AUSTRALIA'S FIRSTCOMPLETE PREGNANCY COVER

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NO OUT-OF-POCKET COSTS* FOR YOUR ENTIRE PREGNANCY AT SYDNEY ADVENTIST HOSPITAL

  • Care under a participating obstetrician, including birth management fee.
  • Anaesthetist costs, including any out of hours services.
  • Delivery suite, theatre costs and ward accommodation.
  • Diagnostics (ultrasounds and pathology provided at Sydney Adventist Hospital and San Ultrasound for Women).
  • Paediatric consultation following birth.
  • Natural and caesarean births.
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AM I ELIGIBLE?

HCF's No-Gap Pregnancy package is available to expectant mothers who have:

  • a valid Medicare card
  • served the waiting period for pregnancy and birth related services by the date of the baby's birth.

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ALREADY HAVE PREGNANCY COVER WITH A DIFFERENT HEALTH FUND?

No problem. As long as you have previously served all waiting periods for hospital cover with pregnancy and birth related services by the birth date of your baby, we can easily switch your health cover to HCF. Your new HCF cover will need to include pregnancy and birth related services to make sure you can get our No-Gap Pregnancy package.

New eligibility requirements from 1 December 2021
From 1 December 2021, eligible members will be required to have held HCF hospital cover with pregnancy and birth related services for 12 months by baby's birth date to access the HCF No Gap Pregnancy package. 

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HOW DO I ACCESS THE PROGRAM?

If you’re an eligible member^ here’s what you need:

  • Obtain a referral from your GP to a participating obstetrician, or visit the Sydney Adventist Hospital website to find a participating obstetrician and contact them to discuss your eligibility.
  • To make sure you have no pregnancy out-of-pocket costs, you’ll need to be accepted into the program by a participating obstetrician.
  • Any services or appointments prior to being accepted into the program are not included and you'll incur these as out-of-pocket costs.
  • If you’d like to chat about your eligibility, please call HCF on 13 13 34.

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SYDNEY ADVENTIST HOSPITAL: PROVIDING UNCOMMON CARE

As a not-for-profit hospital, the San is always striving to offer the best possible care to patients. They understand that private maternity care can be expensive, and would like as many people as possible to be able to access the wonderful service they provide.
 
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Joining and eligibility

Who is eligible to join the package?
HCF No-Gap Pregnancy package is available to expectant mothers who have:

  • a valid Medicare card
  • served the waiting period for pregnancy and birth related services by the date of the baby’s birth.

New eligibility criteria starting 1 December 2021 require members to have held pregnancy and birth related cover with HCF for 12 months by the date of your baby’s birth. Availability is subject to the individual participating obstetrician's capacity and early bookings are encouraged. 

The HCF No-Gap Pregnancy package is not available to Overseas Visitors Health Cover members. Services are only eligible once you’re an HCF member and meet the eligibility requirements.

How do I access the program?
You will need to have an HCF policy with pregnancy and birth related cover, and obtain a referral from your GP to a participating obstetrician at the Sydney Adventist Hospital.

From 1 December 2021, you’ll also need to have held pregnancy and birth related cover with HCF for 12 months. To make sure you have no pregnancy out-of-pocket costs, you’ll need to be accepted into the program by a participating obstetrician. Any services or appointments prior to being accepted into the program are not included and you’ll incur out-of-pocket costs.

Please call HCF on 13 13 34 to check your eligibility and visit the Sydney Adventist Hospital website to make an appointment.

From 1 December 2021, what happens if I’ve served my 12 month pregnancy and birth related services waiting period, but haven’t been with HCF for 12 months, can I still go to the Sydney Adventist Hospital to have my baby?
Yes, you’ll still be able to attend Sydney Adventist Hospital for pregnancy and birth related services and receive benefits that would ordinarily apply at our network hospitals, but will not be eligible for the No-Gap Pregnancy package and out-of-pocket costs will apply.

If I was accepted into the HCF No-Gap Pregnancy package prior to 1 December 2021, does the new eligibility requirement affect me?
No, but the normal pregnancy and birth related services waiting period applies. As long as you've been accepted into the program by a participating obstetrician and have served your 12 month pregnancy and birth related services waiting period by the baby’s date of birth, you'll still be able to access the HCF No-Gap Pregnancy package.

How do I find a participating obstetrician?
For a list of participating obstetricians, please refer to the Sydney Adventist Hospital's website.

What happens if this program ends?
If the program ends and you’ve been accepted into the program by your referring obstetrician prior to the program ending, HCF will honour its commitment to ensure a no-gap experience for your pregnancy and birth.

How do I know if I’m under the right HCF cover?
Please log in to online member services to check your cover details.

If you need to upgrade your cover, call us on 13 13 34 or visit your local branch.

What’s included

What pregnancy out-of-pocket costs will I have?
Members participating in the program will not experience any pregnancy out-of-pocket costs, apart from any policy excess payable (for example, if you're claiming for the first time that calendar year you may need to pay an excess).

If the member seeks additional services, fees may apply. Please speak with the participating medical provider to confirm and ensure a valid Informed Financial Consent is given to you.

Can my partner stay with me in the hospital?
Yes, your partner can stay with you overnight as a carer (but not as an admitted patient), but the HCF No-Gap Pregnancy package doesn’t cover any costs your partner may incur while staying with you at hospital (for example, meal costs). These costs will need to be paid by you and/or your partner to Sydney Adventist Hospital on discharge.

Please refer to the Sydney Adventist Hospital website or contact the Sydney Adventist Hospital for further information.

What is covered with obstetrician fees and management fees?
Participating obstetricians will be providing their standard model of care for all patients. Check with your medical provider to confirm with them their planned consultations and any other services.

How do I make sure I have a no-gap experience?
Please take the following steps to be included in the HCF No-Gap Pregnancy package, Swaddle, at the Sydney Adventist Hospital and to make sure that you’re bulk billed throughout your experience:

  1. Provide your participating obstetrician with your details and HCF membership number when calling to make your initial appointment.
  2. Book into the Sydney Adventist Hospital via the online eAdmission portal (your participating obstetrician will provide details) after your initial consult and before any of your next appointments.
  3. Make sure you have a referral from your participating obstetrician to present at any included pathology tests or ultrasound scans.
  4. Take your Swaddle membership card (provided following your initial obstetrician consult and acceptance into the program), Medicare card and referral (pathology and ultrasound) to all your Swaddle appointments.

Is IVF covered as part of the Sydney Adventist Hospital (San) No-Gap Pregnancy package?
IVF services are not part of the No-Gap Pregnancy package. Following the IVF treatments, if you fall pregnant then you’re eligible to enter the program as long as you're on the correct level of cover (pregnancy and birth related services) and have served the 12 month waiting period by your baby’s date of birth.

New eligibility criteria starting 1 December 2021 require members to have held pregnancy and birth related cover with HCF for 12 months by the date of your baby’s birth.

Pregnancy and birth

Is there a difference in cover between natural and caesarean births?
No, the No-Gap Pregnancy package is inclusive of natural and caesarean births, which also includes any emergency births, as long as you’re under the care of a participating obstetrician at the Sydney Adventist Hospital.

What if I deliver earlier than my expected due date and will not have served the 12 month waiting period by the birth date of my baby, will I still be covered under my policy?
If you've been accepted into the program and you deliver earlier than your estimated due date and completion of your 12 month pregnancy and birth related waiting periods, we’ll need a letter from your participating obstetrician confirming your estimated due date, so HCF can consider whether it will cover the hospital admission and medical services for the delivery under your policy and whether it can be included in HCF’s No-Gap Pregnancy package. If HCF decides not to cover the delivery, you will be required to pay the full cost of the hospital treatment and medical services.

Cover for your baby

How do I make sure my baby is covered with Private Health Insurance?
If you’re pregnant and on a single membership, to cover your child from their date of birth, make sure you upgrade to a family or single parent membership within 2 months of your child’s birth. If your child isn't added to your policy within this time frame, your child won’t be covered for procedures that occur during the initial 2 month waiting period.

The family or single parent membership commences from your baby’s date of birth. For more information call 13 13 34.

If the baby needs special care, are they covered?
In the event your baby requires admission into Sydney Adventist Hospital’s Special Care Nursery, you’ll need to make sure you’ve added your baby to your private health fund cover within 2 months of the baby’s date of birth for this to be covered. You may receive an estimate letter from the Sydney Adventist Hospital if you haven’t added your baby onto your HCF policy.

Please refer to the Sydney Adventist Hospital website or contact the Sydney Adventist Hospital on (02) 9480 4154 for further details.

For more information about adding your baby to your policy, please call HCF on 13 13 34.

Getting in touch

For more information about the program please call HCF on 13 13 34.

You can also visit the Sydney Adventist Maternity’s website, or call them on (02) 9480 4154.

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Important Information

*Except for any hospital excess payable under your cover.

^Available with select obstetricians, pathology and ultrasound providers at the Sydney Adventist Hospital. Must be accepted into the program by a participating obstetrician. Depends on your level of cover (pregnancy and birth related services required). To access the HCF No Gap Pregnancy package up until 30 Nov 2021, you must have served the 12 month waiting period by your baby’s date of birth either with HCF or your previous fund (this is the standard waiting period for pregnancy and birth related services for new joiners to private health insurance). Excludes any policy excess. Not available to Overseas Visitor Health Cover members. To access the HCF No Gap Pregnancy package from 1 Dec 2021, HCF members must have held HCF Hospital Cover with pregnancy and birth related services for 12 months by the baby’s date of birth.