, and email address. Alternatively call HCF on 13 13 34, email service@hcf.com.au or visit one of our branches.

Call HCF on 13 13 34, email service@hcf.com.au or visit one of our branches.

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

• Make sure your contributions are paid up to the date of service
• 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 contributor's or nominated partner's signature must appear on the claim form
• An HCF Recognised Provider 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.

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?

• Yes - Then there's no need to visit Medicare. They will send the bill directly to HCF.
• No - Just take your bill to either Medicare or HCF and complete a Medicare 2 way form.

Here are some 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, 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 by mail

Pick up a claim form from a branch, download one or call 13 13 34 to have one mailed to you.

You then need to:

• Complete and sign the claim form, attaching 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 GPO BOX 4242, Sydney, NSW, 2001
• We will post you a cheque or credit your nominated bank account if the receipt is attached to the form. If there is no receipt, we will draw a cheque to the person or organisation that provided the service
• A statement will be sent to you for your records.

3. 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.

      The Policy holder and their Partner listed on the policy may collect cash or direct debit.*

* All other dependants presenting a claim require a claim form signed by the Policy holder or their Partner listed on the policy before the claim can be paid.

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. Queensland and Tasmanian residents are covered under their state ambulance scheme.

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

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.

Some levels of HCF cover pay 'minimal 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 'minimal benefits', you should consider a higher level of cover to help reduce your out-of-pocket expenses.

All HCF hospital covers allow you to claim for the following expenses:

• Overnight and same day accommodation charges, less your excess (if applicable)
• Operating theatre and critical care fees
• Intensive care and Neo-natal intensive care
• Coronary care
• Prostheses (up to the amount on the Government Approved Appliances List)
• Emergency ambulance cover

Depending on your level of cover, you may also be able to claim for the following services:

• Psychiatric services
• Pregnancy and birth related services
• Assisted reproductive services (e.g. IVF and GIFT)
• Total hip and knee joint replacement surgery
• Cataract and lens related surgery
• Dialysis for chronic renal failure
• Cosmetic surgery
• Surgery by an accredited podiatrist

Please note that some services listed above will only attract 'minimal benefits', which means there may be additional out-of-pocket expenses for these services in a private hospital.

All HCF hospital covers exclude:

• Procedures normally performed in a doctor's surgery or as an outpatient
• Medical gap benefits and hospital benefits where the medical claims is not approved for payment by Medicare Australia.
• Surgery by an accredited podiatrist or cosmetic surgery - no medical benefits apply and only reduced hospital benefits available
• Nursing home-type patients are limited to benefits set by the Commonwealth Department of Health and Ageing
• Private room accommodation for same day procedures
• Luxury room surcharge
• Personal convenience items, e.g. phone calls, newspapers, magazines and beauty salon services etc
• Massage and aromatherapy services
• Respite care
• Take home items, e.g. crutches, toothbrushes and drugs
• Experimental treatments
• Private hospital emergency room fees
• Donated blood and blood products and blood collection and storage
• Special nursing, i.e. your own private nurse
• Pharmaceuticals (including PBS pharmaceuticals benefits) and other sundry supplies not directly associated with the reason for admission
• Some services provided while in hospital by non-hospital providers
• Telephone or online consultations
• Experimental and high cost non-PBS drugs
• All PBS pharmaceutical benefits in non-participating hospitals

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:

• Diagnostic and preventative dental
• Restorative dental (fillings), oral surgery, endodontic services
• Orthodontics
• Dentures, crowns and bridges (dependent on level of cover)
• Optical
• Chiropractic, physiotherapy, hydrotherapy and osteopathy
• Occupational, speech pathology
• Pharmaceutical (HCF approved - non-PBS)
• School accident cover
• Natural therapies: homoeopathy, naturopathy
• Home nursing
• HCF approved artificial aids
• Hearing aids
• HCF approved Health Management Programs

Conditions applying to Extras cover

• HCF does not pay a benefit greater than the charge levied to the claimant.
• Travel and accommodation benefits are only claimable for medically necessary hospital or specialist services that are not available locally. Accommodation is claimable up to a maximum of $30 per night.
• Artificial Aids and Hearing Aid: Depending on the aid or appliance you require, benefits do not necessarily renew every year. Please check with us before you incur any costs.

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 full cover for emergency ambulance services with State Government road or air services where you require hospital or on-the-spot treatment in Australia.

You'll also be covered for State Government non-emergency ambulance services where your doctor requests ambulance transport because your condition requires monitoring and support in transit (up to $5000 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

The Policy holder, their Partner and Dependants listed on the policy. Only the Policy holder can determine who is covered under a membership.

Cover for your dependants

Your children are automatically covered at no extra cost under your family cover until the day before they turn 22.

If your children are full-time students, simply register them as Student Dependants at the start of each academic year, and they will be covered for no extra cost until the day before they turn 25.

If your children are not full-time students, you can also continue to cover them until they turn 25 with Extended Family Cover, available on certain levels of HCF cover. Otherwsie, your grown children will need to take out their own 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.

Single Parent Family cover

The Policy holder and their dependants listed on the policy.

Single parent families receive a reduction (approximately 20%) on their hospital and Extras cover. This reduction in premium is only available on certain levels of HCF cover.

Couples cover

The Policy holder and their Partner listed on the policy.

Singles cover

The Policy holder only

Be aware of these circumstances, which will prevent payment of a claim:

• Lodgement of a claim two years or more after the date of service.
• When you or your dependants have the right to recover costs from a third party or authority, either by law or by statute, or from any insurance or employment benefit schemes.
• Treatment for pre-existing ailments or conditions (within first 12 months).
• Benefits for any period during which your payment is in arrears by more than two months or your membership is suspended.
• Treatment that HCF, after receiving independent medical or clinical advice, deems inappropriate.
• Hospital and general treatment benefits are not payable in respect of any service where the treatment does not meet the standards in the Private Health Insurance (Accreditation) Rules 2008.
• Telephone and/or online consultations are not covered by Hospital or Extras cover unless you are participating in our My Health Guardian program.

In addition, HCF hospital cover does not include:

• Medical Gap and hospital benefits for excluded items or procedures and/or when the claim is not approved for payment by Medicare Australia
• Private room accommodation for same-day procedures
• Experimental treatments
• Experimental and high cost non-PBS drugs
• Procedures normally performed in the doctor’s surgery or as an outpatient
• Private hospital emergency room fees
• Respite care
• Nursing home-type patients are limited to benefits set by the Commonwealth Department of Health and Ageing
• Special nursing i.e. your own private nurse
• Luxury room surcharge
• Donated blood and blood products and blood collection and storage
• PBS pharmaceutical benefits in non-participating private hospitals
• Pharmaceuticals (including PBS pharmaceuticals benefi ts) and other sundry supplies not directly associated with the reason for admission
• Take home items e.g. crutches, toothbrushes and drugs
• Personal convenience items e.g. phone calls, newspapers, magazines and beauty salon services
• Massage and aromatherapy services
• Some services provided while in hospital by non-hospital providers
• Where a service is excluded from the payment of benefits in a hospital, any associated items (e.g. medical gap, prosthesis, pharmacy) are also excluded
• The gap on government approved gap-permitted prosthesis items.

In addition, HCF Extras cover does not include:

• Psychological and developmental assessments. Where psychology is included in your cover, psychology treatment is only payable when Medicare Australia entitlements are exhausted.
• Goods and services while a hospital patient except for eligible oral surgery.
• Pharmacy items that are not on our Approved Pharmacy list e.g. items listed on the PBS, items prescribed without an illness, items that are available without a prescription, or items that are not TGA approved.
• Goods or services that had not been provided at the time of claim e.g. pre-payment.
• Fees for completing claim forms and/or reports.
• Goods and/or services received overseas or purchased from overseas including items sourced over the internet.
• Where no specific health condition is being treated.
• Routine health checks, screening and mass immunisations.
• More than one therapy service performed by the same provider in any one day.
• Co-payments and gaps for government funded health services e.g. the co-payment for PBS items
• Where a provider is not in an independent private practice.
• More than one of the following therapies received on the same day (physiotherapy, chiropractic and osteopathy).
• Claims that do not meet our criteria.

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 on selected levels of HCF 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.

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're between 22 and 25 years, you can continue to be covered under "Extended Family Cover". It simply requires an extra cost of 25% on top of your family's current 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.

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.

Your excess you pay will depend on the level of cover and excess you choose.

If hospitalised, the total excess amount will only apply once per person in a calendar year, and dependant children are exempt. You'll save even more as you won't pay any excess for accidents with HCF.

Log in to the member section of the HCF website and search for your closest Participating Hospital or Health Professional (e.g. Dentist or Therapist) by selecting your state.

An HCF recognised provider must fulfil certain criteria set in place by HCF. Qualifications are carefully assessed in order to ensure a high standard of service is provided to its members.

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.

You should also visit the 'Going to Hospital?' section of our website for more information on common hospital procedures.

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:

• Overnight and same-day accommodation
• Operating theatre and critical care fees
• Supplied pharmaceuticals directly associated with the reason for admission (including the Pharmaceutical Benefit Scheme benefits)
• Allied services such as physiotherapy, occupational therapy and dietetics
• Surgically implanted Government recognised prostheses
• Emergency Ambulance Cover

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

If you go into a private hospital, Medicare will cover a portion of your medical treatment costs, but not a cent of your accommodation and theatre expenses. The only way to cover yourself for those bills - which generally can be quite expensive - is with HCF hospital cover.

Our hospital cover contributes to the portion of treatment costs not covered by Medicare:

• The Government sets a dollar amount for types of in-hospital medical treatment, known as the "Schedule Fee"
  Medicare pays 75% of the Schedule Fee
  HCF Private Hospital Cover pays the remaining 25%
• Some doctors and specialists charge more than the Schedule Fee. The difference between the two is the "gap", which is normally up to you to pay, but if your doctor or specialist is recognised by HCF, they agree with us to charge you either no gap or a maximum 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 name of the member participating in the program
• The type of program
• Who is providing the program
• Where the program takes place (address)
• Start and completion dates of program

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.

The Health Management benefit is available on selected levels of HCF cover, and has a 6 month waiting period. Before you start on any program please contact us on 13 13 34 to ensure you are eligible for a benefit.

You can claim for:

Exercise regimes and gym membership fees

For an exercise program to address or improve a specific medical condition that your doctor has prescribed. Your GP is required to fill out an HCF Exercise & Gym benefits authorisation form.

Childbirth Education

A program provided by a childbirth educator or qualified health professional (such as a midwife or nurse).

Diabetes Association membership fees

For information about diabetes, you can contact Diabetes Australia.

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.

You can join:

• Online
  Choose the cover that's right for you, and then complete the online application form. You will even have the option to make your first payment online.
• Mail
  Mail your completed application form to HCF, GPO BOX 4242, Sydney, NSW, 2001 Or fax it to us, at: 1800 045 563
• Phone
  call 13 13 34

At HCF, we are dedicated to helping members choose the right cover. If you would like assistance with choosing your health cover you can:

• use the various tools available on the HCF website
• call HCF on 13 13 34
• or visit a branch

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.

Depending on the hospital product you choose, HCF may cover some procedures in a public hospital, and pay a small amount towards these in a private hospital. This means you may face significant out of pocket 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 in a private hospital;
• Pay for any Government approved no-gap prostheses (if required); and
• 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 podiatrist). 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.

Depending on the hospital product you choose, HCF may cover some procedures in a public hospital, and pay a small amount towards these in a private hospital. This means you may face significant out of pocket expenses if you have any of these procedures in a private hospital. For procedures attracting minimum benefits in a private hospital, HCF would:

• Pay a small amount towards your accommodation in a private hospital;
• Pay for any Government approved no-gap prostheses (if required); and
• Not pay operating theatre expenses, or labour ward charges.

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 payment authority form

Ezipay (credit card)

Arrange for your bank, building society or credit union to make your payments automatically by direct debit from your credit card. Download payment authority 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.

Payroll deduction

Payroll deduction is an automatic payment from your wages or salary. If your employer participates under an HCF Payroll Scheme, you can arrange to have your contributions paid directly from your salary or wages.

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 13 34.

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, Sydney, NSW, 2001
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.

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

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 there is any doubt as to whether an ailment or condition is pre-existing, a medical practitioner appointed by HCF will examine information provided by your doctor, together with other relevant claim details.

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 minimal benefits are paid on the lower levels of cover. You need to ensure you are on an appropriate level of cover at least 12 months prior to giving birth. 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.

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

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.

There are some services where doctor’s charges are not payable (for example, elective cosmetic surgery and surgery by an accredited podiatrist). 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.

Yes - you're covered throughout Australia. On selected levels of cover, HCF members who live in isolated and rural communities can claim travel benefits where specialist medical and hospital treatment is not available locally. If you're intending to move interstate permanently, please give us a call on 13 13 34 to change your contact details.

No - your HCF cover is only effective in Australia.

We recommend taking out Travel insurance whenever you travel overseas. As an HCF member, you're entitled to a 10% discount on travel insurance . HCF Travel Insurance is issued by HBF Insurance Pty Ltd.

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).

If you do that, then you are considered to be without private hospital cover for that period. Accordingly, you may be liable for the MLS if your taxable income exceeds the relevant threshold.

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.

By maintaining your private patient hospital cover in Australia, you will not be liable for MLS for that period overseas.

Switching to HCF is easy. Choose your cover and receive a quote. Then, fill out your application and the Interfund Transfer. We'll do the rest for you (including contacting your previous fund).

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.

Waiting periods must be served before benefits are paid. They apply to:

• New members.
• Existing HCF members who upgrade to a higher level of cover or reduce excess payable. In this case, you need to serve the necessary waiting period for the higher benefit entitlement.
• Members who switch from another fund who have not already completed the required waiting period for equivalent benefits.
• New dependants, unless they switch from another fund where they have completed the required waiting period for equivalent benefits.
• Treatment of a pre-existing ailment.

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.

Waivers are only available to new members taking both Hospital and Extras cover.
For example, if you join under a promotional waiver for two month waiting periods, you will only be able to instantly access those services that have waiting periods that are two months or less. Waiting periods of more than two months will still apply.

Psychiatric, rehabilitation and palliative care services which have a two month waiting period, as well as pregnancy & birth-related services and any pre-existing conditions, are excluded from all/any waiver offers.

*Correcting grinding or biting on surface of teeth.

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.

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.

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.

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:

• You will receive correct information on private health insurance
• You are aware of the internal and external dispute resolution procedures
• You can make an informed decision about your purchase through informative policy documentation
• You are protected in accordance with privacy principles

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

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.

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:

• Treatment at general and specialist practitioners
• Treatment at public hospitals
• A portion of the cost of medical treatment in private hospitals by surgeons, anaesthetists and other specialists

• Hospital cover covers hospital accommodation and theatre fees at private hospitals and emergency ambulance travel
• Extras cover covers day-to-day health services not covered by Medicare, such as dental treatments, physiotherapy, natural therapies and so on

If you are single and earn more than $80,000 a year or a family or couple earning more than $160,000 a year (increasing by $1,500 for each dependent child after the first) in the 2011/12 Financial year, 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 where you have extras cover. Where you are covered, HCF will pay up to the cost in excess of the current PBS fee for all HCF approved non-PBS drugs.

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.

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 have any questions about the rebate, please call the Australian Taxation Office helpline on 132 861.

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.

HCF has an extensive network of service providers and private hospitals throughout Australia, where specific charges have been negotiated for your benefit.

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 Australia, so ask your doctor if they are able to participate in a no-gap scheme with HCF. This will help minimise your of out-of-pocket expenses for doctors and specialists fees in hospital. Always ask your doctor to detail their charges (and any out-of-pocket expenses) before going to hospital.

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.

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 'First time users' 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.

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.