HBF Private Health Insurance Review

Published: November 11, 2019

If you’re considering HBF private health insurance, but unsure what services and benefits you can expect, this article will help you decide whether the health fund meets your requirements.

HBF Health Insurance is one of Australia’s largest not-for-profit health funds. The fund is owned by its members, meaning any profits made from premiums received gets re-invested back into new or improved benefits for you. HBF serves more than a million members across Australia with Hospital and Extras policies you can mix and match to suit your lifestyle and budget.

ComparingExpert does not currently have access to this provider. Visit www.hbf.com.au/ to request a quote and compare their price and benefits to the Australian private health insurance companies we have access to.

About the Hospital Benefit Fund (HBF)

The not-for-profit health fund was founded in 1941 and is today Western Australia leading health insurer. With over 75 years’ experience, HBF offers a variety of health insurance products, from basic budget plans to comprehensive protection.

According to the funds 2019 Annual report, they returned 90 cents to their members as benefits, for every dollar they received in premiums.

Recent HBF health insurance changes

HBF has implemented the below Australian Government reforms:

  • Standardised hospital categories: HBF has grouped all their private Hospital cover plans into four tiers: Gold, Silver, Bronze and Basic, each including a set number of clinical categories.
  • Selected natural therapies are removed from Extras cover: HBF will no longer provide benefits for specific natural therapies, including aromatherapy, pilates, yoga, naturopathy and reflexology.
  • Increased maximum Hospital excess levels: You can now choose an excess amount that meets your budget. The health fund offers you the choice of $250, $500 or $750 for singles and $1,000 to $1,500 for couples — generally, the higher your agreed excess, the lower your premium.
  • Discounts for young Australians: Health funds may offer 18 to 29-year-olds up to 10% off their Hospital cover. However, HBF has chosen not to implement this discount.
  • Travel and accommodation benefits for rural members: HBF is still deciding whether they’ll implement this change. HBF Hospital policies, however, cover the cost of accommodation and meals for loved ones staying with you, while you recover in hospital.
  • Upgrading Mental Health cover: If your HBF in-hospital mental health treatment is not fully covered by your policy, you can now upgrade to a higher tier without serving a waiting period.

What does HBF health cover?

HBF’s health insurance offers five Hospital Cover options; Basic, Bronze, Silver, Silver Plus and Gold. You also have the choice of 5 Extras options, varying from the affordable basic to the comprehensive option that includes a broad list of benefits with higher limits. You can mix and match Hospital cover with Extras and create a package that suits your requirements.

HBF Hospital cover

Hospital insurance provides benefits for in-hospital services as a private patient in a public or private hospital, generally covering the cost of accommodation and theatre fees. Contributions paid towards the costs of your hospital stay varies according to your chosen cover option: Basic, Bronze, Silver or Gold.

HBF has an extensive network of Member Plus Hospitals across Australia, which may minimise your out-of-pocket costs.

Important: Even when opting for a Member Plus Hospital, you may still need to pay an excess or a co-payment according to your policy option. You can generally select an excess of $250, $500 and $750 for a single policy.

Basic Hospital Plus

This Basic Hospital Plus plan is a low-cost Hospital option covering a few essential services, including accidents. If you’re on a tight budget and considering Hospital cover, this might be a good starting option, especially as it typically includes some additional clinical categories not required by the Australian Government.

  • Private room at a Member Plus Hospital
  • Unlimited urgent ambulance by road.
  • Accident related services
  • Dental Surgery
  • Knee and Shoulder Reconstructions
  • Tonsils, adenoids and grommets
  • Joint reconstructions
  • Hernia and appendix
  • Gynaecology treatments

Restricted benefits for Rehabilitation, Hospital psychiatric services and Palliative care

Excludes air ambulance and 30 other clinical categories, such as heart and vascular system, joint replacement and back, neck and spine.

Bronze Hospital Plus

For a slightly higher premium, the Bronze Hospital Plus is still a budget-friendly option, possibly suited to a young couple that doesn't want children yet. This Hospital cover option generally covers a more extensive selection of 26 clinical categories. It includes everything in the Basic Plus Option, with the following additional benefits:

  • Full coverage for palliative care
  • Brain and nervous system
  • Eyes (not cataracts)
  • Ear, nose and throat
  • Bone, joint and muscle
  • Kidney and bladder
  • Male reproductive system
  • Digestive system
  • Gastrointestinal endoscopy
  • Miscarriage and termination of pregnancy
  • Chemotherapy, radiotherapy and immunotherapy for cancer
  • Skin
  • Medically necessary breast surgery
  • Diabetes management, insulin pumps excluded
  • Lung and chest
  • Blood work
  • Back, neck and spine treatments
  • Medically necessary plastic and reconstructive surgery
  • Pain management device
  • Sleep studies

Restricted coverage for Hospital psychiatric services and Rehabilitation. The Bronze Plus option excludes cover for 10 clinical categories, including joint replacement, insulin pumps and weight loss surgery.

Silver Hospital

A step up from the Bronze Hospital Plus, this option includes cover for 30 clinical categories. It covers all the services listed under the Bronze Hospital Plus plan, as well as the following:

  • Heart and vascular
  • Podiatric surgery performed by a registered podiatric surgeon
  • Implantation of hearing devices
  • Insulin pumps
  • Unrestricted palliative care

Hospital psychiatric services and rehabilitation are restricted, and 6 clinic categories are excluded, such as cataracts, joint replacements and dialysis of chronic kidney failure.

Silver Hospital Plus

The Silver Hospital Plus cover option is similar to the Silver Hospital policy, but also covers:

  • Joint replacements
  • Treatment of cataracts
  • Full rehabilitation care

Hospital psychiatric services are restricted, and cover is not provided for pregnancy and birth-related services, assisted reproductive services, dialysis of chronic kidney failure and weight loss surgery.

Gold Hospital

The Gold Hospital Cover is a top Hospital option, covering all 38 clinical categories, and is usually ideal for those wanting to start or grow their family. The Gold Hospital plan includes all the benefits of the Silver Hospital Plus plan, as well as:

  • Pregnancy and birth-related services
  • Assisted reproductive services
  • Weight loss surgery
  • Full coverage for hospital psychiatric services
  • Dialysis of chronic kidney failure

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HBF Extras

Extras insurance covers you for general treatments and services received outside of the hospital, for example, dental, physio and optical. With HBF, you can choose between Basic, Saver Flexi, Standard, Flexi and Top Extras. Taking out Extras to suit your lifestyle, will generally help prevent significant out-of-pocket expenses.

All HBF Extras options usually have no annual limit on preventative dental, unlimited urgent ambulance by road assistance, flu vaccinations and health checks at selected pharmacies, as well as providing you with a pair of glasses annually.

Basic Extras

This is an entry-level, low-cost policy typically covering your basics such as general dental, optical and five other common services. The Basic Extras also includes:

  • General dental
  • Optical
  • Physiotherapy, Chiropractic and Osteopathy with a combined limit
  • Urgent ambulance
  • Healthy living programs

Saver Flexi Extras

Saver Flexi Extras covers you for two essential services, as well as two more general treatments of your choice. You can typically choose from the following treatments: major dental, optical, physio, chiro, osteo, healthy living programs, non-PBS pharmaceuticals, podiatry and remedial massage.

  • Preventative and restorative general dental
  • Urgent ambulance
  • Two more services of your choice

Standard Extras

Standard Extras covers 19 common services, including:

  • General Dental (sub-limits apply)
  • Major dental combined with endodontic cover (sub-limits apply)
  • Orthodontic
  • Optical (sub-limits apply)
  • Flu vaccination and health checks at selected pharmacies.
  • Chiropractic and osteopathy combined (sub-limits apply)
  • Non-PBS pharmaceuticals
  • Optical (sub-limits apply)
  • Clinical psychology
  • Physiotherapy
  • Podiatry
  • Hearing aids
  • Blood glucose monitors
  • Dietetics
  • Occupational therapy combined with Eye therapy and speech therapy
  • Health management Optical
  • Orthotics

Excludes benefits for acupuncture, and remedial massage.

Flexi Extras

Flexi Extras gives you great flexibility by providing you the choice of 10 general treatments and services. Unlimited urgent ambulance by road usually only applies here if selected as an Extras option.

Top Extras

The Top Extra is HBF’s highest level of Extras cover. This option covers a full range of treatments, including all the benefits listed in the Standard Extras option, plus:

  • General psychology
  • Acupuncture
  • Remedial massage
  • Chinese medicine
  • Exercise physiology

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Ambulance services

Depending on the level of cover you choose, HBF Health Fund generally covers emergency road transport to any destination within Australia, when provided by a recognised state-based ambulance organisation or approved HBF provider.

You will typically be covered for emergency treatment and urgent ambulance transport by road within Australia. 'Urgent ambulance', usually refers to those circumstances where you may need immediate attention, including instances where may need treatment in the emergency department. Generally, 'urgent' also refers to on-site attendance, not requiring transportation.

Those who have concession cards may have a subsidised ambulance service depending on the state they live in.

Urgent Ambulance is not available for sale to QLD or TAS residents as their state-based schemes cover residents.

Waiting periods for Hospital and Extras

  • Rehabilitation: 2 months
  • Palliative care: 2 months
  • Hospital psychiatric care: 2 months
  • Pre-existing conditions: 12 months
  • Pregnancy and birth services: 12 months
  • Accident cover: 1 day
  • Psychology: 2 months
  • Foot orthoses: 12 months
  • Major dental: 12 months.
  • Orthodontics: 12 months
  • Hearing aids and appliances: 12 to 36 months
  • All other services: 2 months

How to make a claim?

After a Hospital procedure, the hospital will generally submit your expense statement directly to the HBF Health Insurer. You may be charged for any out-of-pocket expenses before you leave.

If your treatment is with an Extras HBF preferred provider, a dentist, optometrist or physio, for example, you will generally be able to claim on-the-spot through HICAPS.

HBF Health Insurance usually also offers access to alternative claiming methods such as through the myHBF online portal and the HBF Health app. Alternatively, you can visit your nearest HBF branch or claim via email.

Frequently asked questions and answers

How to join or switch to HBF?

Visit the HBF website, select the cover you're interested in and apply or switch online. Alternatively, you can call them directly, send an email request, visit a branch or book an appointment.

Does HBF offer member rewards?

Yes, HBF offers Momentum Member Benefits, affording members discounts on essential lifestyle choices. For example, a 1-month free gym membership at HIF Arena, 15% off running gear online and 5% off PSM lens and lens extras.

How do you find an HBF preferred provider?

HBF offers a large network of HBF preferred providers, including dental, optical, pharmacy and Hospital providers. These are Member Plus HBF providers that have entered into an agreement with HBF to minimise out-of-pocket expenses associated with treatment. Visit the fund's website and search for selected providers in your region.

What is an HBF Member Plus Hospital?

HBF Member Plus Hospitals strive to offer members value for money. HBF member benefits usually cover accommodation and theatre fees for all agreed services, less any co-payment or excess payable.

What's the best way to contact HBF health?

Contact HBF Health insurance via their website's email address form or directly on 133 423.

What does HBF stand for?

HBF was established in 1941, as the Metropolitan Hospital Benefit Fund of Western Australia, with the core purpose of providing affordable health services to Western Australians.

Does HBF cover gym memberships?

HBF health members can save up to 10% at the HBF Stadium on when on a gym membership. Members may also receive 5% off on casual entry to group fitness classes, pools and the creche.

Is HBF Australia-wide?

Yes, HBF has branches all over Australia. As of July 2019, the majority of members (878,492) are situated in WA, 39,072 live in NSW and 36,480 in VIC. There are over 29,000 members across NT, SA, QLD, ACT and TAS (HBF 2019 annual report).

Does HBF provide health cover for international students?

Yes. If the student's country has a Reciprocal Health Care Agreement with Australia, the student can usually request coverage from HBF. Alternatively, HBF provides health insurance for overseas visitors and those on working visas.

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Need help? Call us on 1300 795 560

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18 Comments

  • Karin Medley |

    Hello,

    I am writing this email inquiry since the website’s price comparison window didn’t submit the info I inputted.

    What would your quote be for a four-person family (2 adults, 2 kids) to sign up for the ‘Young Saver Hospital’ option and just basic GP visits (60% coverage of GP costs)?

    We live in NSW. I presume that your coverage would apply to us here as well.

    I’d appreciate your reply. Thanks!
    Karin

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Karin,

      Thanks for reaching out. When filling in the above quote form be sure to provide a relevant contact number as a health insurance specialist will give you a call and take you through the companies and cover types most suited to your particular situation.

      In the meantime, you can read our review of Australia’s Best Family Health Insurers or perhaps you would like to consult the privatehealth.gov.au website for a complete list of health funds and their respective offerings.

  • Tamara Graham |

    Hello,
    Could you please advise what the waiting period is for IVF services. I live in NSW and would be using a NSW hospital, would this also be covered?

    Thanks
    Tamara

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Tamara,
      Generally, most private health funds will apply a 12 month waiting period for assisted reproductive services, like IVF. However, HBF does state on their website that if there is no pre-existing condition that has led to the need for IVF, your waiting period might only be 2 months.

      HBF’s Smart Saver Twin Pack provides cover for IVF treatment. Premiums start at about $29.35 per week as at February 2018. This does not include the premium increases that apply from 1 April 2018.

      Medicare rebates normally cover a portion of the costs of each treatment cycle, up to 75% of the standard fees charged. Private health insurers usually cover the costs associated with in-hospital treatments and some of the IVF related medications, depending on your insurer.

      Other private health insurers providing cover for IVF include:
      • Medibank Growing Family Complete
      • Bupa Growing Family
      • Australian Unity Platinum Hospital
      • HCF Premium Hospital

  • Dulcie |

    No one can give me a simple answer to the below questions. I am a HBF member, number is 28788***, with a single prime health policy.

    Appoint with Psychiatrist only. Who relate to HBF.
    The Cost of first appointment
    The cost following each other appointments

    Kindly give understandable answers to above.

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Dulcie,
      From your question, it seems you’re wanting to know what HBF will pay for psychiatric appointments (first time, as well as follow-ups) and what out-of-pocket costs you can expect.

      Psychologists and psychiatrists usually work in tandem:
      • Psychologists focus on treating emotional and mental suffering and cannot write prescriptions. You might have regular appointments with your psychologist to address specific issues.
      • Psychiatrist are trained medical doctors that can prescribe medications. You’ll probably only have to visit your Psychiatrist every 3 to 6 months to manage your medications.

      As an HBF Prime Health Package holder, you can claim on Clinical Psychologist assessments from $79 up to a maximum of $720. Consultations and individual treatment from a clinical psychologist will provide a benefit from $44 up to a maximum of $720.

      According to their website, HBF only provides cover for psychiatric care and treatment when carried out in a hospital. Of course, as an HBF client, they would be the best people to contact. Please call them on 133 423.

      There is generally a 2-month waiting period for clinical psychologists and psychiatric care.

  • Paul |

    Hello,
    Does the 10% off gym memberships apply to all gym memberships and what are the healthy living programs mentioned?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Paul,
      HBF Momentum members get 10% off their Snap Fitness gym memberships and up to 15% at Jetta.
      Please visit the HBF website for the types of services included in their Healthy Living Programs.

  • Jazzmyn |

    Hi there,
    I am interested in applying for insurance. I am a Canadian on a working visa in Australia.
    Can I apply for insurance under these circumstances? How much would it cost me?

    Does the insurance cover me in Australia, Canada, Indonesia or anywhere I travel to?
    Is there a limit of how much you can use the insurance in a year/month?
    Do I send the claims to you or does the hospitals etc fill out the claim?

    The services that I am interested having covered are:
    Optical
    Osteopathy
    Urgent ambulance
    Remedial massage
    Natural therapies
    Nutritionist
    Psychology
    Occupational therapy
    Healthy living programs

    Thank you!

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Jazzmyn.
      I’m going to try and answer all your questions, but if I miss anything please feel free to call 1300 786 328 for a specialist to assist you.

      1. Yes, you can apply for private health insurance when on a working visa in Australia. In fact, since 2009, if you apply for a working visa you are required to apply for at least a minimum level of health insurance prior to being granted a visa.
      2. The cost of health insurance depends on the type and level of cover you choose; Hospital only, Extras only or Combined Hospital and Extras.
      3. Generally, private health funds in Australia covers you Australian-wide but will not cover overseas medical expenses.
      4. Health insurance policies have an annual limit on the maximum benefit you can claim for. The limit is dependent on the level of cover you choose; basic, medium or comprehensive.
      5. You can claim health insurance Extras usually on the spot by swiping your membership card at the place where you’ve received treatment OR go online and claim via the health fund’s online claim section OR fill out a claim form (which you can download from the insurer’s website), attach your invoice and receipt and post it to the insurer. For in-hospital expenses, the bill will generally be sent straight to your health insurance provider.
      6. Please fill in the quote form above for a specialist to give you a call and help you compare which health fund will give you coverage for the items you’ve listed. Or you can start your search by reviewing the top 10 health funds in Australia.

  • mary |

    What is HBF service and performance in Victoria like ? How many members do they have in Victoria ?

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Mary.

      You might want to request a quote from HBF and compare their offering to other health insurance companies in Australia to determine how they stack up. To learn more about what others think about the health fund, you could jump onto a chat forum, like whirlpool, and have a read of some of the discussion there.

  • Glenys Stagoll |

    I set up health cover for my daughter, transferring to HBF from Goldfields Medical Fund a few years ago. She has now moved to Melbourne for work which was to be short term, but it looks like it will be extended. Is she covered for treatment at any hospitals in Melbourne? and is she covered on her Young Singles Saver Twinpack & Gap Saver if she remains living in Melbourne for a couple of years?

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Glenys.

      Generally, when moving interstate your health fund will still provide coverage, however, insurance premiums and some benefits might change. Your daughter will need to contact HBF and update her details, then review whether her current policy still suits her. She can register for myHBF (their online member’s portal) and easily manage and update her cover.

  • Janet |

    Hi.
    I would like to know if my husband and I would be eligible to join HBF if we live in South Australia? Would we share all the benefits of those that live in WA are privy to?
    We are in or close to our 60s.
    Thank you.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Janet.

      Generally, the state you live in should not affect the benefits you have access to. However, it will affect the premium you pay for the same level of coverage. Please call 1300 795 560 for assistance.

  • Sharee Betts |

    Hi there

    I’m 65 and I would like to know if I can have private health insurance? Do I have to pay that gap from age 30 to now like other companies?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Sharee. Thanks for reaching out.

      Are you maybe referring to the Lifetime Health Cover (LHC) loading? If so, then yes, the LHC loading applies to everyone and all health funds. If you did not have a complying hospital policy on the 1st of July following your 31st birthday or been granted an exemption, you’re generally liable to pay the 2% yearly loading. In your case, you might have to pay 68% more for your private health insurance policy. Please call 1300 795 560 for immediate assistance from a health insurance specialist.