HBF Health Insurance

Compare the HBF difference – One of the largest not-for-profit health funds in Australia

HBF is one of the five largest health funds in Australia and has been offering its cover options to members for more than 70 years. Owned by its members and based in Western Australia, HBF provides health cover solutions to customers Australia-wide. Private health cover is something every Australian should consider, regardless of whether they have a checkered medical history or if they’re a picture of good health. Taking out health insurance now can provide peace of mind when it comes to the wellbeing of yourself and your family, as well as save you a whole lot of money in the long run.

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HBF Health Insurance options

As a not-for-profit fund, HBF can offer benefits to its members in the form of better policies and lower premiums. With more than 900,000 members, this Western Australian health fund offers everything from budget cover through to comprehensive health protection. If you want hospital only cover, HBF offers a choice of four options at different price levels and designed to suit the needs of customers at different life stages. There are seven HBF extras cover options to choose from ranging from straightforward dental cover through to complete and comprehensive general treatment cover, while a range of combined hospital and extras policies are available for the ultimate peace of mind. There’s even two ambulance cover options available if that’s what you’re looking for. Joining HBF is easy, with a quick and easy quote service offered online.

HBF offers the following hospital only cover options to customers:

  • Young Saver Hospital. This entry-level option offers low-cost hospital cover for more than 5,000 procedures. Urgent ambulance, theatre fees and shared room accommodation are all covered, while restricted cover is included for psychiatric care and rehabilitation.
  • Mid Hospital. With private room and heart treatment cover, this policy aims to provide excellent value for money. Psychiatric care and HBF medical gap cover are included, but some expensive benefits such as maternity cover are excluded.
  • Healthy Saver Hospital. Designed with growing families in mind, Health Saver Hospital Cover includes protection for most hospital services. Maternity and IVF cover are included along with shared room cover, urgent ambulance, in-hospital pharmacy and more.
  • Top Hospital. This high-level hospital cover option offers comprehensive protection for those who want complete peace of mind. From joint replacements and heart surgery to cataracts, maternity and assisted reproductive services, this policy covers the vast majority of hospital treatments.
If you want extras only cover consider the following options:

  • Dental saver. This affordable option offers basic cover for general dental services only.
  • Essentials Saver. This value-for-money policy is designed for those who want basic extras cover, combining benefits for general dental with urgent ambulance and your choice of two of the following: major dental, chiropractic, optical - contact lenses, glasses, osteopathy, physio, pharmacy, podiatry and remedial massage.
  • Easy 8. An Easy 8 policy from HBF covers the fund’s eight most popular extras services: general dental, major dental, chiropractic, optical, osteopathy, physio, remedial massage and natural therapies.
  • Essentials Standard. This higher level of cover provides benefits for 18 popular general treatment options, including staples like optical and major dental along with chiro, podiatry, hearing aids, dietetics and speech therapy.
  • Flexi Extras. Designed to combine affordability and flexibility, Flexi Extras allows you to choose cover for 10 general treatments from 19 available options. This gives you the freedom to tailor cover to suit your unique needs.
  • Extra Essentials. This comprehensive policy offers higher benefit limits and covers 20 essential extras services. Benefits include cover for optical, general and major dental, physio, chiro, natural therapies, dietetics, occupational therapy, speech therapy and flu vaccinations.
  • Premium Essentials. This is the highest level of extras cover available from HBF and it offers generous annual benefit limits on 39 extras services. In addition to all the basics it also offers cover for natural therapies, exercise physiology, a nutritionist and a range of lifestyle therapies.
For combined cover, HBF allows members to mix and match a range of its hospital and extras covers to create your own policy. It also offers the following packaged policy choices:

  • Young Singles Saver Twin Pack. This policy is, as the name suggests, designed to offer broad cover for young singles who are fit and healthy. It combines Young Saver Hospital Cover with a basic level of cover for essential extras.
  • Smart Saver Twin Pack. Designed for growing families, this combines Healthy Saver Hospital Cover with cover for nine popular extras.
  • Prime Health Package. Designed for older singles and couples, this HBF package offers comprehensive hospital cover with no maternity, along with cover for 16 extras treatments.
  • Ultimate Package. his top-of-the-line package option provides the most comprehensive level of cover from HBF. It offers 100% back on most hospital services and 90-100% back on an extensive range of extras.

Are there any additional benefits? You bet

  • Pay your premiums by direct debit and enjoy a saving of 4%
  • Visit a Member Plus dentist in WA and enjoy access to around $100 worth of dental benefits each year
  • Members can visit one of several Member Plus optical stores in WA and enjoy substantial discounts on frames
  • Bundle and save. Combine home, car or travel insurance with your HBF health cover to enjoy significant savings on premiums
  • For members. As a Members Own Health Fund, HBF is focused on providing better products for its members rather than turning a profit
  • Kids covered for free. Your children can receive cover on a HBF family policy for no extra charge
  • Free personal health app. HBF members can use the Pocket Health app to help them achieve their personal health and fitness goals
  • More than 900,000 members. HBF is one of the five biggest private health funds in Australia.

HBF general exclusions, waiting periods and excesses

There are a range of circumstances under which your HBF private health cover claim will not be paid, such as if:

  • It is for services or treatments performed outside of Australia
  • It is for a procedure or treatment for which Medicare does not offer a benefit, such as elective cosmetic surgery
  • It is for a treatment that you received at least two years prior to the date you lodge your insurance claim
  • It is for treatments or services performed during an applicable waiting period on your policy
  • It is for a treatment that is excluded from your type or level of health insurance cover
  • Your premium payments are in arrears
  • It could be covered by workers’ compensation, third party insurance or some other legal right
  • It is for treatment or services required by your employer as a condition of your employment
  • It is for care and treatment in nursing homes
  • It is for a treatment or service that hasn’t been received yet
  • It is for outpatient services.

HBF Health Insurance waiting periods

Just like with any other health fund, waiting periods also apply to your HBF Health Insurance policy. Cover is available immediately for things like accidents, but you’ll need to sit out a two-month waiting period until you are eligible to receive the majority of benefits under your policy. However, certain specific treatments and benefits, such as maternity cover and treatment for pre-existing conditions, require you to serve a longer, 12-month waiting period.

HBF Health Insurance excess

When you take out private health cover, the excess is the amount you contribute to the cost of your hospital treatment and accommodation. An excess only needs to be paid when you are hospitalised overnight and only needs to be paid once per year per policy member - up to a maximum of twice per year on a family policy. The higher the excess on your policy, the lower your premium payments will be.

Frequently asked questions about HBF

What do I need to know about going into hospital?

  • HBF has developed a Hospital Stay Guide (available through its website) to help answer all your questions about going into hospital, including everything from hospital accommodation types to how you can claim. You can also phone HBF directly for more information.

Does HBF cover my kids?

  • Yes, dependent children are automatically covered on most HBF policies until they turn 18. You can also extend cover for unmarried children up to the age of 25 provided they are either a full-time student or earning less than $21,250 a year.

Am I covered outside my home state?

  • Yes, HBF offers health insurance cover and services Australia-wide.

Does my premium change based on the state in which I live?

  • Yes, medical costs vary in different states around Australia, so expect your health cover premiums to reflect those differences.

What is a HBF Member Plus hospital?

  • If you visit a HBF Member Plus hospital you will receive cover for your accommodation and theatre fees (minus any excess or co-payment you are required to contribute). Non-Member Plus hospitals are hospitals with which HBF does not have an agreement in place and you may incur significant out-of-pocket expenses if treated in such a facility.

Does HBF provide a bonus if I don’t claim?

  • Unfortunately, private health funds in Australia are not legally allowed to offer a no claim bonus similar to those offered by car insurance providers.

Does health insurance cover me outside of Australia?

  • No, private health funds are not able to cover you for medical services and treatments received overseas. If you’re planning a trip abroad you will need to consider taking out travel insurance.

Is there an option for overseas visitors?

HBF offers a range of health cover options for people who are in Australia on a working visa or who are visiting here on holidays. These include:

  • Working Visa Hospital Cover. This covers in-hospital medical treatment only and includes cover for more than 5,000 procedures. A private room, theatre fees and urgent ambulance transport are all included in your policy.
  • Working Visa Hospital and Medical Cover. This more expensive option covers in-hospital and out-of-hospital care, including everything from theatre fees, heart services and maternity to psychiatric and palliative care.
  • Standard Overseas Visitors Cover. This offers value-for-money cover for both public and private hospital treatment, covering you for a private room, theatre fees and ambulance transport. More than 5,000 procedures are covered by this policy.
  • Comprehensive Overseas Visitors Cover. This is the highest level of overseas visitor cover available from HBF. It covers you for a private room, theatre fees and ambulance transport, and also includes benefits for psychiatric care, rehab, maternity, heart treatment, joint surgery and more.

How do I make a claim

HBF members can lodge claims in three easy ways:

  • On the spot. When you visit a provider that offers HICAPS electronic claiming, all you need to do is swipe your HBF membership card to receive any benefit you’re eligible for.
  • Online. By logging into myHBF online and clicking ‘Submit a health claim’, members can enter their claim details and upload any receipts or invoices.
  • By mail. HBF members can download and complete a claim form, attach any accounts and receipts and then post everything to HBF.

Download the HBF claims app


How much will I receive from HBF if I claim?

The Australian Medical Association produces an annual report card which rates health funds, including HBF, by the dollar amount they pay for medical services, which you can find below. For the purpose of comparison Medicare's (MBS) benefits are includes as well:

Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia$221.35$335.85
Breast, benign lesion surgical biopsy of excision$260.05$355.20
Carpal Tunnel Release$276.80$459.05
Cataract Surgery$760.55$1,242.25
Complicated Delivery (of baby)$1,629.35$2,649.15
Coronary Artery Bypass$2,200.00$3,665.20
Cytotoxic Chemotherapy$97.95$127.55
Femoral on Inguinal Hernia$464.50$640.60
Hip Replacement$1,317.80$2,146.75
Knee Replacement$2,047.60$2,146.75
Overnight investigation for sleep apnoea$588.00$747.65
Tonsils or Tonsils and Adenoid$295.70$522.05
Uncomplicated Delivery (of baby)$693.95$2,150.35
Vaginal Hysterectomy$674.70$1,252.85
Varicose Veins$109.80$149.95


I recognise most of these funds except for the AHSA, what is that?

The Australian Health Service Alliance is a management services organisation that represents a number of small to medium sized health insurance funds, allowing them to combine resources to deliver a higher quality of service to their members. The funds represented by the ASHA are:
  • ACA Health Benefits Fund
  • Australian Unity Health Limited
  • CBHS Health Fund Limited
  • CUA Health Limited
  • Defence Health
  • GMF Health
  • Budget Direct Health Insurance
  • Frank Health Insurance
  • GU Health
  • HBF Health Ltd
  • Health Care Insurance Limited
  • health.com.au
  • Health Insurance Fund of Australia Limited
  • Health Partners
  • Navy Health
  • onemedifund
  • Peoplecare Health Insurance
  • Phoenix Health Fund
  • Police Health Limited
  • Queensland Country Health Fund Limited
  • Reserve Bank Health Society Ltd
  • rt health fund
  • Teachers Health Fund > UniHealth Insurance
  • Teachers Union Health
  • The Doctors' Health Fund Pty Ltd
  • Transport Health
  • Westfund
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