Health Care Insurance offers hospital and extras cover to suit any need or budget. Compare its policies online and receive a quote.
Health Care Insurance (HCI) has been looking after the health cover needs of Australians since 1938. With an aim of providing quality cover and value for money, Health Care Insurance is wholly owned by its members.
Private health insurance is all about peace of mind and Health Care Insurance offers cover options for singles, couples, families and single parents. You can choose from Hospital Cover, two levels of extras cover, and one combined package to suit different budgets and cover requirements.
Compare Health Care Insurance's policy range
Contents of this article
- Full list of services covered by Health Care Insurance policies
- Are there any excluded treatments or services?
- What are the waiting periods on claims?
- Does Health Care Insurance offer any excess options?
- How do I lodge a claim with Health Care Insurance?
- How do I become a member?
- What's the long-term expense of funeral insurance?
Health Care Insurance offers three types of health insurance policies:
- Hospital cover. For treatments and procedures that require admittance to hospital.
- Extras cover. For out of hospital services such as dental and optical.
- Combined cover. A mix of both hospital and extras cover.
Select the type of policy you are interested in to get a more detailed look at what each Health Care Insurance product offers.
|Policy title||Policy features|
|Policy title||Treatments and services covered|
|Policy title||Policy features|
Health Care Insurance will not pay a benefit in the even that:
- Your claim is for cosmetic surgery.
- Your claim is for treatment received outside of Australia.
- Your claim is for services that are not included in the agreement between Health Care Insurance and your hospital.
- Your claim is for personal expenses you incur in hospital, for example phone calls and TV rental.
- Your claim is for a hospital service that is not eligible for Medicare benefits.
- Your claim is for pharmaceutical items supplied or prescribed on discharge.
- Your claim is for services received more than two years previously.
When you join a health fund for the first time you should also consider the waiting periods that apply to your cover. These are the periods of time you must wait after joining before you can receive any benefits, and they are in place to stop people simply jumping in and out of health funds when it suits them.
Health Care Insurance applies a standard two month waiting period to the majority of hospital and extras benefits. However, for certain services you are required to wait longer.
|Service||Included in which policy type?||Waiting period|
|Treatment for pre-existing conditions||Hospital cover|
|IVF and assisted reproductive services||Hospital cover|
|General dental||Extras cover|
|Major dental||Extras cover|
|Hearing aids||Extras cover|
|Laser eye surgery||Extras cover|
|Non-surgical prostheses||Extras cover|
Health Care Insurance's hospital policy allows you to contribute an excess when you go to hospital, which is effectively your way of contributing to the cost of your accommodation and treatment. This policy is available with four excess options:
- $250 per adult and $500 per policy
- $500 per adult and $1,000 per policy
- $1,000 per adult and $2,000 per policy
The larger the excess you choose, the lower your premium payments will be. You should also note that the excess per adult is only payable once every calendar year, while there is no excess required for day surgery. Finally, you will not have to pay an excess when a dependent child under 18 years of age is admitted to hospital.
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.
- 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
|Health Care Insurance|
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).
Who else can be included in my cover?
You can include your spouse or de facto partner, your unmarried children under 23 years of age, your student dependents (aged 23-25 who is a full-time student and financially dependent on you) and unmarried children aged from 23-25 (conditions apply).
What happens if I want to upgrade my level of cover?
You can upgrade your level of Health Care Insurance cover at any time. However, keep in mind that waiting periods will apply before you are eligible to receive benefits for new services or for services that now have a higher level of cover.
How will my benefits be paid?
Aside from electronic claiming which gives you instant access to your benefits, Health Care Insurance pays benefits to its members either by direct credit or cheque.
Will Health Care Insurance cover me when I’m overseas?
No, Australian private health funds are unable to offer cover for services, treatments or medical appliances that you receive or purchase overseas.
Is there any way to obtain medical cover when I’m overseas?
You can get cover for medical expenses while overseas by taking out travel insurance, and it is strongly recommended that you do so. Travel insurance covers a wide range of costs including overseas medical expenses, lost or stolen luggage, cancellation fees and more. Health Care Insurance has also negotiated a range of travel insurance package deals for its members with QBE Insurance.
Can I suspend my cover for a limited period of time?
Yes, it is possible to apply to have your membership temporarily suspended if you are planning to travel overseas or if you are experiencing financial hardship (conditions apply).
Does Health Care Insurance have a list of recognised and approved funds?
Yes they do. You can call Health Care Insurance on 1800 804 950 to check on a funds approved status.