CARE WHEN IT COUNTS
We have treatment at home options for eligible members on a range of treatments because we want to give you the choice of how you’re treated, whenever we can.
Treatments at home aren’t actually covered by our policies like treatment in hospital is. But we’ve chosen to pay for some treatments you can have in the comfort of your own home when we can make sure the treatment can be given safely and at the same, or better, quality than in hospital. These treatments at home are called hospital-substitute treatment (or HST) because the treatment at home takes the place of treatment you’d have had to go to, or stay longer in, hospital for. Ask your doctor or hospital if there’s an option to be treated at home in your case.
Giving you treatment where you want it, when you need it. That’s care when it counts. Uncommon Care.
WHAT TREATMENT CAN I HAVE AT HOME?
It’s important to know that if you’d be covered for the treatment in hospital, and your treating doctor agrees you can have treatment at home instead, we’ll work with you, your doctor and hospital to cover the cost of the treatment at home for eligible HCF members who need:
- intravenous (IV) therapy antibiotics
- complex wound care with negative pressure wound therapy
- rehabilitation after a hip or knee replacement
- IV chemotherapy.
You might be able to choose your HST provider depending on where you live and the treatment you need.
We’re also providing at-home support during COVID-19 to eligible members who’ve had hip or knee replacement surgery postponed.
HOW DOES TREATMENT AT HOME GET ORGANISED FOR ME?
You should talk to your treatment team about at-home treatment options while you’re in hospital.
We’ve sent hospitals a list of providers that HCF has contracts with to give treatment at home to members, so they’re familiar with the types of treatment at home we’ll cover eligible members for and can refer you straight to a provider.
There are no out-of-pocket costs for treatment at home through HCF-contracted HST providers.
You can also call us on 13 13 34 to find out about our contracted HST providers – where they operate and what treatment they can give to eligible members.
Our contracted HST providers will be able to assess your needs and tell your treating team if you’re eligible. Each type of treatment has slightly different criteria but generally, to be eligible, you’ll need to:
- be a current HCF member
- have served waiting periods for pre-existing conditions
- be covered for the treatment you’re having if you were admitted to hospital
- need treatment that you would have had to stay in hospital for
- live in an area served by an HCF-contracted HST provider
- have a suitable home environment to be treated in.
HOW LONG WILL I GET TREATMENT FOR?
We consider your treatment at home complete when the care you need can be given in the community, rather than what you’d have to stay in hospital for. When you finish your treatment, the HST provider will refer you to community services if you need them.
As an example Hospital Substitute Treatment for complex wound care means we’ll pay for the treatment for the time you would’ve stayed in hospital. Our contracted HST providers will talk to you about when the transition to options in the community will happen (like visiting a GP clinic or getting a referral to community nursing to have dressing changes that would've happened after you left hospital).
MORE SUPPORT DURING COVID-19
We’ve also put at-home treatments in place for eligible members who were booked in to have hip or knee replacements and had their surgery postponed. During COVID-19 we're linking you in with nutrition, exercise and physiotherapy experts so you can be as prepared as possible for your surgery.
END-OF-LIFE TREATMENT AT HOME
If you want to go home from hospital and die at home, we may be able to give you some support during this period. We know you’ll have lots to think about during this time and your situation might be changing quickly. Please contact us by emailing firstname.lastname@example.org so we can consider your needs and how we might best support you.
WHAT ISN’T COVERED?
While we’re expanding services for treatment at home, we only cover specific treatments that we have contracts with providers to deliver.
If the reason you’re in hospital or need treatment at home is in any way related to an incident, accident or surgery you can claim compensation for from another party (like a workers compensation insurer, motor accident authority or a public liability insurer) then you won’t be covered by your private health insurance.