Ambulance and Cash Back Cover Only available to residents of NSW & ACT

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1 Ambulance and Cash Back Cover Only available to residents of NSW & ACT Valid until Reg. No Health Insurance Australia April 2015

2 Why you need Ambulance and Cash Back Cover The cover you need in an emergency Did you know that Medicare doesn t cover the cost of using an ambulance? If you have an accident while playing sport, out and about, or even on the farm, the last thing you want to worry about is a costly ambulance bill. Ambulance services don t come cheap, especially if you live in a remote area. As well as the callout fee, which is several hundred dollars, you re also charged a per kilometre fee which can add up to a very costly ride. An air ambulance is even more expensive. And it doesn t stop there. Other expenses resulting from your accident like surgery, medical bills and childcare can add up quickly. There are two simple and affordable ways to help cover these costs: Ambulance and Cash Back Cover - ideal if you want ambulance cover plus a cash payment to cover additional expenses Ambulance Cover - ideal if you simply want ambulance cover. 30 Day Guarantee You will receive a 100% refund on your cover if you change your mind or cancel your policy within 30 days, provided you haven t made a claim. 2 3

3 What you're covered for Australian Government Rebate on Private Health Insurance Ambulance Cover Cover for emergency ambulance with State Government services where you require hospital or on-the-spot treatment in Australia Up to $5,000 per person per calendar year for State Government, medically necessary, non-emergency ambulance services where your doctor requests ambulance transport because your condition requires monitoring and support in transit When you receive your ambulance bill, all you have to do is send us the bill along with a completed claim form either by post by submitting it at one of our branches This cover is only available to residents of NSW and ACT Visit hcf.com.au for a quote, or call us on , as Ambulance Cover rates vary according to your circumstances Ambulance and Cash Back Cover premiums are payable monthly or yearly. Ambulance Cover premiums are only payable yearly in advance. Cash Back Cover Only $2 per week for singles or $4 per week for families. It is not covered by the Australian Government Rebate on private health insurance Only available to permanent Australian residents aged between 16 and 60, with cover extending until 65 Pays $5,000 if you suffer an accident resulting in surgery Pays $5,000 if you suffer a serious specified medical condition Can claim multiple times - up to $20,000 for singles and $40,000 for family cover. Go to page 8 to see which benefits are paid for. Combined Financial Services Guide and Product Disclosure Statement A Product Disclosure Statement (page 8) and Financial Services Guide (page 9) for Cash Back Cover is included in this brochure. To help make private health cover more affordable, the Australian Government provides a rebate on your health insurance premium. The rebate is available to people with hospital, extras or ambulance cover, and who are registered with Medicare. The rebate is income tested, so your entitlement may change depending on your income and also your age. You can elect to take the rebate either as: A reduced premium A tax offset credit in your annual tax return. When calculating your income you need to include taxable income, fringe benefits, reportable superannuation contributions, net financial investment losses and more. You may incur additional tax payments if you nominate the incorrect rebate tier. We can provide you with general information about the rebate tiers. However, for personal advice specific to your circumstances, please consult your accountant, financial advisor or the ATO at ato.gov.au or on See privatehealth.gov.au/healthinsurance/ incentivessurcharges for the list of rebate percentages. 4 55

4 The things you need to know 66 Ambulance Cover This is a summary of the rules and policies that apply to our Ambulance Cover. So there s no confusion when you need to make a claim, it s important to understand who can be covered under your policy. Who can be covered under your policy? This cover is only available to residents of NSW and ACT. The Policyholder The Policyholder is the person in whose name the health insurance policy is held (also known as the Contributor). The Policyholder: Is our main point of contact Nominates who s covered by the policy Is entitled to access all records and claims history relating to the membership, including end of year tax statements Must advise us of any changes to membership details Is responsible for payment of the premiums. Single cover The person covered under the Single policy is the Policyholder only. Couple cover Covered under this policy are: The Policyholder The Policyholder s Partner listed under the policy. ('Partner' means spouse or de-facto partner). Family cover Covered under this policy are: The Policyholder The Policyholder s Partner listed under the policy The Policyholder s and/or Partner s Child dependant/s The Policyholder s and/or Partner s Student dependant/s. Single Parent Family cover Covered under this policy are: The Policyholder The Policyholder s Child dependant/s The Policyholder s Student dependant/s. Child dependant means a person who: a) Is less than 22 years of age; and b) Isn t married or in a de-facto relationship; and c) Is primarily reliant on the Policyholder (or Partner listed on policy) for maintenance and support; and d) Is related to the Policyholder (or Partner listed on policy) as a Child, Stepchild, Foster Child or other Child that the Policyholder (or Partner listed on policy) has legal guardianship over. Student dependant means a person who: a) Is aged between (inclusive); and b) Is a full time student at school, college or university; and c) Isn t married or in a de-facto relationship; and d) Is primarily reliant on the Policyholder (or Partner listed on policy) for maintenance and support; and e) Is related to the Policyholder (or Partner listed on policy) as a Child, Stepchild, Foster Child or other Child that the Policyholder (or Partner listed on policy) has legal guardianship over. Waiting periods All members must serve waiting periods before benefits are payable. The waiting periods for Ambulance Cover are: One day: emergency ambulance (where not for pre-existing ailments or conditions) Two months: medically necessary non-emergency ambulance (where not for pre-existing ailments or conditions) Twelve months: pre-existing ailments or conditions. Pre-existing ailments or conditions A pre-existing ailment, illness or condition is one where the signs or symptoms existed during the six months before joining HCF or upgrading to a higher level of cover, even though a diagnosis may not have been made. If there s any doubt that an ailment or condition is pre-existing, a medical practitioner appointed by us will examine information provided by your doctor, together with other relevant claim details. Ambulance Transportation HCF pays benefits towards eligible State Government provided emergency and nonemergency ambulance services. The ambulance service provider must be recognised by HCF and the transportation must be to the nearest appropriate Australian hospital able to provide the level of care required. Emergency Ambulance Transportation: Benefits are payable for emergency ambulance services where transport to the nearest hospital or on-the-spot treatment is required. Emergency means an immediate and serious threat to person s health or life. Benefits are not payable: Where the ambulance service is not requested because of an emergency; For transport on discharge from hospital to your home or nursing home; Where you are covered by another funding arrangement such as a State Government scheme; Where you are covered by another third party (such as a state ambulance subscription or the ambulance charges are the subject of a compensation claim); For transfers between hospitals; For charges raised for a medical retrieval team escort; For ambulance transport providers not recognised by HCF. Non-Emergency Ambulance Transportation: You can claim up to a maximum of $5,000 in a calendar year for non-emergency ambulance transport. Non-emergency ambulance transport means transport by a State Government provided ambulance that is requested because your medical condition requires a level of support and medical monitoring in transit that only an ambulance service can provide. Non-emergency ambulance transport must be requested by your treating doctor to be considered for an HCF benefit. Benefits are not payable for Non-Emergency Ambulance transport: Where the transport does not meet the definition above (such as for general patient transport); Where the transport has been elected by the patient or family for reasons such as choice of doctor or hospital or closer to family; Where you are covered by another funding arrangement such as a State Government scheme; Where you are covered by another third party (such as a state ambulance subscription or the ambulance charges are the subject of a compensation claim); For transfers between hospitals; For charges made for a medical retrieval team escort; For ambulance providers not recognised by HCF. 77

5 Ambulance service providers recognised by HCF HCF recognises the following ambulance service providers for the purposes of paying benefits: - ACT Ambulance Service - Ambulance Service of NSW - Ambulance Victoria - Queensland Ambulance Service - South Australia Ambulance Service - St John Ambulance Service NT - St John Ambulance Service WA - Tasmanian Ambulance Service. Product Disclosure Statement for Cash Back Cover Cash Back Cover is sold by HCF and issued by HCF Life Insurance Company Pty Limited. Any Australian permanent resident aged 16 to 60 can combine this cover with Ambulance Cover. You will receive a policy document once your application has been processed that will give you full details of your cover. A copy is also available on request. If you find this policy does not meet your needs, you then have 30 days to cancel by letting us know in writing. Provided you have not made a claim, any premiums paid will be refunded. Benefits paid: Pays you a cash benefit of $5,000 if you or any person covered by your membership suffers an accident that requires surgery in an operating theatre within six months of the date of the accident You also receive $5,000 for malignant cancer, chronic kidney failure, heart disease requiring bypass surgery, heart attack, stroke, or any disease requiring a major organ transplant A maximum of $20,000 is payable for single cover ($5,000 for up to 4 accidents or serious illnesses) and $40,000 for family cover ($5,000 for up to 8 accidents or serious illnesses) if you or your family have a number of accidents or illnesses during the life of the policy. Benefits are not paid for: Surgery for diagnostic purposes only or not carried out in an operating theatre Conditions which arise during the first two months of cover Accidents which occur on or before the cover commencement date, or disablements which occur outside Australia, or are covered by workers compensation, social security, an accident scheme or third party liability insurance Disablements which occur as a result of a pre-existing condition, drugs or alcohol, AIDS or related conditions, intentional self injury, racing, professional sport, military service, private aviation, illegal acts, war or related risks, or terrorism. The cost of HCF Cash Back Cover is $8.65 for singles and $17.30 for families/couples per month. The product is written in HCF Life s No.1 Statutory Fund and does not acquire a cash value at any time. Protecting your rights If you have a complaint about your Cash Back Cover policy, please contact our Policy Service Team on and we will attempt to resolve it promptly. If you are dissatisfied with our response, you can contact the Financial Ombudsman Service. This is an independent body that is available to you free of charge. The Service s address is: The Financial Ombudsman Service, GPO Box 3, Melbourne VIC Telephone: Your policy expires when one of the following events occur: Upon payment of the total benefit amount If you don t pay your premium When the Policyholder turns 65 Upon the death of the Policyholder. Premiums must be paid when due to prevent policy from lapsing. Premiums can only be increased if the increase applies to all Policyholders and we will give you one month's notice of any increase. Taxation Usually, benefits are paid free of personal tax and premiums are not tax deductible. This is a general statement based on present laws and their interpretation. Individual circumstances may vary. Financial Services Guide for Cash Back Cover This Financial Services Guide (FSG) relates to the services provided by HCF (we, us or our) in relation to the products issued by HCF Life Insurance Company Pty Limited. It is designed to assist you in deciding whether to use any of the services offered by us in this FSG. It contains information about remuneration paid to us and our staff for the services offered and how complaints against us in relation to these services are dealt with. If we offer or arrange to issue you any of these products, we will provide you with a Product Disclosure Statement relating to that product - where required. This sets out the significant features of the product and will assist you in comparing and making informed decisions about the product. We provide general advice about the suitability of these products for the needs of members. This means we don't take into account individual objectives, financial situations or needs. You should, before acting on that advice, consider the appropriateness of the advice, having regard to your objectives, financial situation or needs. Please read the Product Disclosure Statement before deciding to purchase any of these products. We are licensed to provide general advice about, and arrange the issue of, life and general insurance products. HCF Life is a wholly owned subsidiary of HCF. When we issue you with a policy, we do so under a binder that authorises us to enter into that contract of insurance on behalf of HCF Life. The premiums for the life insurance products are paid to HCF Life. We receive commission from HCF Life for their sale of 40% of the first year s premium plus an additional commission of 80% of HCF Life s underwriting profit each year, calculated as premiums less claims and expenses. Our staff receive an incentive, depending on the annual premium of these products which they sell. This will not exceed 20% of the first year s premium. We are a not-for-profit organisation and all income received is applied for the benefit of our members. HCF Life Insurance Company Pty Limited ABN , AFSL George Street, Sydney, NSW, 2000 Telephone Dated: 8 January 2015 HCF and HCF Life are each responsible for the entire contents of this Combined FSG and PDS. We hold Professional Indemnity Insurance that complies with the compensation requirements of Section 912B of the Corporations Act. This includes cover for claims in relation to the conduct of representatives and employees who no longer work for us but who did at the time of the relevant conduct. Should you have a complaint about any of the services we offer in this FSG, please contact us and we will endeavour to resolve it as quickly as possible. If we have not resolved your complaint within 45 days or you are not satisfied with our response, you can contact The Financial Ombudsman Service on or by post at GPO Box 3, Melbourne VIC This is an independent body available to you free of charge. The Hospitals Contribution Fund of Australia Limited ABN , AFSL No George Street Sydney Telephone Dated: 8 January

6 Our privacy statement We collect your personal information including sensitive information such as health information from you and/or the Policyholder who is responsible for your policy and/or from other third parties detailed in our Privacy Policy, so we can: Comply with applicable laws Manage our relationship with you Record your treatment Provide health or other insurance, related products and services to you (including through third parties) Manage and pay claims and benefits Assess your insurance, health and related lifestyle needs Investigate fraudulent or improper claims and assess risks Research and develop products, services and benefits that may better serve your needs Assess your possible interest in and tell you about such products and services Administer our business and deal with complaints. The types of organisations and individuals we disclose personal information to include: Third party organisations who deliver services on our behalf or to us, some of whom may be located overseas Health service providers, to improve their ability to provide you with health services Research companies contracted to us to ask your opinion on improving our service, benefits or product offerings Other insurers or reinsurers, including other health insurers if you have moved your insurance to or from HCF Government, including law enforcement agencies Related HCF companies The named Policyholder who has your authority Any other authorised individual. If you do not provide the personal information we request, we may not be able to provide you with our products or services, including health insurance. You can ask us at any time to stop direct marketing to you by ing or calling For more information about the personal information we collect and how we handle it, how to access and correct your information or to make a complaint and how we will respond to complaints, please read our Privacy Policy. To view the HCF Privacy Policy: Visit hcf.com.au/privacy Visit your local branch. All new Policyholders should ensure that all members on the policy are made aware of the HCF Privacy Policy. Changes to products and pricing Please read and retain this brochure for future reference. However, we reserve the right to make changes to prices, product specifications and other conditions relating to the products contained in this brochure. Please contact us prior to purchasing any products to make sure that you have the latest information available. How to apply Call We re open 8am - 8pm, Monday to Friday, 9am - 5pm weekends (AEST) Visit us in person, find your nearest branch at hcf.com.au/branches Go to hcf.com.au/ambulance Download an application form at hcf.com.au/forms and mail your completed form to GPO Box 4242, Sydney NSW

7 Start enjoying benefits only HCF can offer. Join today Go to the HCF website hcf.com.au Visit one of our many branches. Find your closest branch at hcf.com.au/branches Call We re open 8am - 8pm, Monday to Friday, 9am - 5pm weekends (AEST) Mail your application form Claim using our app Take a photo of your extras claim receipt on your phone and submit. Available for iphone and Android Corporate Sales Ask one of our corporate sales representatives to visit your workplace by ing hcf.com.au The Hospitals Contribution Fund of Australia Limited. ABN Head Office: 403 George Street,Sydney NSW APR15_VAL0095_Amb&CBC

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