Keeping your data secure is our priority

We need to collect the information on this and the following screens to process your policy application. By providing HCF with your personal information, and the personal information of persons to be covered by the policy, you give HCF permission, on your behalf and on behalf of each person to be covered, to collect and use your personal information for the purpose of processing your application. If you do not provide this information, HCF will not be able to process your policy application. Information about how HCF manages personal information is contained in the HCF Privacy Policy. If you have any queries or concerns about privacy, you can email privacyofficer@hcf.com.au, visit any HCF branch, or call 13 13 34.

These details will be used to set up and manage your policy

Enter your full name as it appears on your Medicare card:

As your date of birth does not align with the age bracket you provided previously, your premium has been updated.

What's your residential address?

Add address line two

As you've changed your state, your premium has been updated.

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What's your postal address?

Add address line two

Your mobile must start with a '0'. For landlines, include the area code (e.g. 02). Don't include any spaces or country code (+61).

We'll email you the link to your application so that you can complete it later. You can access it for the next 21 days before it expires.

Please tell us your partner’s details

 

Enter your partner’s full name as it appears on their Medicare card:

 

As your partners date of birth does not align with the age bracket you provided previously, your premium has been updated.

Please tell us your dependant’s details

 

Enter your dependant’s full name as it appears on their Medicare card:

 

They’re eligible to be a child dependant on your cover.

As your adult dependant is aged 22-30 years old and isn't studying fulltime, you'll need to take out Extended Family Cover if you'd like to include them on your policy. This will increase the cost of your policy by 28%. The cost won't change if you add more adult dependants. They must not be married or in a de facto relationship and must rely on you for maintenance and support.

The cost of your cover has increased by 28% to include Extended Family Cover. Extended Family Cover includes your dependant who is 22-30 years old (inclusive) and not studying fulltime on your policy.

This dependant can't be added to your cover without Extended Family Cover. If you have other dependants, enter their details above. If you have no other dependants, start a new quote and change your cover to either single or couple.

This dependant can't be added to your cover without Extended Family Cover. Please remove their details.

They’re eligible to be a student dependant on your cover.

An adult dependant (aged 22-30 inclusive and not studying fulltime) can't be added to Ambulance only family cover. Please remove them. If you have other dependants, add their details above or change your cover to single or couple.

As your dependant's age is 31 years or older on the cover start date they can't be covered on your policy. They'll need to take out their own cover.

We'll need to confirm your cover details with your last fund to confirm the price of your cover. For now, we haven’t added loading to your premium, but you can still continue with your purchase online. Learn more about Lifetime Health Cover (LHC) loading and other exemptions here.

We have applied the Government's Lifetime Health Cover loading to your premium. Exceptions may apply if you're a new migrant or an Australian who has been living overseas. If you are eligible for an exemption, your premium will be reduced after you complete your purchase online. Learn more about Lifetime Health Cover (LHC) loading and other exemptions here.

We'll need to confirm your partner's cover details with their last fund to confirm the price of your cover. For now, we haven't added loading to your quote, but you can still continue with your purchase online. Learn more about Lifetime Health Cover (LHC) loading and other exemptions here.

We have applied the Government's Lifetime Health Cover loading to your premium. Exceptions may apply if they're a new migrant or an Australian who has been living overseas. If your partner is eligible for an exemption, your premium will be reduced after you complete your purchase online. Learn more about Lifetime Health Cover (LHC) loading and other exemptions here.

We'll need informtion about your current and last fund so that we can organise the transfer for you.

We'll ask for your current and last fund for a transfer certificate. This will contain the level of cover your were on, and whether you have any Lifetime Health Cover loading.

It will not contain any details about your claims or medical history.

If you have different insurers for your hospital and extras cover, please enter your hospital fund details. Then call us once you've completed your online purchase to provide your extras fund details.

Providing your membership number makes transferring much faster.

We'll need information about your partner's current and last fund so that we can organise the transfer for you.

We'll ask for your partner's current and last fund for a transfer certificate. This will contain the level of cover you were on, and whether you have any Lifetime Health Cover loading.

It won't contain any details about your claims or medical history.

If you have different insurers for your hospital and extras cover, please enter your hospital fund details. Then call us once you've completed your online purchase to provide your extras fund details.

Providing your membership number makes transferring much faster.

Based on your income bracket () you're eligible for a rebate.

Based on your income bracket () you'll receive a 0% rebate.

As you have chosen not to supply your income you'll receive a 0% rebate.

{{ steps.rebateData = { "B": { "base tier": { "value": "24.288", "code": "0" }, "tier 1": { "value": "16.192", "code": "1" }, "tier 2": { "value": "8.095", "code": "2" }, "tier 3": { "value": "0.000", "code": "3" }, "no rebate": { "value": "0", "code": "-1" } }, "C": { "base tier": { "value": "28.337", "code": "1" }, "tier 1": { "value": "20.240", "code": "1" }, "tier 2": { "value": "12.143", "code": "2" }, "tier 3": { "value": "0", "code": "3" }, "no rebate": { "value": "0", "code": "-1" } }, "D": { "base tier": { "value": "32.385", "code": "1" }, "tier 1": { "value": "24.288", "code": "1" }, "tier 2": { "value": "16.192", "code": "2" }, "tier 3": { "value": "0", "code": "3" }, "no rebate": { "value": "0", "code": "-1" } } };"";}}

What's the rebate?
The Australian Government offers a rebate to eligible members to help cover the costs of your premiums.
You can choose to either:

  1. Claim now to reduce your premium
    This means the price of your cover will be reduced by the rebate percentage.
  2. Claim later when you lodge your tax return
    You'll pay the full amount for your cover now, and if eligible claim your savings at tax time.

You can always change your income bracket or rebate status after your cover has started. Simply call our award-winning customer service team once you've completed your online purchase Learn more about the Australian Government Rebate.

Applicants not covered by the policy can't claim the Australian Government Rebate on private health insurance (excluding child-only policies). Employers and trustees of organisations can't claim the Australian Government Rebate on private health insurance on policies paid on behalf of an employee. 

Unfortunately, you can't claim the Government rebate unless everyone is eligible for Medicare. Please return to previous page and select 'No' to claiming your rebate. Alternatively, if you're living in Australia for a short-term ,our Overseas Visitor Health Cover may work for you.

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Invalid Medicare details. Please check that all the details you've provided match your Medicare card.

Review your rebate application

Private Health Fund details

Private health fund name

HCF

Start date for premium reduction

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Rebate tier

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Medicare details

Medicare card number

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Valid to

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Full name
(As it appears on your Medicare card)

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Your details

Current residential address

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Current postal address

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Contact number

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Date of birth

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Gender

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Your partner's details

Name: DOB: Gender:

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Your first dependant details

Name: DOB: Gender: Relationship:

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Your second dependant details

Name: DOB: Gender: Relationship:

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Your third dependant details

Name: DOB: Gender: Relationship:

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Your forth dependant details

Name: DOB: Gender: Relationship:

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Your fifth dependant details

Name: DOB: Gender: Relationship:

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Your sixth dependant details

Name: DOB: Gender: Relationship:

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Your seventh dependant details

Name: DOB: Gender: Relationship:

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Member declaration

  • I am the policyholder and am responsible for the payment of premiums, ongoing maintenance of the policy, and receipt of all policy correspondence which I agree to forward to the Covered Persons.
  • I have the authority to act and give consent on behalf of any dependants under the age of 15 years to be covered under the policy, provide their personal information (including sensitive information) to HCF, and receive their information from HCF for the purposes of the policy.
  • I have been given permission to consent on behalf of any person to be covered on the policy aged 15 years and over (Covered Persons) to provide their information (including sensitive information) to HCF and I have given the Covered Person's HCF's contact details. I have explained to the Covered Persons that HCF may disclose their claims information to me for the purposes of the policy and that HCF cannot cover them without that disclosure, and they have consented to the disclosure.
  • I agree to the following on behalf of myself and each Covered Person, have informed them of the following statements, and have provided them with the relevant documents.
    • I am bound by the HCF Fund Rules including the product schedule for the policy, information relating to our product choice in the HCF Health Insurance Brochure, and any applicable exclusions and waiting periods.
    • I consent to HCF dealing with our personal information in accordance with HCF's Privacy Policy, which contains information on how we can access and seek correction of our personal information, and make a complaint about the handling of our personal information.
    • I warrant that the information I have provided in this application form is true and correct and I understand that giving false or misleading information is a serious offence.
    • The policy will start once my application is accepted by HCF or on the date I have nominated in the application form, whichever is later.
  • I am a Western Australian resident.
  • I understand that I will only be eligible for the joining offer if I am or become a member of the Royal Automobile Club (RAC) and I consent to be contacted by RAC to become a member.
  • I consent HCF and RAC disclosing my personal information to each other for the purpose of redeeming this EFT reward joining offer.
  • I understand that I will receive a discount from HCF on my health insurance premium only while I am a member of the Royal Automobile Association (RAA).
  • I consent HCF disclosing my personal information to RAA for the purposes of administering the discount I receive as an RAA member.
  • I consent to RAA providing my personal information to HCF while I remain a member of RAA and upon my exit from RAA, for the purpose of administering the discount I receive on my HCF policy as an RAA member.
  • I am a member of RAA and am entitled to join the discounted Corporate Plan.

Cover start date

30 day cooling off period : *Payments are refundable if you cancel within 30 days of joining and haven't made a claim.

PAYMENT OPTIONS

By selecting Payroll, you authorise your employer to make payments on your behalf through payroll deduction.

By submitting your payment you authorise HCF to process the payment using the method indicated above and you represent that you have authority to use that payment method.

REGULAR PAYMENTS

Your price has been updated to reflect your new payment frequency.

Once you choose your payment date, your first payment premium will be adjusted to cater for any additional or reduced number of days.

Your gap will automatically be allocated to your first payment, and you won't be able to process your claim until after your first payment is made. Don't worry, you're still covered from your cover start date.

Next Payment
Recurring

CREDIT CARD DETAILS

By submitting your payment details you authorise HCF to process the payment using the method indicated above and you represent that you have the authority to use the payment method.

As you have selected to pay by credit card we will use the same details as above

BANK DETAILS

By selecting bank details, this form is your direct debit request and you authorise The Hospitals Contribution Fund of Australia Limited User ID Number 245164 to arrange for funds to be debited from your account and as prescribed below through the Bulk Electronic Clearing System (BECS). You agree to be bound by the terms described in the HCF Direct Debit Customer Service Agreement and this authorisation is to remain in force in accordance with these terms.

 

It may take up to 4 days to process your payment. You will be able to process your claims once your first payment is made.

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Please visit our homepage, or call us on 13 13 34.