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HCF Health Insurance Review

Megan Fraser
Megan Fraser Updated: 01 June 2021
Types of Health Insurance

There are several benefits for you and your family when you apply for private health cover. But with the large variety of health insurance funds out there, it can be tricky to decide which policy and plan is best for you.

HCF health fund is a leading private health insurance provider that serves millions of customers each year. With a variety of plans and policies to choose from, you’ll be able to find your ideal policy in no time. Choose between one of their four Hospital or one of their five different Extras plans or combine policies for tailor-made health cover.

Key Facts

  • They offer 4 Hospital and 5 Extras policies.
  • Combine plans for cover suited to your requirements.
  • Use one of the 10,000 providers in their network to avoid out-of-pocket expenses on Extras.
  • Take advantage of their Thank You Rewards programme to earn discounts from leading retailers.

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

About HCF Health Insurance

Founded in 1932, HCF provides health insurance to over 1.5 million Australian citizens, making it the largest non-profit health care fund in Australia and the third-largest private health insurer. They offer an array of cover options for both Hospital and Extras plans.

The premiums paid to the fund are paid back into the company. This ensures that they can focus on building better coverage options for members. They strive to make health care and insurance easily accessible, affordable, and understandable.

What does HCF stand for?

Originally, this fund was named the Metropolitan Hospitals Fund. Today, HCF stands for the Hospital Contribution Fund of Australia. They offer various cover options, including health insurance and life cover, travel, and pet insurance.

HCF cover options

HCF health insurance offers many different cover options, tailor-made to suit your individual needs. There are four hospital plans and five extra options. You even have the luxury of combining cover through a mix and match of products, allowing you to craft a package entirely suited for your own benefit and requirements. Every single hospital cover option provides you with in-hospital treatment in both a private or public hospital.

HCF Hospital cover

PLAN PRICE PER MONTH BENEFITS RESTRICTED COVER
Bronze Plus $92.48 
  • Full palliative care.
  • Joint reconstruction.
  • Dental surgery.
  • Male reproductive system.
  • Gynaecology.
  • Miscarriage and termination of pregnancy.
  • Rehabilitation.
  • Podiatric surgery (provided by a registered podiatric surgeon).
  • Hospital psychiatric services.
Standard Silver Plus
  • Tonsils, adenoids and grommets.
  • Sleep studies.
  • Skin.
  • Rehabilitation.
  • Plastic and reconstructive surgery (medically necessary).
  • Palliative care.
  • Rehabilitation.
  • Podiatric surgery (provided by a registered podiatric surgeon).
  • Hospital psychiatric services.
Silver Plus $111.70 
  • Pregnancy and birth-related services.
  • Full rehabilitation cover.
  • Heart and vascular system.
  • Medically required plastic and reconstructive surgery.
  • Podiatric surgery.
  • Implantation of hearing devices.
  • Podiatric surgery (provided by a registered podiatric surgeon).
  • Hospital psychiatric services.
Gold Plus $172.96 
  • Pregnancy and birth-related services.
  • Full rehabilitation cover.
  • Heart and vascular system.
  • Medically required plastic and reconstructive surgery.
  • Podiatric surgery.
  • Implantation of hearing devices.
  • Podiatric surgery (provided by a registered podiatric surgeon).

Source: Privatehealth.com.au April 2021 (Estimates for Singles Cover, no dependents, in NSW)

HCF Extras cover

PLAN PRICE PER MONTH WAITING PERIODS ANNUAL LIMITS
HCF STARTER EXTRAS $16.902 months
  • General dental & other services – $350
  • Physiotherapy, chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services – $150
HCF STARTER EXTRAS (WITH OPTICAL) $22.402 months
  • General dental & other services – $400
  • Optical – $100 for
  • Physiotherapy – $200
  • Chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services – $100
HCF VITAL EXTRAS $78.152-12 months
  • Major dental, endodontic & other services – $800
  • Lifetime limit for orthodontics – $700 / $2,100.
  • Optical – $250
  • Non-pbs pharmaceuticals, vaccinations & other services – $180
  • Physiotherapy & exercise physiology – $350
  • Chiropractic & osteopathy – $250
  • Podiatry, audiology, dietetics/dietary advice, orthotics podiatric orthoses & speech therapy – $200
  • Psychology & occupational therapy – $350
  • Acupuncture, remedial massage, chinese medicine & other services – sub-limits apply – $250
  • Hearing aids – $600 for
  • Blood glucose monitors & other services – $45
  • Health management – $150
HCF TOP EXTRAS $104.502-12 months
  • Major dental, endodontic & other services – $800
  • Lifetime limit for orthodontics – $700 / $2,100.
  • Optical – $250
  • Non-pbs pharmaceuticals, vaccinations & other services – $180
  • Physiotherapy & exercise physiology – $350
  • Chiropractic & osteopathy – $250
  • Podiatry, audiology, dietetics/dietary advice, orthotics podiatric orthoses & speech therapy – $200
  • Psychology & occupational therapy – $350
  • Acupuncture, remedial massage, chinese medicine & other services – sub-limits apply – $250
  • Hearing aids – $600 for
HCF MID EXTRAS $42.502-12 months
  • General dental, major dental, endodontic & other services – $650
  • Optical – $200
  • Physiotherapy & exercise physiology – $350
  • Chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services – $150
  • Health management – $50
  • Vaccinations – $100

Source: Privatehealth.com.au April 2021 (Estimates for Singles Cover, no dependents, in NSW)

Combined cover

HCF provides you with the opportunity to combine Hospital and Extras policy so you can tailor the policy to suit your needs and lifestyle. If you don’t want to combine policies yourself, there are three custom policies you can choose from, named My Future Basic Plus 250, 500 or 750, My Family Silver Plus, and My Family Advanced Silver Plus.

HCF provider networks

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:

Can you get weight loss surgery with HCF?

Yes, if you have an HCF Gold Hospital plan, you’ll typically be covered for weight loss surgery. They offer coverage for the three main types of weight loss surgery. This includes gastric band surgery, gastric bypass surgery and gastric sleeve surgery. Typically, you’ll have to pay between 3%-4% for the procedure while HCF and Medicare pay for the rest.

Waiting periods for these procedures are generally 2 months. However, if the fund determines that your weight is a pre-existing condition, your waiting period could be extended to 12 months.

How much does HCF weight loss surgery cost?

Generally, the amount you’ll pay for weight loss surgery as an HCF member depends on the type of procedure you’re undergoing. Typically, gastric band surgeries are less expensive but out-of-pocket costs are higher. On the other hand, the total cost for gastric bypass or gastric sleeve surgeries is generally higher while out-of-pocket costs are lower as HCF pays a larger percentage of the total costs.

Average costs for gastric band surgery

Typically, the total average cost for a gastric band surgery is $13,875 provided that you visit one of the participating provider hospitals. Once HCF and Medicare have paid their portion, you’ll generally need to pay around $624.

Breakdown of payments:

Source: HCF Cost Calculator (June 2021, estimates for average costs based on an individual on a Gold Hospital plan visiting a participating private hospital with no excess seeing doctors participating in an HCF gap arrangement)

Average costs for gastric bypass and gastric sleeve surgeries

if you decide to opt for a gastric bypass or a gastric sleeve procedure, you’ll generally be able to expect the total average cost to be around $15,545. Both HCF and Medicare will pay a certain percentage towards the total cost while the average out-of-pocket cost for members is $517.

Breakdown of payments:

Source: HCF Cost Calculator (June 2021, estimates for average costs based on an individual on a Gold Hospital plan visiting a participating private hospital with no excess seeing doctors participating in an HCF gap arrangement)

How to join this fund

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.

Special offers and benefits for HCF members

The insurer has launched their Thank You program that rewards members the longer they stay with the fund. You’ll receive savings from a wide range of national brands, for example, Coles, Woolworths, Meyer and David Jones.

Diamond and Ruby members can also use HCF Assist, which includes Clinical Triage and Home Assistance.

Members can view the offers and rewards they have access to by logging into the online member service.

Frequently asked questions

  • How to make a claim online?

    You can make an online HCF claim through the member services portal. To complete your claim application, you will have to upload your original receipts to the health fund.
  • Is HCF health insurance good?

    Whether this company is good generally depends on your requirements. To determine whether this is the right fund for you, it’s a good idea to compare their policies with other leading health funds.
  • What do they cover?

    HCF covers an extremely wide range of hospital treatments that fall into different plans and policies. You’ll generally be able to choose between one of their four Hospital and five Extras plans. You may also be able to apply for an Ambulance only policy from this fund.
  • What are HCF loyalty benefits?

    HCF members with a Vital or Top 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 Top Extras policy for more than 3 years, you can claim physiotherapy for up to $900.
  • Which Health Management Programs can you access?

    Specific HIC health insurance policies include benefits for Health Management Programs, which allows you to claim money back towards programs such as:
    • 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.
    • Bowel cancer testing if you’re 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.
  • Does HCF offer 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 Australian residents not fully covered by their state government but still would like 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.

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