Discover HCF Health Insurance Cover Options

Published: March 5, 2019

You might be considering buying private health insurance for the first time or switching health funds, or perhaps you already have an HCF policy and want to review their cover options before getting married, starting a family or retiring. Whatever your reason for wanting to evaluate HCF insurance, the below information might assist you.

HCF

HCF operates as a not-for-profit private health insurance provider, meaning they re-invest the premiums you pay them back into the company, with the aim to lower your premiums, improve their product offering, and provide you with additional healthy lifestyle programs.

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What does HCF stand for?

HCF stands for the Hospitals Contribution Fund of Australia. Established in 1932, HCF protects over 1.5 million Australians with a wide range of health, lifestyle and disease management programs available to its members. With over 85 years of experience, this not-for-profit health fund continues to choose to invest in their customers, rather than shareholders.

The health fund has over 50 branches Australia-wide and besides private health insurance, they also offer life cover, travel insurance and pet insurance.

HCF health insurance review

The HCF health fund is the third largest private health insurer in Australia, with 10.4% of the market share, as of 2018. They offer a variety of Hospital and Extras policies, as well as a few convenient package options that combine Extras and Hospital cover.

Combined Packages

The health fund offers you the convenience of choosing a combined Hospital and Extras package suited to your specific stage of life: Young and single, starting a family or established family.

HCF health insurance packages

Young starter

Created for the budget conscious young single or couple. Combines Basic Hospital and Extras, however, includes some exclusions and restrictions.

  • Removal of tonsils, adenoids, appendix, kidney stones & gallstones.
  • Joint investigation & reconstruction.
  • Emergency ambulance services.
  • General & Major dental with a combined $500 limit.
  • Optical with a $150 limit.
  • Physiotherapy and chiropractic.
  • Free overseas travel insurance.

My Family

Designed for those planning to start a family. Combines a Mid Hospital policy with a Mid-level Extras policy.

  • Pregnancy and birth-related services.
  • Emergency ambulance cover.
  • Spinal surgery.
  • Ante/post-natal health management programs.
  • HCF approved vaccines and immunisations.
  • $800 combined limit for General, Major and Endodontic dental.
  • Optical with a $200 limit.
  • Non-PBS pharmaceuticals.
  • Psychology.

My Family Plus

A package specifically intended for growing families. Combines a Mid Hospital option with a comprehensive, flexible Extras policy.

  • Pregnancy and birth-related services.
  • Cochlear implant surgery.
  • Sterilisation.
  • Emergency ambulance services.
  • Orthodontics with a $2,100 lifetime limit.
  • Occupational and speech therapy.
  • Dental combined limit of $1,200 per year.
  • School accident benefit.
  • Optical with a $250 limit.
  • Podiatry

HCF Hospital cover options

For a Hospital policy from HCF insurance, you can choose an Excess of either $250 or $500, with their Premium Hospital policy offering a Nil Excess option. All Hospital cover options from this not-for-profit insurer provide you with in-hospital treatments as a private patient in a public or private hospital, and you’ll also receive:

  • Emergency ambulance coverage.
  • Joint investigation and reconstructions.
  • Surgical treatment for a hernia.
  • The removal of kidney stones, gall stones, appendix, adenoids, and tonsils.
  • Cancer-related services.
  • Digestive disorder procedures

Basic

Cheapest option to help you avoid the LHC loading and Medicare Levy Surcharge.

Mid

Affordable, but includes more common procedures:

  • Sterilisation.
  • Heart surgery

Mid Plus

Comprehensive coverage:

  • Hip & knee replacements.
  • Other joint replacements.
  • Cataract surgery.
  • Spinal surgery.
  • Dialysis.
  • Rehabilitation services.
  • Restricted podiatric surgery.

Premium

Top level Hospital insurance for complete peace of mind:

  • Pregnancy and birth-related services.
  • IVF & other assisted reproductive services.
  • Cochlear implant.
  • Obesity surgery & gastric banding.
  • Insulin pump.
  • Psychiatric treatment.

When you have an HCF hospital policy, you won't pay any excess when your children need to go to a hospital, regardless of how many kids you have or how frequently they need to go to the hospital.

Important: Simpler hospital cover categories (Basic, Bronze, Silver and Gold) is set to come into effect by April 2020.

Request and compare HCF health insurance quotes

HCF Extras cover

HCF offers 5 Extras policies, from the cheapest Bronze option to the more expensive and comprehensive Platinum policy. Please remember, while Extras cover some or all of the costs associated with general treatments received outside of the hospital, it does not exempt you from the Lifetime Health Cover loading or MLS.

Bronze

Generally, for those that have a strict budget looking to cover the essential services, including general dental, physiotherapy and ambulance services. With this Extras option, you'll get 100% back on 1 dental check-up per year if done at a participating provider.

Bronze Plus

The Bronze Plus Extras policy includes benefits for optical treatments, as well as increased limits on general dental and selected therapies, including physiotherapy.

Silver Plus

While remaining affordable, this HCF Extras policy provides mid-level extras cover for a broader range of general services, including major dental and higher annual benefit limits. Receive 100% back on 2 dental check-ups per year from participating providers.

Gold

This policy aims to provide you with comprehensive Extras and might be suitable for families with kids as it includes orthodontics, occupational therapy and school accident benefit (for children attending school). However, the Gold option might also be beneficial for people closer to retirement age that wants coverage for hearing aids, osteopathy and dentures.

With this option, you'll receive 100% back on your first physio, chiro, osteo and podiatry consult of the year, for a new health condition or flare-up not treated in the last 3 months. Be sure to visit a participating provider to qualify for this claim.

Platinum

HCF Platinum Extras is their top level of Extras cover and provides coverage for all the general treatments listed in the Gold option, but with even higher benefit limits.

More for You provider network

One of the benefits of joining the HCF health fund is that they enable you to get up to 100% back on selected Extras from over 10,000 participating program providers, depending on your level of cover and annual limits.

You can claim money back on services for your:

tooth

Teeth: Up to 100% back on specific dental services when visiting an HCF Dental Centre or participating provider.

glasses-with-circular-lenses

Eyes: Get 100% back on a range of prescription glasses from participating providers, HCF Eyecare, Specsavers and Dresden Optics.

hearing

Hearing: Get up to 100% back on high-quality hearing aids from Blamey Saunders Hears and participating hearing aid providers.

human-back

Back: 100% back on initial consultation from participating chiropractors and osteopaths, for new and eligible health conditions, including flare-ups not treated in the previous 3 months. Claimable once per year.

tiptoe-feet-outline

Feet: Receive 100% back on your initial consultation with a participating podiatrist for new feet related health conditions, including flare-ups not treated in the last 90 days. Claimable once per year.

muscle

Muscles: Up to 100% back on your initial consult with participating physiotherapist across Australia. Claimable once per year for eligible health conditions that are new or a flare-up that not did not receive treatment from a provider in the last 3 months.

Does HCF have ambulance cover?

Yes, HCF provides emergency ambulance cover via their Hospital and Extras policies. They are also one of the few health funds that offer Ambulance only coverage to those Australian residents not fully covered by their state government and wanting ambulance services. However, an ambulance only policy from HCF does not include non-approved ambulance providers or non-emergency services, for example, patient transport between hospitals.

HCF waiting periods

Waiting period Service
1 Day Emergency ambulance
2 Months
  • All hospital services for conditions that are not pre-existing
  • General dental
  • Optical
  • Physiotherapy
  • Psychology
  • Health Management Programs
12 Months
  • Treatment for pre-existing conditions
  • Pregnancy and birth related services
  • Major dental
  • Hearing aids
  • Blood glucose monitors

Frequently asked questions and answers

What are HCF loyalty benefits?

HCF members with a select Gold or Platinum Extras policy can claim money back on a range of services, up to a maximum limit. The longer you are a member, the higher your benefit limit. For example, if you have a Gold Extras policy for more than 3 years, then you can claim physiotherapy up to $550.

Which Health Management Programs can you access?

Health Management Programmes available to HCF customers, allows you to possibly claim money back on:

  • Weight management programs, helping you achieve and maintain a healthy weight.
  • Exercise or gym programs recommended by your doctor or physiotherapist.
  • Child birthing education programs run by HCF-recognised childbirth educators.
  • Breastfeeding consultation from a lactation specialist that is an AHPRA-registered nurse and midwife.
  • Swimming lessons run by certain swim schools.
  • Bowl cancer testing if you're between a specific age, usually between 50 and 74.

To claim on these programs, you’ll need to complete an HCF claim form, which you can find on their website, and include your original receipt. Download the HCF app on your smartphone or tablet and submit your claim.

How can I find a participating More for You provider?

You can easily find a provider online by going to the health fund's member's portal on their website. Log in and go to ‘Find a Health Professional' tab.

How to claim HCF Extras?

If you’ve gone for a treatment or service after you waiting period, you can claim on your Extras cover by either:

  • Swiping your membership card on the spot when visiting a participating provider.
  • Using the HCF app, available for Android and Apple devices.
  • Presenting your membership card and original receipt at any HCF branch.
  • Posting the completed claim form and receipts to an HCF branch.

How to join?

To become an HCF member you need to choose a policy (Hospital, Extras or Package) that suits your requirements and apply online, through the mail or call them directly, alternatively, you can also visit one of their branches.

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Ask an Expert?

24 Comments

  • Anne Fraser |

    I am currently with BUPA. As I am a senior, I have occasional treatment which is quite expensive. Just yesterday had two syndics’ injections into my knees for therapeutic reasons. I am soon to have an ablation on facet joints which are inflamed and BUPA’s gap is fairly substantial.

    My question is, would I be better to change to your company for my cover. I am currently in top hospital cover and pay a co-payment of $50 per night at the hospital up to a cap of $200 per stay. I also have the usual dental, physiology, podiatry, optical etc. cover.

    Further down the track, I might be looking at bi-lateral knee replacement or if possible, stem cell treatment for my knees, if there are sufficient breakthroughs in that treatment.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Anne,

      Thank you for reaching out. I’m sorry to hear about your knee problems.

      As I’m sure you’re aware, if you have a Commonwealth senior’s health card you can subsidise the cost of certain medical treatments and services. It might be worth asking your doctor if he offers discounts to cardholders and request bulk-billing your appointments.

      Comparing only two health funds might limit your options of finding the best health insurance for your specific requirements. You might want to start by first reviewing the best seniors’ health insurance options available.

      If you would like a specialist to assist you in finding a health fund specific to possible knee replacement surgeries please fill in the form above.

  • MC |

    Good day.
    We have the opportunity to come across to Australia on a sponsored visa for my husband. Our problem however is that I am HIV+ and his company will not sign the medical waiver.

    Would there be any insurance that would cover the condition and the Anti-retroviral that I need to take for the condition? Even if it is treated as an existing condition and I can’t claim for 12 months?

    Your help would be greatly appreciated.
    Kind Regards

    • SPECIALIST
      Anneke Van Aswegen |

      Hello,

      Thank you for reaching out. Your question is dependent on a number of factors, including whether you are from a country that has a Reciprocal Health Care Agreement (RHCA) with Australia, as well as the level of cover you want, for example basic, mid-level or comprehensive.

      Most private health insurance companies provide coverage for out-patient type medications under their member’s Extras cover. You’ll want to look for coverage that includes pharmaceuticals. It’s best to talk with a consultant to provide you with a step-by-step guide.

      You can fill in the form above or give them a call on 1300 786 328, or if you prefer you can start comparing health funds providing cover for visa holders. Make sure your medications are not on the health insurer’s exclusion list.

      You’ll also generally need to get a prescription from an Australian registered medical practitioner to claim for medications.

  • Lynda Collins |

    I am so confused with all the different hospital health fund information. I am considering Gastric sleeve surgery. I have been told I qualify to have this done by the surgeon but have no hospital cover.

    I can join one for 12 months waiting period, but I am scared that they will not pay out or charge me huge hidden gap costs. HCF seem the cheapest but have been warned they have hidden costs and they are difficult to pay out a claim.

    I read bad reviews about HBF and Medibank private too. HCF has given me a quote on an ultimate hospital which seems reasonable, but can they reject my claim with fine print somewhere? I’m so scared of getting the wrong cover.

    Can they charge extra for your cover if you mention you’re interested in Gastric sleeve surgery?
    I’m very scared and confused about choosing one and having problems.
    Please help.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Lynda.
      Thank you for reaching out. Alright, let’s start with the basics.
      1. Your doctor or specialist must deem your weight loss surgery to be medically necessary and not classify it as ‘cosmetic’ for most private health fund to pay your benefit.
      2. As rightly stated you’ll most certainly require a mid to top level health insurance plan from a private health insurance company.
      3. You will have to serve a 12 month waiting period before claiming such a benefit.
      4. Private health insurance providers may not refuse health cover because of your health status or charge you more because of your pre-existing condition.

      Your insurer will usually help pay for your private hospital stay, theatre, atheist fees and post-op doctor’s fees. You’ll also receive a small rebate from Medicare; Gastric sleeve surgery falls under Medicare Benefit Schedule item 31575.

      However, there will usually be an amount not covered by your health fund, this is your out-of-pocket cost. The out-of-pocket costs for someone getting gastric sleeve surgery with private health insurance cover is typically between $2,000 and $7,000, depending on your surgeon and level of cover.

      You might want to first go for a consult with a weight loss surgeon, whereupon they’ll provide you with an upfront quote, including the surgery numbers so you can check with the health insurer before you commit to them.

      If you need help, please do not hesitate to contact our health insurance specialists on 1300 786 328.

  • gautam wahi |

    Which HCF plan is suitable for me? Family of 3 (including 1 child of 5 years).

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Gautam.
      The best health insurance plan for you depends on various factors, including the state you live in, your current health and whether you have a family history of health-related problems that you’d like cover for and if you’re planning to grow your family etc.

      Before choosing a private health insurance company and policy type, a good place to start might be in comparing Australia’s top health funds.

      Have a read of our article about the best family health insurance and when you’re ready you can fill in a health insurance quote form and a specialist will give you a call to help you find the right policy.

  • Fred Jay |

    What cover is provided for SMILE eye Surgery?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Fred,

      Corrective laser eye surgery will generally fall into the category of a combined Hospital and Extras cover, where Optical is usually under your Extras options. Look for a policy offering cover for ‘eye lens procedures’, for example:
      • Bupa’s Ultimate Health Cover policy for $446.60 per month.
      • Medibank’s Ultra Health Cover for $464.30 per month.

      Take note; there will generally be a 12-month waiting period before you can claim for this procedure, dependent on the insurer you choose.

  • Emily |

    Hi there. I want to get a private health fund for me and my 1-year-old son. I am a single mother on Centrelink pension so I can’t afford an excessive amount.

    I’m looking at getting the basic hospital cover + silver plus extras policy. Can you give me a quote on how much per month that would cost me and what exactly it covers? I also would like to know if I would have to be in a lock-in contract or not.

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Emily.

      To provide you with a proper quote from a variety of private health funds we require a bit more information, for example, which state you live in. Please fill in the quote form above or contact the health insurance specialists directly on 1300 786 328.

      When purchasing a private health insurance policy, you are not locked into a contract and can switch health funds at any time.

      Per the HCF website, as of November 2018, an HCF Basic Hospital with Silver Plus Extras package for an individual living in NSW start at about $48.80 per week.

  • Ali Karimpour |

    Hi. My wife and I want to apply for a visa to Australia (type 408).

    Is your insurance ok when applying for a visa? Will it cover all unexpected problems (medical) for us?

    Can we pay week by week after arriving at AU?

    Regards,

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Ali,

      Please note that ComparingExpert is a comparison website and not an insurer. By filling in the quote form above a specialist will give a call and provide you with health quotes best suited to your circumstances. Yes, you can usually pay your premiums on a week to week basis if you prefer; however, you’ll probably need to activate your policy before the visa will be granted and this might require starting premium payments.

      Plenty of private health funds in Australia offers policies specifically for visa applicants and generally you’ll have different levels of coverage to choose from, depending on your requirements.

      HCF, in particular, have a few overseas visitors health insurance options which you can review by visiting their website or contact them directly on +61 29290 0100.

  • KYM WISHART |

    Hi. I am a single man 60 years of age. I have a budget hospital with $500 excess and silver extras. I am not sure if this is good or bad. What can you offer me at what monthly price?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Kym.

      Whether your budget hospital and silver extras plan is a good or bad fit for you, depends on your specific requirements and what you can afford. For example, how is your health, in which state do you live and do you have a medical history that might require additional assistance in future? Your health insurance should suit your individual needs. Please fill in the quote form above and a specialist will give you a call to help you feel confident in your choice of health plan.

  • Edwards |

    I’m wanting ambulance cover only please. I’m a 58 yr old female working part time,no health care card. My daughter is 19 and working part time and living at home. We live in NSW. Would it be more economical to purchase 2 single or a combined cover?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi. Thanks for reaching out.

      Seeing as NSW residents generally get 49% of your emergency ambulance services subsidised, you’re right in considering some additional coverage. However, the right policy for you and your daughter depends on your unique requirements. To provide you with a quote, please fill in the above form and a health insurance specialist will assist you.

  • what if i move to other state |

    Hi there, I live in NSW now but planning to move to VIC. Will this will affect my insurance?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi.

      Generally, moving interstate might have an impact on your health insurance coverage. For example, residents of Victoria do not receive ambulance services by their state government and thus residents might want a health insurance policy that includes ambulance coverage. Additionally, your health insurance premium might be lower or higher depending on where you’re moving to.

      Please contact your health fund and inform them of your address change, so they may help you with any adjustments needed to your coverage.

      Good luck with the move.

  • Androulla Yena |

    I am aged 80 and very confused with all the different health funds and options available.

    I am looking for cover for hospitals and extras private hospital cover for joint replacement, heart condition, cataract and Mid extras – dental, optical.

    How do I find out who the participating providers are for these treatments?

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Androulla. Thank you for reaching out.

      I agree, choosing a private health insurance policy can be a daunting task. You might want to speak to a specialist who can help provide clarity on your options. Please call 1300 795 560 for immediate assistance.

      If you’re wondering where to find participating providers for HCF specifically, you can visit the list here.

  • Lis |

    Hi, I will be moving to Australia soon, and my visa requires my health insurance to have a per annum per person minimum benefit of AUD1,000,000. How do I find out which insurance companies offer this?
    Many thanks

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Lis.

      I’m not sure to which benefit you are referring to; is this for Hospital cover or general treatments? Also, because you mention $1 million coverage, it makes me think you might be referring to life insurance.

      Please feel free to reach out to our specialists on 1300 743 254 for clarification.