Overseas visitors HIF health cover. Visit online to get a quote and join. Call or Int l

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1 Overseas visitors HIF health cover. Visit online to get a quote and join. Call or Int l

2 What s Inside? What do we cover? 4 At-a-glance comparison table 4 Working Visa cover 6 Essentials Working Visa 6 Intermediate Working Visa 8 Comprehensive Working Visa 10 Visitors Visa cover 12 Visitor Saver cover 12 Visitor Value cover 14 Visitor Advantage cover 16 Hospital & Medical cover 18 Extras cover 20 At-a-glance comparison table 21 SmartTeeth 22 Ready to join us? 26 Ways to pay and claim 28 Feedback, disputes & privacy 30 Useful info about tax 31 2

3 Welcome to Australia and a better choice of health cover. Australia s a wonderful place (although we re a bit biased). We hope your stay will be healthy and accident-free, but just in case, we ve created a choice of affordable health insurance for you and your family, whether you re: working here for a while or, even better, relocating here permanently. Who is visitor cover for? We cover overseas workers and other visitors to Australia. Our Working Visa covers are suitable for visitors on working visas and aged under 65. Our Visitor covers are suitable for visitors on other visas and Visitor Advantage is suitable for visitors over 64. We have suitable health cover for: permanent residents (who aren t yet entitled to claim from Medicare) short-term visitors (minimum one month for working visas and two months for others) visa 410, 418, 457 and 485 applicants requiring health cover to meet the conditions of their visa temporary residents norfolk Island residents immigrants. What s Medicare? Medicare is Australia s public health system. How does the health system work in Australia? We have a health system that combines public and private health care services. Medicare is the public health care system. Coming to Australia on a visa? Then your entry to Australia may be dependent on securing private health insurance. Read on to find out about our visa-compliant health cover. Are you covered by Medicare? It depends which country you re from. You may be entitled to limited Medicare cover under a reciprocal agreement but only for emergency treatment, and only under certain conditions. In any case, you won t be able to choose your doctor and you won t be covered for: treatment in a private hospital non-emergency visits to the doctor extras services like dental and optical care or ambulance transport. Not covered by Medicare? You ll have to pay for hospital and medical treatment, which is expensive For example, an emergency appendectomy can cost up to $30,000. And bear in mind that even if you are entitled to cover from Medicare, you may be put onto a hospital waiting list if your condition is not life threatening. No waiting, no stress, no costly health bills With our affordable and easy-to-arrange overseas visitors health cover, you ll be able to access hospital and medical care whenever and wherever you need it. Choose one of our higher levels of cover and you can also choose your doctor and hospital. Smart, easy-to-organise Health Cover Apply online to receive your visa compliance letter instantly! 3

4 Which cover? Take your pick. What s Hospital cover? Our Hospital insurance gives you access to the public and private hospital system in Australia. Ambulance services are included, see page 18 for more information. Check out the different levels of cover to see what s included. What s Medical cover? It covers medical expenses, which includes: consultations medical treatments pathology (e.g. blood tests) X-rays surgical procedures other services that would attract a Medicare rebate if you were an eligible Australian resident treatment at a hospital emergency department. What s Extras cover? Extras health care encompasses a range of services, including: dental healthcare optical physiotherapy chiropractic services complementary therapies (massage, acupuncture and more) osteopathy dietetics healthy lifestyle services (skin cancer screening, health checks) pharmacy podiatry. Working Visa cover comparison table Ambulance cover Private room, private hospital Shared room, private hospital Private room, public hospital Essentials Working Visa Intermediate Working Visa Comprehensive Working Visa Shared room, public hospital Theatre fees, prostheses, inpatient (PBS^) pharmacy items etc Access Gap Cover Outpatient services (covered up to MBS^ fee) Including Up to $500 per person per treatment at a hospital emergency/ calendar year casualty department Optional Excess $500/1000 Bone marrow and organ transplants Assisted reproduction Repatriation* $4,000 lifetime limit, once per person $6,000 lifetime limit, once per person $8,000 lifetime limit, once per person DIAC compliant 4 For more details, please refer to the individual cover descriptions. * For eligibility details see page 18. ^(PBS) Pharmaceutical Benefits Schedule. (MBS) Medicare Benefit Schedule.

5 Smart, easy-to-organise Health Cover Visitor Visa cover comparison table Visitor Saver Visitor Value Visitor Advantage Ambulance cover Private room, private hospital Shared room, private hospital Private room, public hospital Shared room, public hospital Theatre fees, prostheses, inpatient (PBS^) pharmacy items etc Access Gap Cover Outpatient services (covered up to MBS^ fee) Including treatment at a hospital emergency/ casualty department Excess Bone marrow and organ transplants Assisted reproduction Repatriation* DIAC compliant $250 / $500 not optional Up to $500 per person per calendar year $250 / $500 not optional Up to $1,500 per person per calendar year $200 / $400 not optional For more details, please refer to the individual cover descriptions. * For eligibility details see page 18. ^(PBS) Pharmaceutical Benefits Schedule. (MBS) Medicare Benefit Schedule. 5

6 Essentials Working Visa (Hospital only cover). This is our entry level cover for visitors to Australia on working visas aged under 65 years. It covers all the essentials, making it a popular choice for those who just want Hospital cover and are happy to be treated in a shared hospital room in a public hospital. However, it doesn t cover visits to a general practitioner (GP) for things like the flu or a virus. Yes, it s DIAC-compliant! Essentials Cover is the minimum cover required to meet the Department of Immigration & Citizenship s (DIAC) visa requirements. Some of our other covers are DIAC-compliant too. What s covered if you are admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared room as a public patient in a public hospital. Inpatient medical (doctors) bills. You re fully covered for all charges up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology (e.g. x-rays) and pathology (e.g. blood tests). Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. 6

7 What isn t covered with Essentials? You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia. Services that are not covered at all (known as exclusions) include: bone marrow and organ transplants. artificial reproductive techniques and investigations or treatment relating to infertility (IVF) any service not normally covered by Medicare for Australian residents, including cosmetic and podiatric surgery outpatient medical services, including visits by doctors and specialists, radiology and pathology, obstetric related visits except public hospital emergency department fees that lead to an admission in hospital services and treatments that are covered by compensation and damages provision. What about repatriation? You are covered for repatriation up to $4,000 per person, payable once in a lifetime. See page 18 for more information about repatriation. Waiting periods for new and upgrading members Psychiatric, rehabilitation and palliative care. Obstetric (pregnancy) related conditions 1. All other covered treatment in relation to a pre-existing ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient)? There s no excess, and you are fully covered for all inpatient medical (doctor) bills up to the MBS fee. What s more, no co-payments are required for a shared room in a public hospital, although you may be required to make an additional co-payment for each day that you stay in a private room. We recommend you contact us before going into hospital to find out if you will incur an out of pocket expense. Working Visa Cover Find out more about ambulance services, exclusions and repatriation on page 18. Or download the full policy document from hif.com.au 7

8 Intermediate Working Visa (Hospital and Medical cover). A step up from Essentials Working Visa cover, our mid-range intermediate option for visitors on working visas aged under 65 years covers you for a shared room in a private or public hospital. Plus, you re covered for some out-of-hospital medical expenses, such as x-rays and visits to a GP. You can also choose your doctor. Yes, it s DIAC-compliant! What s covered if you are admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service. That includes emergency admission to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared room in a private hospital or shared or private room as a public patient in a public hospital. Inpatient medical (doctors) bills. You re fully covered for all charges up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology (e.g. x-rays) and pathology (e.g. blood tests). Theatre fees and labour ward charges. Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. What services are covered if you re not admitted to hospital? All outpatient medical (doctor) bills are covered, as are public hospital emergency department fees that lead to an admission to hospital. So that s full cover up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology and pathology (up to $500 per person, per calendar year). What isn t covered with Intermediate Working Visa cover? (exclusions) You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia. Services that are not covered at all (known as exclusions) include: bone marrow and organ transplants artificial reproductive techniques and investigations or treatment relating to infertility (IVF) any service not normally covered by Medicare for Australian residents, including cosmetic and podiatric surgery services and treatments that are covered by compensation and damages provision. 8

9 What about repatriation? You are covered for repatriation up to $6,000 per person, payable once in a lifetime. See page 18 for more information about repatriation. Working Visa Cover Waiting periods for new and upgrading members Psychiatric, rehabilitation and palliative care. All obstetric (pregnancy) related conditions 1. All other covered treatment in relation to a pre-existing ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient)? There s no excess, and you are fully covered for all inpatient medical (doctor) bills up to the MBS fee. What s more, no co-payments are required for shared rooms in HIF contracted hospitals. However, you may be required to make an additional co-payment for each day that you stay in a private room or non HIF contracted hospital. We recommend you contact us before going into hospital to find out if you will incur an out of pocket expense. Find out more about ambulance services, exclusions and repatriation on page 18. Or download the full policy document from hif.com.au 9

10 Comprehensive Working Visa cover. Hospital and Medical cover, with an optional excess Designed for visitors on working visas and aged under 65 years, this option provides complete peace of mind. You get full cover for a private room in a private hospital and out-of-hospital medical expenses for a host of services. Choose your doctor, visit a GP, and with the excess option, get it all at a reduced premium. Yes, it s DIAC-compliant! What s covered if you are admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared or private room in a private hospital or as a public patient in a public hospital. Inpatient medical (doctors) bills. You have full AccessGap cover for medical procedures. Theatre fees and labour ward charges. Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. What services are covered if you re not admitted to hospital? All outpatient medical (doctor) bills are covered, which means full cover up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology and pathology. 10

11 What isn t covered with Comprehensive Working Visa cover (exclusions)? You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia. Services that are not covered at all (known as exclusions) include: any service not normally covered by Medicare for Australian residents, such as cosmetic and podiatric surgery services and treatments that are covered by compensation and damages provision. What about repatriation? You are covered for repatriation up to $8,000 per person, payable once in a lifetime. See page 18 for more information about repatriation. Optional excess You can reduce your premium by selecting an optional excess of $500 for a single policy or $1,000 for a family policy. Waiting periods for new and upgrading members Psychiatric, rehabilitation and palliative care. All obstetric (pregnancy) related conditions 1. All other covered treatment in relation to a pre-existing ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient)? Yes, if you select the optional excess, you will have to pay an excess of $500 per person, per overnight admission, up to a maximum of $1,000 per family policy per calendar year. That said, you are fully covered for all inpatient medical (doctor) bills up to the Access Gap fee (see page 19) and the excess doesn t apply to same-day surgery. What s more, you aren t required to make any co-payments for any room in an HIF contracted hospital. We recommend you contact us before going into hospital to find out if you will incur an out of pocket expense. Working Visa Cover Find out more about ambulance services, exclusions and repatriation on page 18. Or download the full policy document from hif.com.au 11

12 Visitor Saver cover (Hospital only cover). 12 Hospital only cover Designed for young holiday makers and visitors on non-working visas. This product covers the basics in a shared room in a public hospital. This cover is not compliant for visa purposes. What s covered if you are admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared room in a public hospital. Inpatient medical (doctors) bills. You re fully covered for all charges up to the Medicare Benefit Schedule fee (MBS) This includes consultations with doctors and specialists, radiology and pathology. Theatre fees. Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. What isn t covered with Visitor Saver? You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia. Services that are not covered at all (known as exclusions) include: bone marrow and organ transplants artificial reproductive techniques and investigations or treatment relating to infertility (IVF) any service not normally covered by Medicare for Australian residents, including cosmetic and podiatric surgery outpatient medical services, including visits by doctors and specialists, radiology and pathology, except public hospital emergency department fees that lead to an admission in hospital services and treatments that are covered by compensation and damages provision heart (cardiac) procedures including medical treatment or surgical procedures for cardiac conditions such as, arrhythmias, artery bypass grafts, coronary angioplasty, congenital defects, heart disease, heart transplants, pacemakers and defibrillators, and stent insertion. eye surgery (any procedure on the surface or within the structures of the eye) gastric banding and obesity services joint replacement obstetrics or any maternity related services palliative care psychiatric rehabilitation renal dialysis.

13 Waiting periods for new and upgrading members All covered treatment in relation to a preexisting ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient) Yes, you will have to pay an excess of $250 per person per admission up to a maximum of $500 per family policy per calendar year. That said, no co-payments are required for a shared room in a public hospital. Visitors Cover Visa Cover We recommend you contact us before going into hospital to find out if you will incur an out-of-pocket expense. Find out more about ambulance services, exclusions and repatriation on page 18. Or download the full policy document from hif.com.au 13

14 Visitor Value cover. A step up from Essentials Working Visa cover, our mid-range intermediate option for visitors on working visas aged under 65 years covers you for a shared room in a private or public hospital. Plus, you re covered for some out-of-hospital medical expenses, such as x-rays and visits to a GP. You can also choose your doctor. This cover is suitable for visitors of all ages. What s covered if you are admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared room in a private hospital or shared or private room as a public patient in a public hospital. Inpatient medical (doctors) bills. You re fully covered for all charges up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology and pathology. Theatre fees and labour ward charges. Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. What services are covered if you re not admitted to hospital? All outpatient medical (doctor) bills are covered, as are public hospital emergency department fees that lead to an admission to hospital. So that s full cover up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology and pathology (up to $500 per person, per calendar year). What isn t covered with Visitor Value cover (exclusions) You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia repatriation Services that are not covered at all (known as exclusions) include: bone marrow and organ transplants artificial reproductive techniques and investigations or treatment relating to infertility (IVF) any service not normally covered by Medicare for Australian residents, including cosmetic and podiatric surgery services and treatments that are covered by compensation and damages provision. 14

15 Visitors Visa Cover Waiting periods for new and upgrading members Psychiatric, rehabilitation and palliative care. All obstetric (pregnancy) related conditions 1. All other covered treatment in relation to a pre-existing ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient)? Yes, you will have to pay an excess of $250 per person per admission up to a maximum of $500 per family policy per calendar year. That said, no co-payments are required for a shared room in a public hospital, although you may be required to make an additional co-payment for each day that you stay in a private room or a non HIF contracted hospital. You are fully covered for all inpatient medical (doctor)bills up to the MBS fee. We recommend you contact us before going into hospital to find out if you will incur an out-of-pocket expense. 15

16 Visitor Advantage cover. Hospital and Medical cover Designed for holiday makers and visitors on non-working visas, this superior cover provides peace of mind with full cover for a private room in a private hospital and up to $1,500 per person per year for out of pocket hospital medical expenses. What s covered if you re admitted into a hospital (as an inpatient)? Ambulance. You re covered 100% for transport by road ambulance with a government approved ambulance service to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment. Hospital accommodation. You re covered for a shared or private room in a private hospital or as a public patient in a public hospital. Inpatient medical (doctors) bills. You have full AccessGap cover for medical procedures. Theatre fees and labour ward charges. Pharmaceutical drugs. You re required to make a contribution (equal to the Australian government patient contribution), but you receive a benefit for the rest of the cost, based on the PBS (Pharmaceutical Benefits Schedule) listed price. This is paid for all PBS listed drugs that are prescribed according to the PBS s approved indications and administered during, and as part of, an admitted episode of care. Benefits may not apply or may be restricted for non-tga (Therapeutic Goods Administration) approved, experimental or high cost drugs. Surgically implanted prostheses. You get a benefit at least equal to 100% of the minimum benefit amount listed for No Gap and Gap Permitted prostheses, as listed in the Private Health Insurance (Prostheses) Rules Benefits may be restricted for non-approved medical treatments or consumables. 16

17 What services are covered if you re not admitted to hospital? All outpatient medical (doctor) bills are covered, as are public hospital emergency department fees that lead to an admission to hospital. So that s full cover up to the Medicare Benefit Schedule fee (MBS). This includes consultations with doctors and specialists, radiology and pathology (up to $1500 per person, per calendar year). What isn t Covered with Visitor Advantage cover (exclusions)? You are not covered: en route to and from Australia for services provided outside Australia for services arranged prior to coming to Australia repatriation Services that are not covered at all (known as exclusions) include: any service not normally covered by Medicare for Australian residents, such as cosmetic and podiatric surgery artificial reproductive techniques and investigations or treatment of infertility (IVF). Waiting periods for new and upgrading members Psychiatric, rehabilitation and palliative care. All obstetric (pregnancy) related conditions 1. All other covered treatment in relation to a pre-existing ailment or condition 1. Do you have to pay anything if you go to hospital (and are admitted as an inpatient)? Yes, you will have to pay an excess of $200 per person, per overnight admission, up to a maximum of $400 per family policy per calendar year. That said, you are fully covered for all inpatient medical (doctor) bills up to the Access Gap fee (see page 15) and the excess doesn t apply to same-day surgery. What s more, you aren t required to make any co-payments for any room in an HIF contracted hospital. We recommend you contact us before going into hospital to find out if you will incur an out of pocket expense. Visitors Visa Cover Find out more about ambulance services, exclusions and repatriation on page 18. Or download the full policy document from hif.com.au 17

18 Need-to-know info about Hospital and Medical cover. Ambulance cover Ambulance services includes transport by an approved road ambulance service where it is necessary due to your medical condition. You are covered if: you need to be transported in an ambulance to a hospital or medical facility to receive immediate professional attention you are an admitted patient and you need to be transferred to another hospital because the admitting hospital does not have the required clinical facilities an ambulance is called to attend to you, and you require immediate professional attention but transport by ambulance is not subsequently required. Benefits for ambulance services are payable under all of our policies for overseas visitors, except where you re entitled to benefits from another source, such as ambulance subscription or a state ambulance transport scheme. Please note, benefits are not paid for off-road or air ambulance services. Exclusions Please note, we will not pay a benefit: where benefits are payable or can be claimed from any other source, employer or insurer when you re travelling to or from Australia when services are provided outside Australia if the service is not normally covered by Medicare for all Australian residents. What about repatriation? If you are covered by one of our Working Visa covers and you have to be repatriated to your home country because you are terminally ill or suffer from a substantial life-altering illness or injury, we will pay a contribution towards the cost of your return travel with another family member and a professional who s qualified to provide medical supervision. The benefit is only payable after we and the treating medical practitioner agree that repatriation is necessary due to a terminal illness or a substantially lifealtering illness or injury. Choice that goes with you. Visiting another part of Australia? With HIF you have access to over 500 private and public hospitals right across this big country. 18

19 In the event of death, the deceased person s mortal remains may be repatriated to their home country, if legally permissible. Medicare Benefits Schedule (MBS) The Medicare Benefits Schedule (MBS) is the schedule of fees set by the Australian Government for standard medical services. Hospital and Medical Cover AccessGap Cover Doctors can charge more than the MBS and if they do, their patients without gap cover insurance will incur an out of pocket expense for the difference between the fee charged and the MBS. The good news is that AccessGap cover is HIF s medical gap cover arrangement, designed to minimise or eliminate these out-of-pocket expenses for medical services whilst an in-patient in a registered overnight hospital or day facility. Australian doctors can nominate to opt in or out of the AccessGap arrangement, which may mean that if you choose an AccessGap Doctor you can have lower out-of-pocket costs. It is advisable to ask EACH doctor or Specialist if they will treat you under the AccessGap cover if you hold a Comprehensive Hospital product. A list of registered participating doctors is available on our website, hif.com.au 19

20 Extras cover? You re spoilt for choice. Even if you re covered by Medicare for emergency treatment as an overseas visitor, you won t be covered for day-today services. But fear not. Our Extras cover options have you covered for all those everyday services you re likely to need services such as: dental optical physiotherapy chiropractic complementary therapies pharmacy podiatry ambulance. All you have to do is choose the most suitable level of Extras cover from our four options. Saver Options Special Options Super Options Premium Options Just need cover for the essentials? No worries. Saver Options offers great value, entry-level Extras cover ideal for younger people who want affordable cover for common services including (but certainly not limited to) general dental, optical, physio and emergency ambulance*. If it s intermediate Extras health insurance cover you re after, we have just the product. Special Options includes major dental services, plus many other essential services like emergency ambulance, optical, podiatry, chiropractic, pharmacy, physiotherapy and more*. Drum roll please... Introducing our most popular Extras health insurance cover. Super Options has practically everything you could wish for dental, chiro, physio, optical to name just a few, plus it covers a host of other services like orthoptics (eye therapy), podiatry consultations and speech therapy*. Here it is, the Extras health insurance cover to top all Extras health insurance covers. Premium Options has it all. It s the very definition of comprehensive, including all the services we mentioned for Super Options, as well as larger rebates and higher annual limits*. *For inclusions, benefits and annual limits, please refer to the separate PDS (Product Disclosure Statement) or visit hif.com.au/overseaspds And there s more to smile about: SmartTeeth Dental No matter which Extras cover you choose, you re covered by SmartTeeth, our unique big-benefits dental program that means you can claim up to 100% of your dental provider s fee. Find out more about SmartTeeth on page

21 Use the comparison table below to help choose the Extras cover that is right for you and your budget. Extras Cover Type of Service Saver Special Super Premium Waiting Period Ambulance (urgent) Auxiliary Home Nursing Asthmatic Spacers Chiropractic Complementary Therapies Dental General Unlimited Diabetes Education Dietetics Healthy Lifestyle Occupational Therapy Optical Orthoptics (Eye Therapy) Osteopathy Peak-flow Meter Pharmacy Drugs Physiotherapy Podiatry Consultations Speech Therapy Dental General Limited Blood Glucose / Pressure Monitor Dental Major Nebuliser / Humidifier Orthotic Appliances Psychological Consultations Assisted Reproduction Drugs Hearing Aids Up to months 36 months Please note: Some waiting periods may apply. Download the policy documents from hif.com.au for more details. For items or services not listed in the above table, please contact us or refer to the separate PDS (Product Disclosure Statement) for coverage details. Legal dependants of members will be covered until they turn 21 years of age, or 25 if they are in full-time study. 21

22 Choose higher rebates with SmartTeeth. SmartTeeth is a unique benefits program that sets our private dental insurance cover apart. It s brilliant. And we can say that in all modesty because it was our members idea. They asked us for dental cover that rewards proactive dental care and provides higher rebates for the most popular services. So that s what SmartTeeth provides up to 100% rebate for the most popular dental services, like: Brush up on your dental care Check out our free online dental information resource our Healthy Advice Blog by Dr Emma. Focusing solely on dental health matters, it s written by a professional dentist who answers questions from our members. Visit hif.com.au/members-centre examinations remineralisation plaque and calculus removal dentist-fitted sports mouthguards. And it doesn t cost you a thing As a standard part of our Extras health insurance cover, SmartTeeth provides added value, but at no added cost. SmartTeeth: An example Mary is covered under Super Options and she visits her family dentist who completes Mary s first oral examination and her first plaque removal in the calendar year. As recommended by her dentist, Mary has a second (6 monthly) examination later that year. The following table is an example of the dentist s fee and the rebates Mary will attract. Maximum Dental Rebate Example Dental Item Description Dentist Fee 011 Oral examination (first visit) Percentage of Fee Maximum Payable Rebate paid to Mary $ % $59.25 $ Removal of calculus (first visit) Oral examination (second visit) $ % $ $95.00 $ % $42.20* $42.20 * Figure represents 80% of the maximum rebate which is the maximum amount payable for subsequent visits. 22

23 Extras Cover Choose your own dentist. Unlike some health funds, we don t have contracted dentists. With HIF, you re free to choose any dentist you want. In fact, the Australian Dental Association of Western Australia (ADAWA) has publicly commended our stance on protecting your right to choose. That makes us the only health insurance fund in Australia with an ADAWA commendation. 23

24 How will my SmartTeeth dental rebate be calculated? We will pay a percentage of the dentist s fee, up to a set maximum benefit for each item of service^. For example, with our Premium Options Extras cover you get: 1 Top 24 general dental services: 80% to 100% of the fee, up to a set maximum benefit per item. 2 All other general dental services: 70% of the fee, up to a set maximum benefit per item^. 3 All other (i.e. major) dental services: 60% of the fee, up to a set maximum benefit per item^. ^ Benefits may be limited where potential rebates exceed dental service sub limits or annual limit. 24

25 Our top 24 SmartTeeth dental services Extras Cover Item Number 011 or 012 Description First Visit Subsequent Visits Oral examination 100% 80% 111 or 114 or Removal of plaque, stain or calculus Topical application of remineralising agent 100% 80% 100% 80% 151 or 153 Provision of a mouthguard 100% 80% Please note: These benefits are payable on all our Extras products. The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or annual dental limit. See the example on page 22 for more information. Item Number Description Premium Options Super Options Special Options Saver Options 013 Emergency oral examination 80% 70% 65% 65% 014 Consultation 80% 70% 65% 65% 022 Intraoral periapical or bitewing radiograph 80% 70% 65% 65% 118 Bleaching, external per tooth 80% 70% 65% 65% 161 Fissure sealing per tooth 80% 70% 65% 65% 311 Removal of permanent tooth 80% 70% 65% 65% Metallic restoration two surfaces direct Metallic restoration three surfaces direct Adhesive restoration one surface anterior Adhesive restoration two surfaces anterior Adhesive restoration three surfaces anterior Adhesive restoration one surface posterior Adhesive restoration two surfaces posterior Adhesive restoration three surfaces posterior 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 575 Pin retention per pin 80% 70% 65% 65% 577 Cusp capping per cusp 80% 70% 65% 65% Please note: The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or overall annual limit. 25

26 Ready to join us? Got a question? 26 Maybe you ve already chosen from our Overseas and Extras cover options. Perhaps you re not quite sure which combination is right for you and you need a bit of advice. Either way, we re here to help you, so get in touch. Online. Visit hif.com.au to use our online product selector (it s easy). You can also get an instant quote and join online. By phone. Call us on (or if you re calling from outside of Australia) and speak to one of our friendly sales consultants. They understand our cover options inside out, so they can help you make a decision and join over the phone. By . us at A member of our team will contact you with all the information and assistance you need to make the right decision and join. Joining us and activating your policy When you sign up for HIF health insurance, you can nominate a start date the date your policy will commence. Please note, to initiate your policy we ll need an activation payment. This is usually at least one month s premium for Working Visa Covers or two months for other covers (which is the minimum period). To activate your membership, we ll also need a copy of your visa and passport details (confirming arrival dates) for everyone covered on your policy. We require these details within one month of your arrival in Australia. Can someone else arrange the cover for you? Absolutely. However, if someone is purchasing the policy on your behalf, they will need to be an agent authority on your membership. That means they can claim any refunds or cancel the policy on your behalf. If you re currently outside Australia, you can nominate a relative or friend here who can communicate with us on your behalf it can help streamline the application process. Minimum cover period The minimum period for Working Visa covers is one month and for Visitor covers its two months. Premiums won t be refunded if you cancel in the minimum period. Visa compliance and cancelling your policy If you apply online or over the phone, we ll a visa compliance letter to you instantly. If your visa isn t granted and you need to cancel your policy, an administration fee of AUD$50 will be charged. Transferring from another Australian fund? No problem If you re switching, we can take care of the paperwork for you. All you have to do is complete one little form we ll take care of the rest. Better still, if you re switching to us with an equivalent or lower level of cover, you won t have to serve new waiting periods^. Call us on (or if you re calling from outside of Australia) or our team at to find out more about switching. Don t throw me away It s important that you read and keep this brochure and the accompanying PDS. We ll be testing you to make sure you ve digested all the information... OK, so we won t be testing you, but you really should keep hold of all the information you receive about membership, benefits and conditions.in fact, we re continually improving our benefits, so it s worth downloading the latest version of this brochure and the PDS from time to time. It s the best way to ensure you get the most out of your cover when you need to claim. Visit hif.com.au for the most up-to-date publications.

27 Ready to join Affordable health cover is just a click away. To join, get an instant quote or simply learn more about HIF and our popular range of health cover options, visit hif.com.au ^ To ensure that all your existing benefits and previously served waiting periods are recognised, you must switch within two months of leaving your previous health fund. Please note... Your fund membership will commence on the date your completed application form is lodged with HIF, or a date after the date of lodgement which you have nominated. (The date of lodgement is the date we receive your application.) While we ll take care of all the paperwork associated with switching from another health fund, you are required to contact your previous fund directly to cancel any direct debits that may be set up with them. Minimum cover period: one month for Working Visa covers and for other covers. 2727

28 We re all about choice and making life easy at HIF. That s why, in addition to a choice of affordable cover options, we also offer a choice of ways to pay your premiums and make a claim, all designed to make life simple. 28 Please remember All providers must be registered with HIF for claim benefits to be paid. Benefits will not be paid for any hospital or Extras costs incurred outside Australia or which are not provided as part of a recognised consultation process. Conditions apply for SmartClaim and Fast-Track claims. Please visit hif.com.au or call us on for more details. Upon joining HIF, member cover, benefits and services are subject to our Business Rules. For a copy of the rules, contact us.

29 Your choice of ways to pay and claim. Ways to pay Direct debit. Flexible. Automatic. Convenient. No wonder it s our most popular payment option. Manual invoice. We send you an account when your premium is due and you can pay however you like: Phone call for over-the-phone credit card payments (we accept Mastercard, Visa, Diners Club and AMEX) BPAY through your bank s phone or internet banking system Billpay via your phone or the internet In person at any Australia Post branch By mail post your cheque or money order and the lower half of your invoice to: HIF, GPO Box X2221, Perth WA Discounts and special offers Premiums are discounted for members who pay in advance via direct debit or manual invoice: 2% for half-yearly and 4% for yearly. We also operate other special offers throughout the year. Visit hif.com.au to see what s new. Fast-Track Claiming. For paid Extras claims of $700 or less, try our quick and easy Fast-Track option. Simply scan your completed HIF claim form and associated receipts and invoices, and a copy to Alternatively, fax a copy to (08) or if you re outside of Australia, fax to Hospital and AccessGap Accounts. Your doctor can send your account directly to us. Alternatively, you can send your unpaid account to us and we ll send the payment direct to your doctor or hospital. Either way, it s a good idea to contact us before you go into hospital so we can help you with your claims. By post. If you would rather claim by snail mail, that s fine too. Simply complete a claim form and post it to: HIF, GPO Box X2221, Perth WA Claim forms can be downloaded from hif.com.au or mailed to you on request. Visit hif.com.au to find out more about our claiming options. Ready to join Ways to claim Electronic Claiming. Healthcare providers with electronic claiming technology (HICAPS or IBA) can settle your account with you on the spot. All you need to do is swipe your HIF membership card and pay any difference. SmartClaim for mobile. If you have an Apple or Android mobile device, you can submit paid Extras claims of $700 or less by using your mobile s in-built camera to photograph receipts and invoices. Visit hif.com.au or download HIF SmartClaim now from the Apple App Store or the Android Market. 29

30 Feedback, disputes and privacy. Compliments and complaints Your feedback is valuable to us, so don t be afraid to get in touch. You may wish to comment on your personal experiences with HIF, or lodge a compliment (or complaint) about the service you ve received from our team. Whatever your feedback relates to, we address each and every compliment/ complaint and will always respond accordingly. Your input is a vital part of ensuring our organisation meets or exceeds your expectations at all times. To submit feedback, simply visit hif.com.au and complete the online feedback form. Alternatively, you can or call us on Our dispute resolution process We are committed to providing our members with access to the highest level of service and we value the feedback that our members provide. If you have a concern regarding your HIF membership, our products, benefits or our service, we would be happy to hear from you please call us on or Our friendly customer service consultants will gladly discuss the matter with you or escalate the matter to a senior manager if required. Should you be unhappy with the outcome, please rest assured that we have an internal dispute resolution process in place. To escalate your complaint to this level, please put the issue in writing and send it to: Your privacy The personal information you provide will be primarily used by us to deliver health insurance products and services as requested by you. The information supplied by you will remain confidential. This information may be disclosed to third parties and authorised government agencies in order to facilitate the delivery of services associated with your health insurance. Failure to provide personal information may result in the failure to process or deliver the service requested. You may request access to all stored personal information requests must be made in writing and will be acknowledged within 14 days of receipt. For a complete HIF Privacy Policy brochure, please contact us on or download a copy at hif.com.au Cancelling your membership Early termination of cover. An administration fee of AUD$50 may be charged if you cancel prior to the commencement date of your cover. DIAC disclosure. As per visa condition 8501, the Department of Immigration and Citizenship and your sponsor/ employer may be informed if you cancel your cover. Member Action Review Committee HIF GPO Box X2221 PERTH WA

31 Useful information about tax. If you re an Australian resident for taxation purposes, which includes residents of countries that have a Reciprocal Health Care Arrangement with Australia, you may be required to pay the Medicare Levy and the Medicare Levy Surcharge or MLS (Medicare is Australia s public health system). It applies proportionately for any period during the tax year when an appropriate cover was not held. To avoid the MLS you can take out an entry level domestic Hospital cover. This could be cheaper than paying the MLS. Please note that no rebates can be paid to overseas visitors on domestic cover. Ready to join The Medicare Levy The Medicare Levy is imposed by the Australian Government to fund Medicare. It s normally calculated at 1.5% of your annual taxable income, but this rate may vary depending on your circumstances. Medicare Levy Surcharge (MLS) The MLS is an additional 1%* tax on individuals and families on higher incomes who do not have an appropriate level of private health cover for themselves and all of their dependants. Want to find out more? Visit hif.com.au for more information about the current income threshold amounts for an individual, couple or family. Alternatively, contact the Australian Tax Office (ATO) on or Medicare Australia on , or visit their websites ato.gov.au or medicareaustralia.gov.au You spread the word, we ll share the love. Our satisfied members spread the word for us. And when they do, we like to say thank you via our Member Rewards Program you get a $70 gift voucher every time a new member joins us as a result of your recommendation and mentions your name on their application form. * The MLS may be more than 1% depending upon Australian Government legislation and your income. Please note Overseas hospital and medical insurance, including the products listed in this brochure, will not exempt you from the Medicare Levy Surcharge. However, we can advise you how you can avoid paying the levy. 31

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