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Health Care Insurance

Health Care Insurance offers one top-tier Gold policy and a choice of three levels of extras cover.

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Health Care Insurance (HCI) is a not-for-profit health insurer, meaning that all surplus profits are rerouted back into the fund rather than into shareholders' pockets. This allows HCI to be more competitive with its products and perks. They offer three hospital policies: Gold Hospital, Silver Plus Hospital and Bronze Hospital, which can be combined with any of their extras policies.

Top 3 features
  • Good for people who want top cover. HCI's Gold Hospital with Premier Extras is a combined policy that gives you among the highest levels of hospital and extras cover you can find.
  • Good for people who want to save on out-of-pocket costs. HCI gives you access to more than 30,000 private doctors who have agreed to reduce or eliminate their gap.
  • HCI offer cover for single parents at a competitive rate.

Contents of this article

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Who is HCI Health Insurance?

HCI is a not-for-profit insurer that has been based out of Burnie, Tasmania since 1938. It is wholly owned by its members, who are also responsible for electing the fund's board of directors.

HCI is part of the Australian Health Services Alliance (AHSA), an alliance of not-for-profit insurers that gives these funds access to more than 30,000 private doctors around Australia who have agreed to reduce or eliminate certain out-of-pocket costs for all members.

What health insurance options are available?

  • Gold Hospital. This meets the government's requirement for gold cover, meaning it fully covers all 38 clinical categories of treatment including not only basic treatments but also more complicated ones like heart disease, cancer, pregnancy, insulin pumps and kidney dialysis. You can choose an excess of $0, $250, $500 or $750.
  • Silver Plus Hospital. This comes with excess options of $250, $500 and $750, and covers similar services to Gold Hospital, except doesn't include pregnancy and other less common procedures. It's ideal for complete families or those not planning to have a child soon.
  • Bronze Hospital. This covers everything that's required for bronze level cover, such as brain, eye, ear, nose and throat, tonsils, adenoids and grommets.

You can buy both policies in a package with HCI's top level of extras cover, purchase it separately or mix and match it with one of HCI's other two extras policies described below.

HCI offers two extras policies, although one only comes as a bundle alongside the Gold Hospital policy:

  • Gold Hospital or Silver Plus Hospital with Premier Extras. This comprehensive package covers you for all (or almost all) hospital and extras services available with health care. You can't get Premier Extras on their own; this is the only way you can get top cover for both hospital and extras services.
  • Silver Plus Hospital or Bronze Hospital with Healthy Extras. With this package, you'll get everything covered with a bronze hospital or silver plus hospital policy, depending on which you choose, plus extras cover services including dental, chiropractic and natural therapies.
  • Active Life Package. This is packaged cover tailored to the healthy and active, covering you for services like general dental, major dental, optical and some therapies like acupuncture, physio and chiro. It also lets you choose between gold, silver plus and bronze hospital cover.

Member offers

Here are some other perks you'll get as an Health Care Insurance member:

  • Access Gap Cover. HCI has a network of over 30,000 doctors and 500 private hospitals in their Access Gap Cover schemes. If you visit one of these, you can reduce or eliminate the gap that many private doctors commonly charge above the standard benefit amount.
  • No excess for day admissions. Gold Hospital members on excess levels $0, $250 or $500 do not need to pay an excess for same day procedures.

How to make a claim

There are several options available when you need to claim a benefit from Health Care Insurance. These include:

  • HICAPS claiming system. Many funds will offer electronic claiming through HICAPS. To receive your benefits just swipe your membership card at the relevant terminal.
  • Smartphone. You can submit your claim via mobile using the Health Care Insurance app. It is available on both iOS and Android and can be downloaded below.
  • HICAPS Go. By downloading the HICAPS Go App, you'll be able to find practitioners in your area, get quotes, calculate their rebates, and pay. The app is available on Android and iOS.
  • Email, fax or post. Submit a completed claim form (which are available for download from the Health Care Insurance website) to the health fund via email, post or fax.
  • In person. If you are a resident of Burnie in Tasmania you can drop off a form in person at Health Care Insurance's head office.
    Hospital claims. Your hospital should forward the details of your claim directly to the Health Care Insurance. If you receive a bill from your doctor for medical treatment you received in hospital, you'll need to lodge your claim with Medicare first before submitting it to Health Care Insurance.

Download the Health Care Insurance app

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How do I become a member?

If you would like to join Health Care Insurance you can do so quickly and easily online. You will need to provide the following details when filling out a membership application form:

  • The details of everyone who will be covered.
  • Your bank account or credit card details.
  • Information concerning your previous health fund (if applicable).

Further information about this health fund

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