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" } } };"";}}

My annual income is between

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:

Claim now to reduce your premium
This means the price of your cover will be reduced by the rebate percentage.
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.

Do you want to claim your rebate?

Yes

No

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.

Is everyone to be covered by this policy eligible for Medicare?

Yes

No

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.

<Name>

Invalid first name, please check your name matches your Medicare card

First name

Middle initial (optional)

The text will appear here

Last name

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

Read the Medicare privacy notice

Review your rebate application

Private Health Fund details

Private health fund name

HCF

Start date for premium reduction

Rebate tier

Medicare details

Medicare card number

Valid to

Full name
(As it appears on your Medicare card)

Your details

Current residential address

Current postal address

Contact number

Date of birth

Gender

Your partner's details

Name: DOB: Gender:

Your first dependant details

Name: DOB: Gender: Relationship:

Your second dependant details

Name: DOB: Gender: Relationship:

Your third dependant details

Name: DOB: Gender: Relationship:

Your forth dependant details

Name: DOB: Gender: Relationship:

Your fifth dependant details

Name: DOB: Gender: Relationship:

Your sixth dependant details

Name: DOB: Gender: Relationship:

Your seventh dependant details

Name: DOB: Gender: Relationship:

Member declaration

I acknowledge and agree that:

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 agree that my insurance will start once my application is accepted. I declare the information provided to be true and complete and I understand that giving false or misleading information is a serious offence.

RAC purhcase declaration

I am a member of RAC and I am entitled to join the discounted Corporate Plan.

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.