NO-GAP JOINTS PROGRAM THAT PUTS YOU IN CONTROL
We believe in taking a holistic approach to your health and wellbeing. So, when it comes to having primary hip or knee replacement surgery, we want to give eligible members* greater flexibility to make their experience simple and supported.
Our No-Gap Joints program for primary hip and knee replacements, gives eligible members peace of mind with no out-of-pocket costs from hospital admission through to discharge and post-surgery rehab, with participating private hospitals and clinicians*.
The No-Gap Joints program is scheduled to end between March 2024 and September 2024, depending on the participating hospital.
WHAT AM I COVERED FOR?
Eligible members are accepted into the program if they meet the clinical criteria outlined by participating clinicians and hospitals* .
Members can get:
- primary hip and knee replacements with no out-of-pocket costs^ through participating private hospitals and clinicians in NSW and Vic
- costs covered^ during and after surgery, so you can focus on recovery
- continuity of care with the same health professionals and hospital coordinating your care from admission through to post-surgery rehab
- treatment with a participating surgeon in a holistic package including rehab.
Already an HCF Member?
Eligible members* who have had HCF hospital cover that includes primary hip and knee replacements for at least 12 months are covered for No-Gap Joints.
Members need to be accepted into the program by a participating surgeon and hospital before the relevant end date (excludes Overseas Visitors Health Cover members)*.
NOT A MEMBER YET?
CARE AND SUPPORT WHEN IT COUNTS
We help eligible members find ways to be fit and strong before a procedure with access to a range of chronic disease management programs including our Healthy Weight for Life program. These programs are available to members who are overweight and have osteoarthritis+ or are at risk of developing a chronic condition#.
Where can you access our No-Gap Joints program?
We know that giving you the choice of specialists, hospitals and services is important. That’s why we’ve partnered with these hospitals to make your primary hip or knee replacement experience as simple, affordable and supportive as possible.
DO YOU HAVE MORE QUESTIONS ABOUT NO-GAP JOINTS?
How do I know if I’m eligible for the No-Gap Joints program?
Eligible members that have held HCF hospital cover including primary hip and knee replacements for at least 12 months are covered for No-Gap Joints, once they are accepted into the program by a participating surgeon and hospital (excludes Overseas Visitors Health Cover members)*. Please visit the participating hospitals' page to see the list of surgeons involved in the program.
Will I have any out-of-pocket costs?
Our No-Gap Joints program covers eligible members on their primary hip or knee replacement journey from hospital admission through to discharge and post-surgery rehab, with participating private hospitals and clinicians*.
HCF members who are eligible to participate in the program won’t have any out-of-pocket costs except for any hospital policy excess (an excess may apply depending on your level of cover and if you’re claiming for the first time in a calendar year), or any additional services. Additional services may be required if you have other medical conditions such as diabetes or cardiac conditions. These additional services are not covered by the No-Gap Joints program and additional costs may apply.
If there are complications during your hospital admission that require additional care or services beyond what's included in the No-Gap Joints program, there may also be additional costs. Please speak with your participating surgeon about any risks that may be associated with your chosen surgery.
The No-Gap Joints program includes:
- participating surgeon costs for primary hip or knee replacement surgery. This doesn’t include pre-surgical consultations but includes post-surgical consults
- diagnostics (pathology and radiology) for any inpatient diagnostics performed while admitted for the primary hip or knee replacement surgery
- hospital services including accommodation and theatre. Excludes any hospital excess you need to pay
- any costs related to anaesthetists and theatre support to assist with the surgery
- rehabilitation, organised by the participating hospital if clinically required.
Please speak to your participating surgeon to make sure you’re aware of and have given Informed Financial Consent for any additional costs.
How do I access the No-Gap Joints program?
To access the program, eligible HCF members need to be accepted into the program in line with clinical criteria by a participating clinician and hospital on a patient by patient basis and undergo their joint replacement surgery before the relevant proposed trial program end date*. Please visit the participating hospital’s page to see the list of surgeons involved in the program.
Can I choose my surgeon?
You can choose any of the participating No-Gap Joints program surgeons - please visit the participating hospitals to see the list of surgeons in the program. You’ll need to confirm whether the hospital and surgeon is available and they must accept you into the program.
If I change cover or move health funds, is there a waiting period?
Yes, the program is only available once you’ve held hospital cover that includes primary hip and knee replacements with HCF for 12 months (excluding Overseas Visitors Health Cover)*.
What if I can’t access or don’t live near one of the participating hospitals?
If you can’t participate in the No-Gap Joints program, you can still access No-Gap or Known Gap surgeons who participate in our No Gap or Known Gap arrangement. Call us on 13 13 34 to find out more on hospitals and surgeons that are part of our participating network near you. Please note participating surgeons in the No-Gap Joints program have the discretion to choose in line with clinical criteria if members are accepted into the program on a patient-by-patient basis.
When does the No-Gap Joints program end?
The No-Gap Joints program is proposed to end at:
- Hurstville Private Hospital, NSW on 31 March 2024
- East Sydney Private Hospital, NSW on 31 March 2024
- Vermont Private Hospital, Vic on 30 April 2024
- Macquarie University Hospital, NSW on 30 September 2024
You must undergo your joint replacement surgery before the relevant proposed trial program end date.
I have more questions about the No-Gap Joints program – who can I speak to?
Will HCF contact me regarding No-Gap Joints?
As part of our No-Gap Joints program we may email you a short survey about your experiences with HCF and the program. Hearing your feedback will help us improve the services we offer you and other members.
More of Our Programs
PREPARING FOR HOSPITAL: KNEE REPLACEMENT
Learn how the surgery works, how to prepare, what your recovery may be like and more.
PREPARING FOR HOSPITAL: HIP REPLACEMENT
Learn about what to do and expect when preparing for a hip replacement.
LIVING WITH OSTEOARTHRITIS
People living with osteoarthritis share their strategies for managing their condition.
HEALTHY WEIGHT FOR LIFE
This program is designed for eligible members to kickstart your weight loss, improve activity and provide tools to create healthy routines.
* Eligible members will need to have HCF hospital cover including primary hip and knee replacements for 12 months (excluding Overseas Visitors Health Cover). Members will be accepted into the program in line with clinical criteria by the participating clinician and hospital on a patient-by-patient basis. Must be admitted at Macquarie University Hospital, East Sydney Private Hospital, Hurstville Private Hospital or Vermont Private Hospital. You must undergo your joint replacement surgery before the proposed trial program end date. The No-Gaps Joint Program is proposed to end on 31 March 2024 at Hurstville Private Hospital, 31 March 2024 at East Sydney Private Hospital, 30 April 2024 at Vermont Private Hospital and 30 September 2024 at Macquarie University Hospital.
^ Excludes any hospital excess payable.
+ Must have held hospital cover that covers joint replacement surgery for 2 months, have knee or hip osteoarthritis and a Body Mass Index of 28 and above. Clinical eligibility applies. See hcf.com.au/hwfl
# Must have hospital cover, multiple lifestyle risk factors (e.g. smoking, physical inactivity, poor nutrition) and a Body Mass Index of 28 and above. Clinical eligibility applies. See hcf.com.au/hwfl