HCF Hospital Silver Plus and HCF Top Extras cover summary

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HCF Hospital Silver Plus and HCF Top Extras product summary

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519.6KB PDF

What's covered

HCF Hospital Silver Plus

Comprehensive hospital cover for those who don’t need cover for pregnancy.

Services

Waiting period

Emergency ambulance	1 day
Rehabilitation	2 months
Hospital psychiatric services This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable. Members who have held hospital cover for at least 2 months and upgrade to HCF Hospital Gold to receive hospital psychiatric services as covered services may not be required to serve the waiting period for hospital psychiatric services. This exemption can only be accessed once in a member's lifetime.	2 months
Palliative care	2 months
Brain and nervous system (e.g. stroke, brain or spinal cord tumours)	2 months (12 mths pre-existing)
Eye (not cataracts e.g. retinal detachment, eye infections)	2 months (12 mths pre-existing)
Ear, nose and throat (e.g. damaged ear drum, sinus surgery)	2 months (12 mths pre-existing)
Tonsils, adenoids and grommets (e.g. hospital treatment of the tonsils, insertion or removal of grommets)	2 months (12 mths pre-existing)
Bone, joint and muscle (e.g. fractures, joint fusion and surgery for bone cancer)	2 months (12 mths pre-existing)
Joint reconstructions (e.g. torn tendons and damaged ligaments)	2 months (12 mths pre-existing)
Kidney and bladder (e.g. kidney stones, adrenal gland tumour)	2 months (12 mths pre-existing)
Male reproductive system (e.g. male sterilisation, prostate cancer)	2 months (12 mths pre-existing)
Digestive system (e.g. oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids)	2 months (12 mths pre-existing)
Hernia and appendix (e.g. hernia operations and appendicitis)	2 months (12 mths pre-existing)
Gastrointestinal endoscopy (e.g. colonoscopy, gastroscopy)	2 months (12 mths pre-existing)
Gynaecology (e.g. endometriosis, polycystic ovaries)	2 months (12 mths pre-existing)
Miscarriage and termination of pregnancy	2 months
Chemotherapy, radiotherapy and immunotherapy for cancer	2 months (12 mths pre-existing)
Pain management (e.g. treatment of nerve pain and chest pain due to cancer by injection of a nerve block)	2 months (12 mths pre-existing)
Skin (e.g. surgery to remove melanoma, minor wound repair or abscesses)	2 months (12 mths pre-existing)
Breast surgery (medically necessary e.g. breast lesions, breast tumours, asymmetry due to breast cancer surgery)	2 months (12 mths pre-existing)
Diabetes management (excluding insulin pumps e.g. stabilisation of hypo- or hyper-glycaemia, contour problems due to insulin injections)	2 months (12 mths pre-existing)
Heart and vascular system (e.g. heart failure and heart attack, monitoring of heart conditions)	2 months (12 mths pre-existing)
Lung and chest (e.g lung cancer, respiratory disorders such as asthma, pneumonia)	2 months (12 mths pre-existing)
Blood (e.g. blood clotting disorders and bone marrow transplants)	2 months (12 mths pre-existing)
Back, neck and spine (e.g sciatica, prolapsed or herniated disc, and spine curvature disorders such as scoliosis)	2 months (12 mths pre-existing)
Plastic and reconstructive surgery (medically necessary e.g. burns requiring a graft, cleft palate)	2 months (12 mths pre-existing)
Dental surgery (e.g surgery to remove wisdom teeth and dental implant surgery)	2 months (12 mths pre-existing)
Podiatric surgery (provided by a registered podiatric surgeon) Limited Benefits apply. Default Benefit level payable by HCF for Hospital Treatment as determined under the Private Health Insurance Act.	2 months (12 mths pre-existing)
Implantation of hearing devices	2 months (12 mths pre-existing)
Cataracts	2 months (12 mths pre-existing)
Joint replacements	2 months (12 mths pre-existing)
Dialysis for chronic kidney failure	2 months (12 mths pre-existing)
Pain management with device (e.g. treatment of nerve pain, back pain with a device)	2 months (12 mths pre-existing)
Sleep studies (e.g sleep apnoea and snoring)	2 months (12 mths pre-existing)
Waiting periods for pre-existing ailments (excluding rehabilitation, hospital psychiatric services and palliative care) The waiting period for pre-existing ailments is 12 months. The waiting period for hospital psychiatric services, rehabilitation services and palliative care is 2 months. A pre-existing ailment, illness or condition is one where the signs or symptoms existed in the six months before joining HCF or upgrading your cover.	12 months

HCF Top Extras

Top level extras with the highest coverage for therapies and services

Waiting periods

extras waiting period

Waiting Periods

General dental	2 months
Major dental	12 months
Optical	2 months
Therapies (excluding foot orthotics)	2 months
Travel and Accommodation	2 months
Vaccines and Immunisations	2 months
Artificial aids	12 months
Hearing aids	12 months
Health Management Programs	2 months
School accident benefit	2 - 12 months
*Please see the Product summary for information on policy inclusions

Category

Services

Benefits

Dental Hide details

Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year

General dental	Examinations	$34 - $84
General dental	Single film x-rays	$34
General dental	Removal of plaque / calculus	$40 - $75
General dental	Application of fluoride	$29

Year 1 $1,000 limit

General dental	Direct fillings (1-2 surfaces)	$105 - $148
General dental	Direct fillings (3 or more surfaces)	$177 - $256
General dental	Simple extractions	$120 - $175
Major dental	Indirect fillings	$341 - $783
Major dental	Surgical extractions	$210 - $330
Major dental	Occlusal therapy	$38 - $400
Major dental	Treatment of tissue surrounding teeth	$27 - $430
Major dental	Treatment of root canals	$32 - $285
Major dental	Placing of crowns and bridges	$280 - $1,100
Major dental	Dentures and/or components (partial and complete) - Limits renew every 3 years	$33 - $1,300

$800 LIMIT for ORTHODONTISTS ($400 LIMIT if general dentist) Lifetime limit $2,400 or $1,200 for services by dentists, other than orthodontists

Major dental

Orthodontics - orthodontist / other dentists

Up to $800/$400

Optical View details

$275 limit

Optical	Spectacle frames	$135
Optical	Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting)	$150
Optical	Contact lenses - pair	$160

Therapies View details

Year 1 $600 limit

Therapy	Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program)	$60 / $54
Therapy	Exercise physiology (group / class consultations covered under Health Management Program)	$40

Year 1 $600 limit

Therapy	Occupational therapy	$72
Therapy	Psychology (after Medicare entitlement used up)	$100

Year 1 $300 limit

Therapy	Chiropractic - initial / subsequent	$45 / $35
Therapy	Osteopathy - initial / subsequent	$50 / $40

Year 1 $300 limit Sub-limit $300 per therapy service

Therapy	Remedial massage and myotherapy - initial / subsequent	$40 / $35
Therapy	Acupuncture and Chinese herbal medicine consultation - initial / subsequent	$40 / $35

Year 1 $250

Therapy	Podiatry (including foot orthotics) - initial / subsequent	$40 / $35
Therapy	Dietetics - initial / subsequent	$55
Therapy	Audiology - initial / subsequent	$70
Therapy	Speech pathology - initial / subsequent	$83

Other View details

Max $250 per policy

Other

Travel and Accommodation (200km round trip)

$50

$280 limit

Other	HCF approved pharmacy (After PBS equivalent co-payment subtracted)	Up to $50 per script
Other	HCF approved vaccines and immunisations (After PBS equivalent co-payment subtracted)	Up to $50 per script

Max $200 per policy

Other

Artificial aids (HCF approved e.g. low vision aids)

$55 - $200

$800 - $1,800

Other

Hearing aids

$800 (benefits accrue and renew every three years)

$200 per person max $400 per policy

Other

Health Management Programs (HCF approved e.g. exercise classes)

$200 per person/max $400 per policy

$200 per eligible child

Other

School Accident Benefit

Up to $200 per eligible child

HOSPITAL SERVICES NOT COVERED IN THIS PACKAGE

Pregnancy and birth

Assisted reproductive services

Weight loss surgery

Insulin pumps

Want to see all exclusions

Product summary

HCF Hospital Silver Plus and HCF Top Extras

From
$*Per week

What's covered

HCF Hospital Silver Plus

HCF Top Extras

HOSPITAL SERVICES NOT COVERED IN THIS PACKAGE

* Important information

Any questions?

Call us

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HEALTH INSURANCEShow more

CONTACT USShow more

ABOUT HCFShow more

Health

Income, illness & injury cover

Travel

Pet

Manage your health

No-gap services

Access medical resources

Member offers & discounts

Find a branch

HCF centres

Participating hospitals

Find a participating provider

About HCF

HCF Research Foundation

Media centre

Careers

Health

Income, illness & injury cover

Travel

Pet

Manage your health

No-gap services

Access medical resources

Member offers & discounts

Find a branch

HCF centres

Participating hospitals

Find a participating provider

About HCF

HCF Research Foundation

Media centre

Careers

HCF Hospital Silver Plus and HCF Top Extras

From $*Per week

HCF Hospital Silver Plus

HCF Top Extras

What's covered

HCF Hospital Silver Plus

HCF Top Extras

HOSPITAL SERVICES NOT COVERED IN THIS PACKAGE

* Important information

Any questions?

Call us

Visit a branch

HEALTH INSURANCEShow more

CONTACT USShow more

ABOUT HCFShow more

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From
$*Per week