HCF Health Insurance Review

Published: July 17, 2017

There are more private health insurers to choose from than ever before, and each one is competing for your business. It can be difficult to determine which one is right for you. That is why reviewing and comparing private health insurers, like HCF Health Insurance, will help you figure out if their particular selection of policies, exclusions, benefits, and features offers you true value for money.

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HCF Hospital Cover

  • Basic Hospital
  • Mid Hospital
  • Premium Hospital

HCF Extras Cover

  • Bronze Extras
  • Silver Extras
  • Gold Extras

HCF Packages

  • Singles & couples
  • Pregnancy
  • Family

Investing in health cover is serious business, so let our review assist you in making the best decision for you and your family. It’s also a good idea to review and compare other health insurance companies so that you can be confident in your decision.

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What does HCF stand for?

HCF stands for “Hospitals Contribution Fund” and is perhaps one of the most well-known companies in Australia. With over 80 years’ worth of experience, they are one of the biggest private health insurance companies in the country, offering a variety of hospital, extras, and packaged policies, as well as a range of excesses for you to choose from.

Health insurance HCF operates as a “not-for-profit”, or a “for members” provider. This simply means that they re-invest their profits back into the company to improve their product offering, provide additional savings opportunities and lower premiums.

HCF private health insurance packages and options

HCF offers 4 Hospital Cover policies, 5 Extras Cover policies, and 5 Package Cover policies. With their wide range of options, you can customize your cover or choose a policy that combines different treatments and services to suit your unique lifestyle.

Compare HCF Hospital Cover

HCF provides four hospital cover options, from affordable entry-level policies to more expensive cover that offers complete peace of mind. These policies include Basic Hospital, Mid Hospital, Mid Plus Hospital, and Premium Hospital health insurance.

However, it’s important to know that there are certain treatments and services for which HCF will only pay a Minimum Benefit, meaning they will only pay the rate set out by the Commonwealth Minister for Health.

Basic Hospital

The HCF Basic Hospital is their most affordable hospital policy. This product gives you cover for a wider range of treatments than most other insurers’ entry-level policies.

  • Ideal if you’re on a tight budget and just need cover for basic hospital treatments in an HCF-affiliated private hospital.
  • Covers emergency ambulance, accident-related treatments, rehabilitation services, cancer-related services (like chemotherapy), and psychiatric services, removal of tonsils, appendix, kidney stones, and digestive disorder procedures (like bowel surgery).
  • Excludes cover for heart and spinal surgery (including diagnostic procedures), gastric banding and obesity surgery, assisted reproductive services (like IVF), and pregnancy and birth-related services.
  • Minimum benefits are provided for rehabilitation services, psychiatric services, and joint investigations and reconstructions.

Mid Hospital

HCF’s Mid Hospital policy provides cover for some common procedures and includes a wider range of hospital treatments than their Basic option, with only a slightly higher premium.

  • An affordable choice, whether you’re single, a single parent, or a couple that needs a bit more cover and wants to include pregnancy services.
  • Covers everything listed in the Basic Hospital cover and also includes heart surgery, joint reconstruction, and pregnancy and birth-related services.
  • Excludes cover for gastric banding and obesity surgery, cataract and other lens-related surgery, insulin pump treatments, and assisted reproductive services (like IVF).
  • Minimum benefits are provided for spinal surgery, rehabilitation services, psychiatric services, and pregnancy and birth-related services.

Mid Plus Hospital

The HCF Mid Plus Hospital policy provides moderately more cover than their Mid option and includes more complex procedures, like eye surgery.

  • Provides cover for common and complex procedures but excludes pregnancy services.
  • Includes the same services as Mid Hospital, like heart surgery and joint reconstruction, as well as more complex procedures, like spinal surgery, cataract surgery, and other lens-related surgeries.
  • Excludes cover for gastric banding and obesity surgery, assisted reproductive services (like IVF), pregnancy and birth-related services, insulin pump treatments, and care involving dialysis for chronic renal failure.
  • Minimum benefits are provided for psychiatric services and podiatric (foot) surgery.

Premium Hospital

For more comprehensive cover you can choose their Premium Hospital policy. This is HCF’s most expensive policy with the highest level of cover available. It is also their only policy with no exclusions and full cover for assisted reproductive services, pregnancy, and birth services.

  • Perfect if you want total peace of mind knowing that you’re covered for almost every eventuality as a hospital patient.
  • Cover includes all treatments and services, from emergency ambulance and cancer-related services (like chemotherapy) to eye surgery (including cataract surgery) and gastric banding and obesity surgery, as well as assisted reproductive services, pregnancy, and birth services.
  • No exclusions.
  • Minimum benefits provided for Podiatric (foot) surgery.

Compare HCF Extras Cover

HCF offers 5 Extras Cover policies, each with varying levels of cover, and each with different restrictions, features, and benefits. You can choose to take out these policies as standalone, or you can customize your cover by adding the one that best suits your chosen hospital cover.

Bronze Extras

As HCF’s most affordable Extras policy, Bronze provides cover for the basic out-of-hospital treatments and services that you might need, from general dental to chiropractic treatment.

  • Best for those that have a strict budget, are young and healthy, and only want cover for the basics.
  • Includes cover for general dental (including 1 check-up, 1 scale and clean, and 1 fluoride treatment per year), physiotherapy, chiropractic/osteopathy, and a few therapies (like remedial massage, acupuncture, and a nutrition consultation).
  • Excludes cover for major dental (like tooth extractions, oral surgery, and dentures), optical treatments (like glasses and contact lenses), and other therapies (like occupational therapy, podiatry, speech therapy, hearing aids, and more).
  • Get 100% back on 1 dental check per year, although not available to Northern Territory and Tasmania residents.

Bronze Plus Extras

While on the surface, this appears to be the same as Bronze, HCF’s Bronze Plus Extras goes one step further and includes benefits for optical treatments.

  • Bronze Plus is suited to the young and healthy who are budget conscious, while still allowing you to claim for optical treatments.
  • Covers everything in the Bronze option, but with higher limits and added cover for simple tooth extractions and optical treatments (like glasses and contact lenses).
  • Excludes a few therapies like occupational therapy, podiatry, speech therapy, hearing aids, and more. Also excludes major dental, for example, oral surgery and dentures.
  • This policy gives you 100% back on 1 dental check per year, although this isn’t available to Northern Territory and Tasmania residents.

Silver Plus Extras

While this remains an affordable policy, the HCF Silver Plus Extras provides mid-level extras cover for a range of services and therapies. This allows you to benefit from higher annual benefit limits and cover for more services than either of the Bronze policies.

  • Great for families and those wanting cover for more dental procedures, more therapies, and prescription glasses.
  • Covers all general and most major dental services, from check-ups and cleanings to fillings and oral surgery, as well as optical treatments (like glasses and contact lenses), and a few more therapies, including physiotherapy, chiropractic, exercise physiology, osteopathy, remedial massage, acupuncture, and health management programs (HCF-approved exercise classes and weight management).
  • Excludes cover for orthodontics, hearing aids, artificial aids (like glucose monitors), and a few therapies (including podiatry, dietetics, audiology, and speech pathology).
  • You’ll receive 100% back on 2 dental checks per year, although this isn’t available to Northern Territory and Tasmania residents, and 100% back on certain spectacles and lenses, and free digital retinal imaging eye check.
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Gold Extras

The HCF Gold Extras provides you with quality cover for comprehensive extras. This policy increases the benefit limits for a wide range of services for every year that you stay with HCF and maintain your Gold policy.

  • Ideal if you want more extras services, or if you have a family and want comprehensive cover.
  • Covers general and major dental services, with no annual limit for some treatments, as well as optical services (contact lenses and glasses), all therapies from physiotherapy and occupational therapy to remedial massage, acupuncture, and podiatry, as well as hearing aids, artificial aids (like blood glucose monitors), and health management programs (HCF approved exercise classes and weight management).
  • No exclusions.
  • This policy gives you 100% back on 2 dental checks per year (not available to Northern Territory and Tasmania residents), 100% back on an initial physiotherapy, chiropractic, osteopathy, and podiatry consultation, and 100% back on certain spectacles and lenses and free digital retinal imaging eye check.

Platinum Extras

The HCF Platinum Extras is their top level of extras cover and provides you with the highest level of cover and highest limits.

  • Ideal for families, couples, and those who want total peace of mind knowing that they’ve got comprehensive cover for a wide range of extras.
  • Includes everything that’s covered under Gold Extras, plus higher benefit limits.
  • No exclusions.
  • You get 100% back on 2 dental checks per year (not available to Northern Territory and Tasmania residents), 100% back on an initial physiotherapy, chiropractic, osteopathy, and podiatry consultation, and 100% back on certain spectacles and lenses and free digital retinal imaging eye check.

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Compare HCF Packaged Cover

You can also choose from one of HCF’s ready-made package options that combine Hospital and Extras cover. All you need to do is select the Package Cover category that best describes your lifestyle, and they will recommend a few packaged policies for you to choose from.

These 5 categories include Young Singles and Couples packages, Planning a Family, Family with Kids, No Pregnancy, and Top Cover.

Young Singles and Couples Package

As a young single or couple, you can get affordable cover for services you are more likely to use by excluding those that you don’t, like pregnancy, birth, and assisted reproductive services.

Policies you can choose from:

  • Basic Hospital + Bronze Plus Extras
  • Young Starter Package
  • Mid Hospital + Silver Plus Extras

Planning a Family Package

People who are planning a family have different health concerns, the most obvious of which includes pregnancy and birth-related services. HCF provides packages that specifically includes these services.

Policies you can choose from:

  • Premium Hospital + Silver Plus Extras
  • Premium Hospital + Gold Extras
  • Premium Hospital + Platinum Extras

Family with Kids Package

Due to the varied nature of a family’s needs, HCF provides more comprehensive and affordable options for you to choose from.

Policies you can choose from:

  • Basic Hospital + Silver Plus Extras
  • Mid Hospital + Gold Extras
  • Premium Hospital + Platinum Extras

No Pregnancy Package

The No Pregnancy Package from HCF is ideal for those who are looking for a more comprehensive level of health insurance but don’t need cover for pregnancy, like couples who have chosen not to have children, seniors, or families with older children.

Policies you can choose from:

  • Mid Hospital + Silver Plus Extras
  • Mid Plus Hospital + Gold Extras
  • Mid Plus Hospital + Platinum Extras

Top Cover Package

The most expensive package is Top Cover, which takes the top Hospital policy and combines it with the most comprehensive Extras policies.

Policies you can choose from:

  • Premium Hospital + Silver Plus Extras
  • Premium Hospital + Gold Extras
  • Premium Hospital + Platinum Extras

What is HCF Membership Benefits?

HCF Membership Benefits are the programs available to HCF customers. To gain access, simply register online, download their apps and choose from a list of health and wellbeing programs.

As an HCF member, you can get 100% back on selected extras and free initial consultations for physiotherapy, chiropractic, and osteopathic services. You’ll also be awarded higher benefit limits the longer you maintain your cover with HCF, and you could get free comprehensive travel insurance, depending on your policy.

Other benefits include:

  • Access to 35 000+ Specialist Doctors: With so many specialist doctors who participate in the HCF Medical Gap Cover scheme available for you to see, you’ll have little to no out-of-pocket expenses.
  • Access to My Global Specialist: If you need a second opinion, you can get the best advice from a global network of 50 000+ medical experts.
  • Access to My Health Guardian: This is HCF’s chronic disease management program, which provides telephonic and face-to-face support to help members with chronic diseases, like diabetes, to manage their condition and live healthier lives.
  • Zero Excess: You won’t pay a hospital excess for children, or for yourself if you have been in an accident and are admitted to an HCF-participating hospital.

What HCF doesn’t cover | Exclusions

A list of HCF general exclusions, which applies to all their policies:

  • Any claims made 2 years after the date of service.
  • Any claims that fail to meet the HCF Fund Rules.
  • Any claims you make for extras where you have already exceeded your limit.
  • Any elective cosmetic surgery or emergency room fees.
  • Any fees related to ambulance transfers between hospitals.
  • Any medicine considered “take-home/discharge drugs”.
  • Any nursing home or respite care fees.
  • Any prostheses used for cosmetic reasons and where no Medicare benefit applies.
  • Any services that aren’t received face-to-face, except for services received under a Chronic Disease Management Program or Health Management Program.
  • Any treatments and services provided to you by a family member, business partner, or a provider that isn’t recognised by HCF.
  • Any treatments and services you received from outside of Australia.
  • Any treatments and services you received while your policy is in arrears, suspended, or within a waiting period.

HCF No Gap Services

One of the benefits of joining HCF is that they offer a range of fully covered services through their More for You provider network, depending on your Extras policy.

HCF No Gap services include:

  • Your Back: The initial consultation with a participating chiropractor or osteopath (1 per calendar year) is fully covered.
  • Your Eyes: Get a free digital retinal imaging with your eye test and 100% back on a range of prescription glasses – excluding add-ons, like high index material, coatings, and tinting.
  • Your Feet: The initial consultation with a participating podiatrist (1 per calendar year) is fully covered.
  • Your Hearing: Get up to 100% back or a valuable discount, on high-quality hearing aids from Blamey Saunders Hears, depending on your level of cover and entitlements.
  • Your Muscles: The initial consultation with a participating physiotherapist (1 per calendar year) is fully covered.
  • Your Teeth: Depending on your policy, you could get 1-2 fully covered check-ups per calendar year and 2 fully covered mouth guards (limits apply).

Frequently Asked Questions and Answers about HCF

Does HCF have ambulance cover?

Yes, HCF provides Ambulance Only Cover, from $1.15 per week. It is available to NSW/ACT residents and covers the cost of Emergency Ambulance Transport services throughout Australia, where this is provided by state government Ambulance Service Providers. It doesn’t include private hospital cover or cover as a privately insured patient in a public hospital.

What are HCF health dollars?

HCF Health Dollars are the fund’s loyalty benefits, paid to members who have an eligible Hospital and/or Extras policy. They can only be used to pay towards your hospital excess and general extras, like dental and physiotherapy. Importantly, your Health Dollars balance is renewed each year, and any unused Health Dollars won’t be carried over to the following year.

Before you get an HCF health insurance quote, make sure that you compare HCF’s wide range of products with other top health funds. This way, you’ll be confident that you are getting the best cover for your needs and budget.  

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14 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.