Australians have trusted HCF with their health insurance needs since 1932. Is it the right health fund for you?
Hospitals Contribution Fund (HCF) is one of the largest and most well-known private health insurance brands operating in Australia. As a not-for-profit provider, HCF has committed to re-investing its earnings back into the fund, allowing it to offer more competitive premium rates and additional savings to its members.
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How can I choose a HCF policy?
HCF offers standalone hospital and extras policies in a range of cover levels to suit different needs and budgets. It also offers package policies designed for different life stages and events.
To learn more about what HCF has to offer, simply select the type of health insurance you are interested in:
Those seeking cover for hospital treatments can choose from four HCF policies. These can be taken out by themselves or paired with extras cover:
- Basic Hospital. An affordable policy for those watching their wallet. Covers you for essential treatment in an HCF affiliated private hospital and includes an emergency ambulance transport benefit. *Starts at $20.80 per week
- Mid Hospital. Slightly higher premium than Basic Hospital but covers a wider range of hospital treatments such as heart surgery, joint reconstruction and sterilisation. *Starts at $25.31 per week
- Mid Plus Hospital. A step up from Mid Hospital, this allows you to receive benefits for complex procedures such as joint replacements, eye surgery as well as rehabilitation services. *Starts at $36.10 per week
- Premium Hospital. The highest level of cover available. It is the only hospital policy offered by HCF that fully covers pregnancy and birth-related services. *Starts at $38.82 per week
*Pricing is based on a single male in New South Wales in April 2018.
Need insurance for out-of-hospital services like dental or optical? HCF offers five extras policies that can be taken out as standalones, or added to your hospital cover:
- Bronze Extras. Basic extras that include cover for general dental, physiotherapy, chiro and a selection of natural therapies.
- Bronze Plus Extras. Covers the same services as Bronze Extras but includes benefits for optical accessories.
- Silver Plus Extras. Offers higher annual benefit limits than both Bronze policies and covers more services.
- Gold Extras. Comprehensive extras that increase the benefit limits of certain services for each year you hold cover.
- Platinum Extras. Covers all the services included in Gold Extras with higher annual benefit limits and per year increases.
Starting a family or just looking for both in and out of hospital cover? HCF saves you the hassle of sifting through policies by offering pre-packaged options:
- Young Singles & Couples. This package focuses on affordability by excluding premium-raising cover for treatments and services young people are not likely to use.
- Planning a Family. Ensures that the birth of your new family member does not come with a costly medical bill by including cover for pregnancy and maternity services.
- Family with Kids. Includes cover for services your children might need such as tonsil removal, immunisations, vaccines, general dental and major dental.
- No Pregnancy. This package is for those who may want a comprehensive level of cover but have no need for pregnancy benefits, such as families with older children or seniors.
- Top Cover. Combines top tier hospital with comprehensive extras options. If you are seeking the highest level of protection available from HCF this may be the policy for you.
Get bonus benefits with the HCF Young Starter Package*
HCF is currently offering a unique hospital and extras policy called the Young Starter Package. This policy contains additional benefits not available with other Young Singles & Couples packages. These include:
- 100% back on up to 2 dental checks each year.
- 100% back on select spectacles and lenses plus a free retinal imaging eye check.
- Free HCF comprehensive travel insurance.
*Available to singles and couples only. The increased dental and optical benefits are based on comparing those offered by the lowest cost Young Singles & Couples package.
How do the HCF extras loyalty benefits work?
If you purchase HCF Gold Extras or Platinum Extras, you can enjoy a loyalty bonus which increases your annual benefit limits on certain services for each year that you maintain your cover. The benefit increase is applied whether Gold or Platinum Extras are taken out as standalone policies, paired with hospital cover or included in a package:
|Service||Treatments included||Gold Extras||Platinum Extras|
How many members does HCF service?
Servicing almost 1.5 million members, HCF is Australia’s largest nonprofit health fund. This gives it a market share of 10.3%.
HCF accounts for:
- 10.3% of the Australian health insurance market
- 10.9% of all complaints about benefit payments
- 8.6% of all complaints about service
- 9.6% of all complaints that require investigation
Source: Private Health Insurance Ombudsman, State of the Health Fund Report 2016
How many hospital agreements does HCF have in my state and in total?
If you receive hospital treatment in Australia, there are two important factors that influence the benefit you will receive from your health fund:
- The level of cover you have in place
- Whether your health fund has an agreement with the hospital where you receive treatment
The table below features the number of hospital agreements HCF has in each state and territory around Australia compared to the maximum of any health fund across the industry:
|Private hospital agreements||Day hospital agreements|
|NSW||84 (industry maximum: 101)||82 (industry maximum: 96)|
|ACT||5 (industry maximum: 7)||6 (industry maximum: 9)|
|VIC||70 (industry maximum: 84)||48 (industry maximum: 75)|
|QLD||48 (industry maximum: 57)||36 (industry maximum: 51)|
|SA||25 (industry maximum: 29)||17 (industry maximum: 27)|
|WA||18 (industry maximum: 23)||8 (industry maximum: 26)|
|TAS||5 (industry maximum: 8)||3 (industry maximum: 5)|
|NT||1 (industry maximum: 2)||1 (industry maximum: 1)|
What additional benefits does HCF offer?
- Discounts on other HCF products. Becoming an HCF member awards you with a 10% discount if you choose to take out HCF travel or pet insurance.
- Free comprehensive travel insurance. Enjoy complimentary travel insurance if you purchase Premium Hospital, Mid Plus Hospital or the Young Starter Package, if you're under 75.
- Unemployment subsidy. HCF will pay your premium for up to 183 days if you become unemployed through no fault of your own. This is included in all HCF retail hospital products currently available for purchase. Eligibility criteria apply.
Does HCF offer any excess options?
All HCF hospital cover policies have a selection of excess fees to choose from. This is an amount you nominate to pay if you are admitted to hospital, with the upside being that it reduces the premium cost of your policy. With HCF you are only required to pay one excess fee per year, regardless of the amount of treatment or care that you receive.
The Basic, Mid and Mid Plus Hospital policies allow you to select from either a $250 or $500 excess, while Premium Hospital gives you a choice between no excess, $250 or $500. When considering your options it can be helpful to think about whether you want to pay less or more over time, as the lower your excess the higher your premium
What are the general exclusions?
Below you can find examples of treatments, services and claims that HCF does not pay benefits for or accept. These are universal exclusions which apply to every policy offered by this health fund:
- Any elective cosmetic surgery procedure.
- Claims made two years after the date of service.
- Claims that fail to meet the HCF Fund Rules.
- If you have the right to claim costs from a third party.
- Pre-existing condition claims within the waiting period.*
- Any service or treatment listed as an exclusion.
- Services received while a policy is in arrears, not financial, suspended or within a waiting period.
- Treatment deemed inappropriate or unreasonable by HCF.
- Any fees associated with emergency room treatment.
- Services received from a provider not recognised by HCF.
- Services that are not received face-to-face.**
- Services provided outside of Australia.
- Ambulance transfers between hospitals.
- Any service or treatment that fails to meet Private Health Insurance (Accreditation) Rules.
**Does not apply to services received under a Chronic Disease Management Program or Health Management Program.
What affects the cost of my HCF health insurance?
The cost of your HCF health insurance premium depends on a number of factors:
- The number of people on the policy. A singles policy is going to be less expensive than a couples or family policy.
- How comprehensive the policy is. Top level hospital and extras policies are going to cost more than lower tiered ones.
- The excess amount chosen. Selecting a larger excess fee results in larger reductions on your premium.
- If government penalties are applied. If the Lifetime Health Cover loading is applied then the premium amount increases.
Paying your HCF health insurance premiums
You can pay your HCF health insurance premiums in the following ways:
- Direct debit from your credit card or bank account
- Payroll deduction via your employer (if your employer has an arrangement with HCF)
- Phone 13 14 39 to pay by credit card
- Visit hcf.com.au to pay by credit card online
- Visit hcf.com.au/bpay
- By credit card, cheque or money order at your nearest HCF branch
Premiums can be paid monthly, quarterly, half-yearly or yearly.
How do I submit 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.
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Final details about this health fund
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- Waiting times for elective surgeries rise
- Use your extras benefits before January 2019