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HCF is the third-largest health insurer by market share in Australia and the biggest not-for-profit health fund, meaning money goes back to its members, not shareholders.
- For every dollar its members paid in premiums, HCF has paid out more in benefits than the industry average over the past 5 years, according to the APRA, Statistics: Private Health Insurance Operations Report 2016-20.
- HCF's policies often give you more than the minimum hospital tier requirements but are still competitively priced. For example, its bronze plus policy covers 26 treatments (19 is the requirement) and its silver plus includes 30 treatments, 4 more than what is required.
- It had 230 complaints between October and December, according to the Private Health Insurance Ombudsman report — the highest of all insurers. Keep in mind that though it's also one of the biggest so is likely to get more.
Review by our insurance writer Gary Hunter
Compare HCF health insurance options
Looking to compare health insurance options and quotes with HCF? Use this free tool to see options side by side, or use the filters to find specific treatments.
Who is HCF?
HCF is a not-for-profit insurance company, meaning any profit goes back into the fund rather than being shared among shareholders. Over the last 5 years, HCF have paid out more in premiums to members in benefits than the industry average.
What health insurance options are available?
|Benefit||HCF Hospital Bronze Plus||HCF Hospital Standard Silver Plus||HCF Hospital Silver Plus||HCF Hospital Gold|
|Hospital psychiatric services|
|Brain and nervous system|
|Eye (not cataracts)|
|Ear, nose and throat|
|Tonsils, adenoids and grommets|
|Bone, joint and muscle|
|Kidney and bladder|
|Male reproductive system|
|Hernia and appendix|
|Miscarriage and termination of pregnancy|
|Chemotherapy, radiotherapy and immunotherapy for cancer|
|Breast surgery (medically necessary)|
|Diabetes management (excluding insulin pumps)|
|Heart and vascular system|
|Lung and chest|
|Back, neck and spine|
|Plastic and reconstructive surgery (medically necessary)|
|Podiatric surgery (provided by a registered podiatric surgeon)|
|Implantation of hearing devices|
|Dialysis for chronic kidney failure|
|Pregnancy and birth|
|Assisted reproductive services|
|Weight loss surgery|
|Pain management with device|
|Apply||Go to Site||Go to Site||Go to Site||Go to Site|
- HCF Starter Extras. This basic extras policy gives you 100% back on one dental check per year at participating providers and a $350 limit per person.
- HCF Starter Extras (with optical). Covers the same services as Starter Extras but also includes optical, including glasses and contact lenses and has a $400 limit per person.
- HCF Mid Extras. This comprehensive policy gives you 100% back on up to two dental checks per year. It also includes prescription glasses - excluding some add-ons - and free digital retinal imaging eye check as well as cover on a range of therapies.
- HCF Vital Extras - For around $50 a month you can get a range of important services on a range of therapies as well as everything in the Mid extras.
- HCF Top Extras - The most comprehensive cover, this one gives you higher annual limits and increases your loyalty limits each year.
Looking for both hospital and extras cover? You can combine any hospital policy and extras policy from the previous two tabs, or you can choose one of these three custom policies that combine hospital cover and extras cover you can't buy on their own:
- My Future Basic Plus 250, 500 or 750. The hospital policy in this package is an enhanced Bronze policy offering cover for bones, joints, hernias, skin issues and dental surgery. The extras policy is quite basic, covering optical, general dental, major dental, a few therapies, emergency ambulance and some vaccines. You can choose between three different hospital excesses: $250, $500 or $750. A higher excess means lower premiums, but it also reduces your benefit limits on your extras policy.
- My Family Silver Plus. The hospital policy in this package offers more than what is required of a Silver policy, but slightly less than what you'd get through HCF's standalone Silver Plus policy since it doesn't cover kidney dialysis, insulin pumps, cataracts or joint replacements. That makes it ideal for families that want a high level of cover but may not need treatments that are largely associated with ageing. The extras policy covers optical, general dental, major dental, a range of therapies and emergency ambulance. Other than optical, you get a combined limit on the other treatments meaning you can spend your limits however you choose.
- My Family Advanced Silver Plus. The hospital policy in this package is practically the same as what you get in the My Family Silver Plus policy except that you get full cover for podiatric surgery rather than limited benefits. The extras policy is very similar as well, except you're covered for orthodontics, artificial health aids, podiatry and a few others. Your benefit limits are also slightly higher on a few extras treatments.
How does HCF Ambulance Cover work?
Ambulance Cover from HCF is only available for residents of NSW, VIC, SA, NT, WA and the ACT. It provides cover for emergency ambulance travel provided by state government services anywhere in Australia.
You also have an annual cover limit for medically necessary, non-emergency ambulance services where your doctor requires you to be transported by ambulance, for up to $5,000. This occurs in situations where your condition needs to be monitored and the right medical support provided while you are in transit.
This cover is offered for singles, couples, families and single parent families, and there is no need to pay upfront for the ambulance service you use once you're insured.
Ambulance Cover is available as a standalone policy or with Cash Back Cover. Cash Back Cover offers a cash benefit to help you cover additional expenses that arise when you are sick or injured. Available from $2 a week for singles, Cash Back Cover provides:
- A $5,000 benefit for accidents requiring surgery
- A $5,000 benefit for serious specified medical conditions including malignant cancer, chronic kidney failure, heart disease requiring bypass surgery, heart attack OR stroke
You're also eligible to make multiple claims, up to a limit of $20,000 for singles and $40,000 for families.
Policy limitations, exclusions, waiting periods and excesses
Always check the conditions and the list of general exclusions to make sure you know what is and isn't covered. HCF will not pay your claim if:
- The ambulance transport you receive does not meet the approved definition supplied in the PDS (For example, if it is for transport you receive when you are discharged from hospital)
- You are covered by another arrangement, such as a state government ambulance subscription scheme
- It is for transfers between hospitals
- It is for transport provided by an ambulance service not recognised by HCF
Are there waiting periods?
There are waiting periods which apply when you take out HCF Ambulance Cover. A one-day waiting period applies to emergency ambulance. There is a two-month waiting period for medically necessary non-emergency ambulance. If you require ambulance transport or treatment for a pre-existing ailment or condition, keep in mind that you will have to serve a 12-month waiting period.
How much does HCF Ambulance Cover cost?
There are several factors that can influence how much HCF Ambulance Cover costs:
- Whether you take out a single policy or a couples, family or single parent family policy.
- Whether you live in NSW, VIC, SA, NT, WA and the ACT.
- Your age and income have an impact on the amount of Australian Government private health insurance rebate you are entitled to.
As a not-for-profit organisation, HCF have a number of member offers and benefits including:
- Diamond members. If you've been with HCF for over 25 years and have a top tier policy, you are rewarded with preferential servicing, a growing range of exclusive offers, VIP experiences and more.
- Ruby. If you've been with HCF for more than 10 years, you get access to special offers and rewards, exclusive access to unique events and more.
- Emerald. For 5 years service or more you can access an increasing range of discounts and privileges from HCF partner brands.
- Opal. Customers who have been with HCF for under 5 years are still rewarded with various exclusive offers and rewards.
How to make a claim
If you need to make an extras claim with HCF, you can lodge your claim in the following ways:
- On the spot. You can swipe your HCF membership card when you visit your service provider to claim immediately.
- Via the HCF mobile app. You can take a photo of your receipt with your smartphone to submit your claim.
- Online. Online claims can be made through the HCF member services portal. You'll need to post your original receipts to the health fund to complete your claim.
- At a branch. Claims can be lodged in an HCF branch by presenting your membership card and your original receipts.
- By post. You also have the option of downloading a claim form from the HCF website or phoning the health fund to request one. You can then send the completed claim form and your receipts to: HCF, GPO Box 4242, Sydney NSW 2001.
As for medical bills from your treating doctor, if you were treated under the HCF Medicover agreement the bills will go directly to HCF. If not, you can submit your health insurance claim at any HCFor Medicare branch.
Overseas visitors or Students
If you're planning on visiting or working in Australia, HCF have a range of options available to you. It's important you have the right level of health insurance as part of your visa requirements.
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