Health insurance that gives you more. July 2014

Transcription

1 Health insurance that gives you more July

2 We're commited to giving you more As Australia s largest not-for-profit health fund, we return the highest benefits back to our members, not shareholders Contents You ll get more with HCF 4 Health and wellbeing programs 6 Range of covers 8 Hospital benefits summary 10 Extras benefits summary 13 Loyalty benefits 16 Cash Assist covers 18 More insurance options 20 Rebates, surcharges and incentives 22 Things you need to know 24 How your rights are protected 28 Our privacy statement 31 Changes to products and pricing 31 Cash Assist Combined Product Disclosure Statement and Financial Services Guide 32 Branch, Dental and Eyecare Centre locations 36 How to join 38 3

3 You ll get more with HCF We provide health cover to help you stay healthy More peace of mind Want to avoid public hospital waiting lists? Want a doctor you know and trust? With HCF, it s your choice. More benefits As Australia s largest not-for-profit health fund, we seek to return the highest benefits back to our members, not shareholders. And we have the figures to prove it. We returned 91.6 cents in the dollar in benefits compared to an average of 86.4 cents for other health funds in the 2013 financial year. This means you get more value with HCF. But don t just take our word for it. Canstar, one of Australia s leading independent rating agencies, has awarded us their top national award for outstanding value health insurance five years in a row. More savings Depending on your level of hospital cover, you can reduce your premium by opting for a higher excess, or pay a bit more to get a lower excess. An excess is the amount you nominate to pay if you re admitted to hospital. You can also save more if you need to claim because: You won t pay a hospital excess for dependent children or treatment as a result of an accident You pay only one hospital excess amount per person per calendar year if an excess is applicable. Medicover No-Gap Arrangement Many doctors charge above the Medicare Benefits Schedule fee which can lead to significant out-ofpocket expenses for in-patient medical services. HCF can save you even more on in-patient medical bills if you choose a doctor who is registered to use our no-gap HCF Medicover arrangement. This may help to prevent you paying extra out-ofpocket expenses for in-patient medical services. More cover You'll get the best full coverage for medical services of any health fund in Australia (PHIO report 2013) You get a range of fully covered services for teeth, eyes, muscles, backs and feet under our More for You programs. More rewards for you We value our members and want to show it. The longer you're with HCF, the more we'll give back. Depending on your level of cover, the amount you can claim on many of our extras increases each year. For more information on loyalty benefits, see page More than health insurance Look after your health and wellbeing easily with our My Health Guardian program Eligible members in selected areas can access our afterhours My Home Doctor service Get a 10% discount on travel and pet insurance Access affordable Cash Assist cover from HCF Life Expect high-quality, award-winning customer service. HCF has been recognised by the Customer Service Institute of Australia for our continued commitment and dedication to our customers. More for You programs Our More for You programs reduce your out-of-pocket costs to help you look after your health. You may be eligible to claim under these programs depending on your level of cover and available limits. For details of services available in your area, and which services are available on your level of cover, visit hcf.com.au More for Teeth offers a range of fully covered diagnostic and preventative dental services. Available in Sydney through HCF Dental Centres and across Australia (except NT and Tas) through participating dental providers. More for Eyes provides a selection of fully covered glasses and access to free digital retinal photography. Available across Australia through participating optical providers and HCF Eyecare Centres in Sydney. HCF Eyecare is independently owned and operated by Eyecare Holdings Pty Limited ACN More for Muscles gives you one fully covered initial consultation a year for eligible conditions. Available across Australia through participating physiotherapists. More for Backs provides one fully covered initial consultation a year for eligible musculoskeletal conditions. Available across Australia through participating chiropractors and osteopaths. More for Feet offers one fully covered initial consultation a year for eligible foot conditions. Available across Australia through participating podiatry providers. Health management programs Looking to improve your health? On eligible extras products, you can claim on a range of HCF approved health programs to help you lead a fit and healthy life. They include: Healthy Weight for Life Exercise and gym membership for a specific health problem (Doctor's referral required) Learn to swim programs A six month waiting period and conditions apply. Visit hcf.com.au/healthmanagement for more details and a full list of programs. HCF's 30 Day Guarantee We want you to be happy with your health cover and make sure you re comfortable with your choice of cover. We ll give you a 100% refund if you change your mind or cancel your policy within 30 days if you haven t made a claim. Bonus on Top Plus Hospital cover You won t pay an excess for same day hospital treatment after serving the relevant waiting periods. See page 10 for more details. 4

4 Health and We give you access to easy-to-use health and wellbeing management tools, home care and support for a number of specific health conditions. Health and wellbeing My Health Guardian is our unique online health and wellbeing management program, that lets you create an easy and effective wellbeing plan. Whether you want to lose weight, have more energy or simply feel healthier, this innovative service helps you take the necessary steps on the path to a healthy, happy life. Helpful tools include: Wellbeing assessment and action plan a simple, guided process to assess your lifestyle and overall health and put together your plan Online resource library access hundreds of articles, exercises and recipes Your personal health coach ask any diet, exercise and lifestyle questions Exercise and diet plans create personalised plans using the Get Fit and Eat Fit tools. My Health Guardian is a fully covered service for members aged 18 years and over with hospital or extras cover. 6 wellbeing programs Well-being Plus mobile app To help keep you motivated and on target to achieve your health goals, you can track your health and wellbeing wherever you are with the My Health Guardian mobile app, 'Well-being Plus'. Visit hcf.com.au/myhealthguardian for information on how to use the app, which is available for iphone and Android. Getting started? We recommend you see how you or a family member can benefit. To find out what My Health Guardian can do for you, take the virtual tour at hcf.com.au/mhg Home Telemonitoring Service HCF has partnered with Telstra and Healthways to provide an extension to the My Health Guardian program, a new home telemonitoring service for members with chronic conditions, like high blood pressure or diabetes. The service is available for members already participating in the telephonebased My Health Guardian component of the program. It allows regular monitoring of your chronic condition via an easy to use wireless device so that My Health Guardian nurses can provide you with more informed tailored care and advice. To join the Home Telemonitoring Service or find out more, contact us or visit hcf.com.au/chronic After-hours home doctor service My Home Doctor is a convenient non-emergency after-hours home doctor service for eligible members in selected areas. The service is provided at no cost to you if you have hospital cover. Think of the peace of mind, having access to such a service. Whether it s having your distressed young child seen by a doctor in the middle of the night, or simply helping you get treatment sooner when you feel sick. Coverage spans most of Sydney, Melbourne, Geelong, Adelaide and South East Queensland, and is constantly expanding. To see if your area is covered, contact us or visit hcf.com.au/mhd Access world leading medical experts If you or someone on your family membership had a serious illness, wouldn t it be reassuring to know that you could access a world-leading medical expert to review your case? My Global Specialist is an innovative medical information service available to members with Top Plus Hospital cover with nil excess, and either Multicover / Super Multicover Extras. You ll have access to a global network of 50,000 medical experts to review your medical records and report on your diagnosis and treatment plan. This service is available through Best Doctors, the world s leading resource for specialist medical advice founded by doctors from the Harvard Medical School. Please visit hcf.com.au/mgs or contact us for more information. Healthy Weight For Life Programs HCF believes healthy living starts with awareness and education. Our Healthy Weight For Life Programs are designed to promote and teach skills to achieve and maintain a healthy weight. The programs have shown positive results including major improvements to the health and weight of participants with type 2 diabetes, heart conditions and osteoarthritis. Each program has a three-phase weight loss action plan, teaching you weight control skills to live healthily for life. For more information visit hcf.com.au/hwfl Our new service More at Home is a community care service providing home support to those who need a helping hand either on a regular basis or once off. More at Home gives you access to a compassionate professional who will assist you with domestic and/or personal care. They ll help with housework, shopping and meal preparation or even just getting ready in the morning and providing transport if needed. You ll also receive ongoing nursing care with a registered nurse if you need it. This paid service is managed by Manchester Unity, a HCF subsidiary with 65 years of experience providing high quality aged care services for Australians. To find out more visit moreathome.com.au or call

5 Suggested health cover packages To make choosing your health cover easier, we ve created a selection of packages to suit your lifestage, budget and usage. 1. Which best describes you? Optional 2. We suggest Cash Assist Covers under 30 yrs Great for young adults Cover for the essentials without blowing your budget More Much More Much, Much More Budget Hospital Young Singles & Couples Package Hospital Advanced Savings + Multicover Extras Cash Back Cover Pays $2,500 if you suffer an accident requiring surgery within 6 months or suffer a listed serious medical condition.? Planning a family Cover for when you re having kids More Much More Much, Much More Top Plus Hospital + General Extras Plus Top Plus Hospital + Multicover Extras Top Plus Hospital + Super Multicover Extras Income Assist Insurance Pays 75% of your monthly income (up to a max $6,000) for 12 months if you are unable to work for more than 30 days. Family with kids Cover for every type of family More Much More Much, Much More Hospital Advanced Savings + General Extras Plus Top Plus Hospital + Multicover Extras Top Plus Hospital + Super Multicover Extras Kids Accident Cover Pays up to $100,000 if your child (under 17) is accidently injured. Only 90 cents per child per week. Over 30 yrs under 65 yrs No kids, no worries Cover for singles & couples without kids More Much More Much, Much More Hospital Advanced Savings + General Extras Plus Fit & Free Package Top Plus Hospital + Multicover Extras Medical Trauma Pays a specified sum, up to $50,000, if you suffer one of the 40 listed serious medical conditions. Complete peace of mind Cover for anyone wanting complete peace of mind More Much More Much, Much More Top Plus Hospital + General Extras Plus Top Plus Hospital + Multicover Extras Top Plus Hospital + Super Multicover Extras Smart Term Insurance Pays the sum insured (up to $300,000) in the event of death or terminal illness. Benefit is doubled if death is due to accident. Stand-alone cover Quality cover when you need it More Budget Hospital Ambulance Cover Much, Much More Top Plus Hospital Multicover Extras Only For more details on our health cover packages see overleaf. For all Cash Assist Covers, see pages 18 & 19. 9

6 Hospital benefits summary Key features Top Plus Fit & Free Hospital Advanced Savings Young Singles & Couples Excess (per person per calendar year) Nil, $250 or $450 $250 $250 or $450 $450 $450 No excess for accident related treatment No excess for kids NA NA No excess for same day treatment 12 month waiting period applies to pre-existing conditions 2 month waiting period applies to all other procedures Available as hospital cover only (without extras) Yes (Nil or $450) No No No Yes Example hospital procedures at HCF participating private and public hospitals Accommodation, operating theatre, intensive care Accident related treatment Physiotherapy & pharmaceuticals # related to admission Removal of tonsils Removal of adenoids Removal of appendix Hernia treatment Removal of kidney stones & gall stones Digestive disorder procedures (e.g. bowel surgery) Cancer related services (e.g. chemotherapy) Government approved prostheses for covered services Heart surgery including diagnostics and therapeutic cardiac procedures Spinal fusion, spinal scoliosis & disc replacement surgery Cochlear implant surgery & bone anchored hearing devices* Insulin pump treatments Dialysis for chronic renal failure Rehabilitation services Psychiatric services Gastric banding & obesity surgery Assisted reproductive services (e.g. IVF, GIFT) Pregnancy & birth related services Hip & knee joint replacement surgery Cataract & other lens related surgery Elective cosmetic surgery Podiatric surgery by an accredited podiatrist Emergency ambulance (state government service only) Non-emergency ambulance (state government service only, up to $5,000 per year) Best cover Mid-range Budget friendly Budget Hospital Hospital waiting periods Palliative care Psychiatric services Rehabilitation services Pre-existing ailments or conditions Pregnancy & birth related services All other hospital services Extras waiting periods Health management programs Artificial appliances (e.g. orthopaedic footwear, blood glucose monitors) Dental bleaching Dental bridges Dental crowns Dentures Endodontics Foot orthotics Occlusal therapy Oral surgery Orthodontics Periodontics Pre-existing ailments & conditions Prosthodontics Veneers Hearing aids All other extras services Ambulance waiting periods Emergency ambulance (where not for pre-existing ailments) Medically necessary non-emergency ambulance (where not for pre-existing ailments) Pre-existing ailments 2 months 12 months 2 months 6 months 12 months 24 months 2 months 1 day 2 months 12 months Covered Minimal Benefits. See page 24 for definition Exclusions. See page 25 for definition # Excluding experimental and high cost non-pbs drugs * Includes associated speech and sound processors including upgrades Certified type C procedures and certified overnight type C procedures for the treatment of diabetes. Reduced or no benefits may apply. See hcf.com.au/insulinpumps or page 15 of the Member Guide for details For more information on waiting periods, see page 20 of the Member Guide. 12

7 DENTAL OPTICAL THERAPIES OTHER Extras benefits summary Diagnostic Preventative Services Details Waiting Period Super Multicover Multicover Fit & Free General Extras Plus Young Singles & Couples Benefits Limits Benefits Limits Benefits Limits Benefits Limits Benefits Limits Examinations general dentist/prosthetist 2 services 2 services 2 services 2 services 2 services $32 - $80 $30 - $55 $30 - $55 $30 - $55 $30 - $55 Examinations specialist dentist 1 service 1 service 1 service 1 service 1 service Single film x-rays initial/subsequent $30/$25 No limit $25/$18 No limit $25/$18 No limit $25/$18 No limit $25/$18 No limit 2 months Remove plaque & calculus $40 - $63 2 services $36 - $57 2 services $33 - $57 2 services $36 - $57 2 services $33 - $57 2 services Application of fluoride $27 1 service $27 1 service $27 1 service $27 1 service $27 1 service Fillings Metallic & tooth coloured (direct) $105 - $210 $550 $75 - $140 $550 $75 - $140 $550 $65 - $115 $400 $65 - $115 $400 Orthodontics E.g. braces to straighten teeth. Lifetime limit applies 12 months Accrues at $440 per year. Up to $2,640* for orthodontist (Sublimit of $1000 for general dentist). Lifetime limit applies Accrues at $440 per year. Up to $2,640* for orthodontist (Sublimit of $1,000 for general dentist). Lifetime limit applies $165 - $240 Accrues at $250 per year. Up to $1,500* for orthodontist (Sublimit of $1,000 for general dentist). Lifetime limit applies $150 - $215 Current as at 1 July Benefits shown are valid until 30 June Annual limits are per person per calendar year, unless otherwise specified. Surgical extractions $210 - $330 $165 - $240 $150 - $215 Oral surgery $300 Extractions 2 months $120 - $175 $90 - $130 $90 - $130 $80 - $110 $80 - $110 $300 Occlusal therapy Treatment to improve bite $35 - $300 $500 $35 - $250 $500 $35 - $250 $500 Endodontic services Treatment of root canals $60 - $190 $50 - $187 $50 - $187 $40 - $130 Periodontic services Treatment of tissue around teeth $25 - $305 $15 - $281 $15 - $ months Complete dentures & components $35 - $800 $800 over 3 years $30- $800 $800 over 3 years Dentures Maintenance & repair $37 - $200 $200 $29 - $120 $120 Crowns, bridges & implants Preparation & placing $20 - $750 $800 - $1,200 $20 - $635 $800 $20 - $635 $800 Spectacle frames $135 $250 $85 $85 $75 $75 Spectacles & contacts Spectacle lenses pair 2 months $130 - $330 Sublimit of $250 $92 - $180 $220 $92 - $180 $250 $80 - $140 $180 $80 - $140 $180 Contact lenses pair $160 - $250 for contact lenses per year $140 - $220 $140 - $220 $140 - $180 $140 - $180 Psychology (after Medicare exhausted) $80 per visit $600 $75 per visit $300 $75 per visit $300 Dietetics $55/$40 $350 $45/$35 $300 $45/$30 Podiatry consultation $38/$34 $400 $33/$25 $200 $300 $38/$34^ Sublimit of $200 Audiology $58/$40 $350 $52/$35 $500 $52/$35 for foot orthotics Speech pathology (SP) $83/$51 $500 $60/$40 Sublimit of $200 audiology $60/$40 $40/$30 Occupational therapy (OT) $72/$50 $600 $62/$40 $500 $62/$40 $40/$30 First/subsequent visits (unless otherwise specified) 2 months $42 visits 1-2, $32 visits 1-2, $40 first visit, $28 visits 1-2, $30 first visit, Chiropractic $33 visits 3-11, $28 visits 3-11, $35 visits 2-6, $20 visits 3-11, $20 visits 2-6, $18 visits 12+ $600 - $1,200 $14 visits 12+ $600 - $1,000 $20 visits 7+ $10 visits 12+ $10 visits 7+ Sublimit of $600 each Sublimit of $375 $500 $45 visits 1-2, $35 visits 1-2, $40 first visit, $30 visits 1-2, $30 first visit, Osteopathy $35 visits 3-11, for chiro & osteo $29 visits 3-11, each for chiro, $35 visits 2-6, $600 $20 visits 3-11, Sublimit of $250 $20 visits 2-6, $18 visits 12+ $400 for EP $14 visits 12+ osteo & EP $20 visits 7+ $10 visits 12+ each for chiro, osteo and $10 visits 7+ EP, $200 combined for OT and SP. Exercise physiology (EP) $40/$33 $30/$28 $30/$28 $25/$20 $25/$20 $100 combined remedial massage, $53 visits 1-2, $45 visits 1-2, $45 first visit, $33 visits 1-2, myotherapy, acupuncture $30 first visit, Physiotherapy $38 visits 3-11, $600 - $1,200 $32 visits 3-11, $600 - $1,200 $40 visits 2-6, $20 visits 3-11, and CHM $25 visits 2-6, $18 visits 12+ $17 visits 12+ $22 visits 7+ $10 visits 12+ $10 visits 7+ Acupuncture/Chinese herbal $200 First/subsequent visits medicine consultation (CHM) Sublimit of $100 for CHM $22/$10 $25/$20 $600 $30/$17 Remedial massage/myotherapy 2 months $40/$25 Sublimit of $250 $27/$20 $300 per therapy (max. $100 for CHM) $200 Alexander technique $27/$20 Homoeopathy $27/$17 Up to $100 per trip, Up to $100 per trip, Travel & accommodation per membership $400 per membership $400 for hospital treatment 200km + return trip 2 months ($30 per night ($200 accomm. sublimit) ($30 per night ($200 accomm. sublimit) accomm.) accomm.) HCF approved pharmacy After PBS equivalent co-payment subtracted Up to $50 per script $700 Up to $50 per script $600 Up to $50 per script $500 Up to $50 per script $500 Up to $50 per script $200 Artificial aids Approved appliances (e.g.cpap) 12 months $20 - $500 $600 $20 - $500 $500 Hearing aids Every 5 years (depending on length of membership) 24 months Up to $1,800 $800 - $1,800 every 5 years Up to $1,600 $600 - $1,600 every 5 years Health management programs HCF approved single/couple or family 6 months Up to $200 $200 single/$400 couple or family Up to $150 $150 single/$300 couple or family Up to $200 $200 single/$400 couple or family School accident cover Approved ancillary services only 2-12 months Up to $800 $800 Up to $800 $800 Up to $400 $400 $350 Sublimit of $150 for remedial massage, myotherapy, acupuncture and CHM For more information on waiting periods, see page 20 of the Member Guide. *At a specialist orthodontist, members receive $1,720 for full up per and lower braces on Super Multicover and Multicover and $1,200 on General Extras. Loyalty benefits. See pages ^Up to $200 for orthotics 12 months waiting period.

8 Loyalty benefits More rewards for members Multicover Extras (when packaged with hospital cover) Service Orthodontics Loyalty limits Limit accrues at $440 per year. Up to $2,640 for treatment by an orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies. Physiotherapy Limit starts at $600 and accrues at $120 per year up to $1,200 per person per year. The longer you stay with us, the higher your extras limits can become. Depending on your cover, the amount you can claim on many of our extras increases each year. These increased limits are shown below. Super Multicover Extras Service Loyalty limits Please note that when you upgrade your cover you will need to serve waiting periods before you can take advantage of the increased benefit and limits. Chiropractic, osteopathy & exercise physiology Combined limit starts at $600 and increases by $100 per year up to $1,000. Sublimits apply. Hearing aids Length of membership Loyalty limits Under 2 years 2-5 years 6-9 years years years 20+ years Nil $600 $800 $1,000 $1,200 $1,600 Orthodontics Crowns, bridges & implants Optical (when taken with Top Plus Hospital) Physiotherapy Chiropractic, osteopathy & exercise physiology Limit accrues at $440 per year. Up to $2,640 for treatment by an orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies. Limit starts at $800 and accrues at $100 per year up to a maximum of $1,200 per person per year. Once you have been a member on this cover for 12 months, your optical limit converts to a 2 year limit of $500. Your $500 limit always spans the current and previous year and entitles you to claim the full $500 in one year or progressively over the two year period. If the full limit of $500 is exhausted in one year, there is no benefit the following year. Sublimit of $250 per year for contact lenses applies. Limit starts at $600 and accrues at $120 per year up to $1,200 per person per year. Combined limit starts at $600 and increases by $120 per year up to $1,200. Sublimits apply. Multicover Only Extras Service Orthodontics Loyalty limits Limit accrues at $440 per year. Up to $2,640 for treatment by an orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies. Hearing aids Length of membership Loyalty limits General Extras Plus Under 2 years 2-5 years 6-9 years years years 20+ years Nil $600 $800 $1,000 $1,200 $1,600 Hearing aids Length of membership Loyalty limits Service Loyalty limits Under 2 years 2-5 years 6-9 years years 15+ years Nil $800 $1,100 $1,400 $1,800 Orthodontics Limit accrues at $250 per year. Up to $1,500 for treatment by an orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies

9 Cash Assist Covers Financial cover for accidents and illnesses Now that you ve selected the right hospital and extras options, you should think about topping up your cover with one or more of these Cash Assist covers. Combined Product Disclosure Statement and Financial Services Guide These products are issued by HCF Life Insurance Company Pty Ltd ABN , AFSL Please read the Product Disclosure Statement before you apply and consider whether this cover is appropriate for your objectives, financial situation or needs, as the information we have provided does not take these into account. The Product Disclosure Statement and Financial Services Guide for Cash Back Cover, Kids Accident Cover and Permanent Disability Benefit Plus, is available on pages For more information on Smart Term Insurance, Income Assist Insurance, Medical Trauma and Personal Accident Insurance please visit hcf.com.au, call , or visit your local branch. Cooling off period When you receive your policy document from us, you have 30 days to check whether the policy meets your needs. Within this time, you may cancel your policy in writing and receieve a full refund of any money paid provided you have not made a claim. Affordable cover which pays up to $100,000 if your child (under 17) is accidently injured. Specified sum paid for injuries Cover against accidents Cover 24 hours a day anywhere in Australia Paid regardless of any other benefits $ Kids Accident Up to $100,000 cover Only 90 cents per week per child Cash Back Cover $2,500 Benefit $1 per week for singles $2 per week for families Pays $2,500 if you suffer an accident requiring surgery within 6 months or suffer a listed serious medical condition. Cover for illnesses such as heart attack, cancer and stroke Single and family cover options Make multiple claims up to a total of $10,000 for singles and $20,000 for families Cover against accidents and illness Permanent Disability Benefit Plus Up to $100,000 cover $1 per week for singles $2 per week for families Low cost cover which provides up to $100,000 protection in the event you are permanently disabled due to an accident. Single and family cover options Up to $10,000 is paid for each of your children Pays your HCF Health Insurance premium if on claim (up to $1000 for singles, $2000 for families) Cover against accidents Specified sum paid for injuries Smart Term Insurance Up to $300,000 cover From $3.45 per week Pays the sum insured in the event of death or terminal illness. Five benefit levels to choose from, ranging from $100,000 to $300,000 Lump sum cash benefit Benefit doubled if death is caused by an accident Easy to apply- no blood tests or medicals Income Assist Insurance Up to $6,000 per month From $1.65 per week Pays 75% of your monthly income (up to a max $6,000) for 12 months if you are unable to work for more than 30 days. Cover against accident and illness Additional benefits paid for child care expenses and bed confinement Premiums may be tax deductible Protection for your biggest asset - your income Medical Trauma Up to $50,000 cover From $2.50 per week Pays a specified sum if you suffer one of over 40 listed serious medical conditions. Choice of $25,000 or $50,000 cover Lump sum cash benefit Cover for serious illnesses such as heart attack, cancer and stroke Single and family cover options 90 day waiting period applies for heart attack, cancer and stroke Personal Accident Insurance Up to $50,000 cover From $3.15 per week Designed for those aged 55 and over this cover pays a specific cash benefit if you suffer one of the listed injuries such as burns, fractures and dislocations. Choice of $25,000 or $50,000 cover Lump sum cash benefit No Pre-Existing conditions exclusions Pays a benefit in the event of accidental death For more information on Cash Assist Covers visit hcf.com.au/cashassist 18 19

10 More insurance options More financial protection for you, your family and pets Travel Insurance When you travel overseas, Australian health cover doesn t protect you. As our member, you get 10% off our international travel insurance. It provides: Worldwide emergency assistance A range of benefits for overseas medical and hospital expenses Legal assistance Compensation for journey delays or lost luggage Plus more. Visit hcf.com.au/travel for more information. We recommend that you read the Travel Insurance Product Disclosure Statement and Financial Services Guide which is available by calling or visiting hcf.com.au/travel before deciding to buy or continue to hold this product. The HCF Travel Insurance Policy is issued by QBE Insurance (Australia) Limited ABN , AFSL Pet Insurance As an HCF member you also get 10% off HCF Pet Insurance. If your dog or cat is suddenly or unexpectedly injured or becomes ill, pet insurance can help pay for veterinary expenses. Choice of two comprehensive covers Up to 80% of covered veterinary expenses (less an annual excess that you choose). Visit hcf.com.au/petinsurance for more information. We recommend that you consider the Pet Insurance Product Disclosure Statement and Financial Services Guide which is available by calling or visit hcf.com.au/petinsurance before deciding to buy or continue to hold this product. HCF Pet Insurance is issued by The Hollard Insurance Company Pty Ltd (Hollard), ABN , AFSL Bonus Fit & Free includes FREE Overseas Travel Insurance for people under 75 The Hospitals Contribution Fund of Australia Limited (HCF) has obtained overseas travel insurance under a Master Policy issued by AIG Australia Limited (AIG), ABN , AFSL It is intended that this overseas travel insurance cover will remain in place while you remain a Fit & Free policy holder; however we reserve the right to remove or alter the cover by giving you 30 days notice. The terms, conditions and exclusions of the overseas travel insurance are specified in the Fit & Free overseas travel insurance Conditions of Use and may be amended from time to time. The Conditions of Use document must be reviewed to make sure that the overseas travel insurance meets your needs. The Conditions of Use document is available at hcf.com.au/fitandfree or by calling

11 Rebates, surcharges and incentives Changes to private health legislation can affect your choice of health cover, so it s important to understand how to maximise your entitlements, and avoid unnecessary expenses. Australian Government Rebate on Private Health Insurance 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. Income thresholds for the 2014/15 income tax year Income Type of member No Tier Tier 1 Tier 2 Tier 3 Singles $90,000 $90, ,000 $105, ,000 $140,001 Families* $180,000 $180, ,000 $210, ,000 $280,001 Rebate < Age % % 9.680% 0% Age % % % 0% Age % % % 0% Medicare Levy Surcharge You can use the table below as a guide to nominating your rebate tier. When calculating your income you need to include taxable income, fringe benefits, reportable superannuation contributions, net financial investment losses and more. We can provide you with general information on these thresholds. However for personal advice specific to your circumstances, please consult your accountant, financial advisor or the ATO at ato.gov.au or Government rebate change In April this year, the Australian Government changed how your rebate is calculated. The private health insurance rebate will be adjusted on 1 April each year. This change will apply to all Australian private health funds. See below table for the list of rebate percentages. All ages 0.0% 1.0% 1.25% 1.5% Medicare Surcharge The Medicare Levy Surcharge is an Australian Government initiative designed to encourage high-income earners to take responsibility for their health care. It applies to people earning a taxable income of $90,001 or more per year for singles and $180,001 and over for couples and families where they don t have eligible private hospital cover. You can avoid having to pay this simply by having eligible HCF hospital cover. If you don t have eligible private hospital cover and you fall into these income thresholds then you will be charged up to an additional 1.5% surcharge on your Medicare levy when your tax return is assessed. Please refer to the 'Medicare Levy Surcharge' section of the table opposite to see what your surcharge may be. Lifetime Health Cover Lifetime Health Cover (LHC) is a Government initiative designed to encourage people to take out hospital insurance earlier in life and maintain their cover. In some cases you may be exempt or fit into a special circumstances category. If you do not have a product that includes hospital cover with an Australian registered health fund on 1 July following your 31st birthday and then decide to take out hospital cover later in life, you will pay a 2% loading on top of your premium for every year you are aged over 30. For example, if you take out hospital cover at age 40 you will pay 20% more than someone who first took out hospital cover at age 30. The maximum loading is 70%. Once you have paid a LHC loading for 10 continuous years, the loading is removed as long as you retain your hospital cover. The Australian Government Rebate no longer applies to the LHC component of private health insurance. This means if you are eligible to receive the rebate and also have a LHC loading, the rebate will not apply to the LHC portion of your health insurance. You can use the Lifetime Health Cover calculators to find out if you need to pay the LHC loading by visiting privatehealth.gov.au and looking for Lifetime Health Cover. For more information visit hcf.com.au or call us on *Note: Single parents and couples (including de facto couples) are subject to the family tiers. For families with children, the thresholds are increased by $1,500 for each child after the first. Thresholds effective from 1 July Rebate amounts listed are effective from 1 July 2014 to 31 March

12 Things you need to know 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 HCF will examine information provided by your doctor, together with other relevant claim details. Hospital cover in-patient services Hospital benefits are payable when you re admitted to hospital for treatment. These are called in-patient services, and only in-patient services are covered by your hospital cover. HCF has agreements with over 440 private hospitals around the country to cover accommodation and other hospital-related services depending on your choice of cover. For a full list of participating private hospitals visit hcf.com.au/participatinghospitals Minimal Benefits If you choose a product with Minimal Benefits for some procedures (like pregnancy and birthrelated services), you ll be covered in a public hospital shared room, but your private hospital costs won t be fully covered. This means you could face significant personal expense if you have any of these procedures in a private hospital. For procedures attracting Minimal Benefits in a private hospital, we would: Pay a small amount towards your accommodation Pay for Government approved prosthesis for covered services Not pay operating theatre expenses, or labour ward charges. There are also some services where doctor s charges aren t payable (for example, elective cosmetic surgery and surgery by an accredited podiatric surgeon). For these, we will only pay a small amount towards the total cost of the procedure (and no doctor s charges). This only applies to services which don t attract a benefit from Medicare. Who can be covered? Prior to taking out health insurance, we encourage you to understand who can be covered under your policy. Our staff will be only too happy to explain who can be covered and answer any questions you have. Alternatively, you can read more about who can be covered in the HCF Member Guide or by visiting hcf.com.au/faqs, and look under 'Who does my membership cover?' Cover for your dependants If you're pregnant and on a single or couple membership, make sure you upgrade to a family membership at least 2 months prior to the birth of your child to ensure your child is covered. Your children are covered under your family cover until the day before they turn 22, provided they aren t married or in a de-facto relationship. If your children are full-time students aged between 22-24, aren t married or in a de-facto relationship and are primarily reliant on you for maintenance and support, you can register them as student dependants, and they will continue to be covered for no extra cost until the day before they turn 25. If your children aren t full-time students, you can also continue to cover them until they turn 25 with extended family cover, provided they aren t married or in a de-facto relationship. You can take out this cover for a surcharge on top of your existing premium if you have Budget Hospital, Hospital Advanced Savings or Top Plus. Insulin Pumps For information about insulin pump initialisation, replacement pumps and your benefit entitlement please refer to the Member Guide or hcf.com.au/insulinpumps Exclusions If you need treatment for any procedures listed as an Exclusion in your hospital cover, you won t receive any benefits from us and you may have significant out-of-pocket expenses. Make sure you have reviewed the excluded services on your selected hospital cover on pages 10-11, and general Exclusions on the following page before purchasing your cover

13 What's not covered There are a number of situations where our health insurance doesn t cover you: Where there are Exclusions on your policy Claims made two years or more after the date of service When you or your dependants have the right to recover the costs from a third party other than us, including an authority, another insurer (like motor vehicle or workers compensation), or under an employee benefit scheme Treatment for pre-existing ailments or conditions within waiting periods Goods and services received during any period where your payment is in arrears, your membership is suspended or you re within waiting periods Treatment that we deem inappropriate or not reasonable, after receiving independent medical or clinical advice Any service where the treatment does not meet the standards in the Private Health Insurance Accreditation Rules 2011 or as amended Services that aren t delivered face to face, like online or telephone consultations, unless you re participating in one of our chronic disease management or health improvement programs like My Health Guardian Goods or services supplied by a provider not recognised by us Goods or services provided outside Australia, which don t meet the requirements under the Private Health Insurance Act (2007) Claims that don t meet our criteria. Please Note This is not a comprehensive list of items not covered under hospital or extras cover. Please call to check what you re covered for prior to going to hospital or for treatment. In addition, our hospital cover doesn t include: Medical and associated hospital benefits for which there is no Commonwealth Medical Benefits Schedule item number or when the medical services are not approved for payment by Medicare Private room accommodation for same-day procedures Experimental treatments Experimental and high cost non-pbs drugs Procedures normally performed in the doctor s surgery or as an outpatient Private hospital emergency room fees Respite care Nursing home-type patients are limited to benefits set by the Commonwealth Department of Health Special nursing like your own private nurse Luxury room surcharge Donated blood and blood products and donated blood collection and storage PBS pharmaceutical benefits in non-participating private hospitals Pharmaceuticals (including PBS pharmaceuticals benefits) and other sundry supplies not directly associated with the reason for admission Take home items e.g. crutches, toothbrushes and drugs Personal convenience items e.g. phone calls, newspapers, magazines and beauty salon services Massage and aromatherapy services Some services provided while in hospital by non-hospital providers Where a service is not covered for the payment of benefits in a hospital, any associated items (e.g. medical gap, prosthesis, pharmacy) are also not covered The gap on government approved prostheses in non-participating private hospitals The gap on government approved gap-permitted prostheses items. In addition, our extras cover doesn t include: Psychological and developmental assessments. Where psychology is included in your cover, psychology treatment is only payable when your GP has prescribed a mental health plan under Medicare and your psychology entitlements from Medicare for that year are exhausted Goods and services while a hospital patient except for eligible oral surgery Pharmacy items that aren t on our approved pharmacy list e.g. items listed on the PBS, items prescribed without an illness, items that are available without a prescription, or items that are not TGA approved Goods or services that had not been provided at time of claim e.g. pre-payment Fees for completing claim forms and/or reports Goods and/or services received overseas or purchased from overseas including items sourced over the internet Where no specific health condition is being treated or in the absence of symptoms, illness or injury Routine health checks, screening and mass immunisations More than one therapy service performed by the same provider in any one day Co-payments and gaps for government funded health services e.g. the co-payment for PBS items, or services where you receive a rebate from Medicare such as the Child Dental Benefit Schedule, or Chronic Disease Management - Individual Allied Health Services Where a provider is not in an independent private practice More than one of the following therapies received on the same day (physiotherapy, chiropractic and osteopathy). This brochure should be read in conjunction with the HCF Member Guide, a copy of which is available on the HCF website or at HCF branches

14 How your rights are protected Private Health Insurance Code of Conduct We support the Private Health Insurance Code of Conduct by ensuring: You receive correct information about private health insurance You re aware of the internal and external dispute resolution procedures You can make an informed decision about your purchase through informative policy documentation You re protected in accordance with the privacy principles. For a full copy of the code, visit privatehealth.com.au/codeofconduct Private Patients Hospital Charter We also support the Private Patients Hospital Charter, which outlines what members can expect from doctors, hospitals and their health fund. For a copy call or visit the Private Health Insurance section for consumers at health.gov.au Private Health Insurance Ombudsman Should any problem arise concerning your membership, contact HCF directly so that it can be resolved as quickly as possible. An internal dispute resolution officer will be appointed to independently review your complaint. If your complaint isn t dealt with satisfactorily, you can also contact the Private Health Insurance Ombudsman, an independent body formed to help resolve complaints and provide advice and Information. To contact the Ombudsman: Call: Visit: phio.org.au Write: Private Health Insurance Ombudsman Suite 2, Level 22, 580 George St Sydney NSW

15 Our privacy statement HCF is committed to best practice privacy protection 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 policy holder 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. We however, 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

16 Cash Assist Combined Product Disclosure Statement and Financial Services Guide Product Disclosure Statement This is a Product Disclosure Statement for Cash Assist insurance products and the bonus $10,000 Permanent Disability from Accident Benefit sold by HCF and issued by HCF Life Insurance Company Pty Limited. Cash Assist options are available to permanent Australian residents aged between with the exception of Kids Accident Cover which is available for children under 17. Cash Back Cover Only $1 per week for singles or $2 per week for families. Pays you a cash benefit of $2,500 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 $2,500 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 $10,000 is payable for single cover and $20,000 for family cover if you or your family have a number of accidents or illnesses during the life of the policy. Kids Accident Cover Only 90 cents per child per week. Pays up to $100,000 if your child (under 17) is accidentally injured, 24 hours a day, anywhere in Australia provided the accident results in impairment immediately or permanent disability within six months. The sum is paid regardless of any liability or damages claimed and covers impairments detailed in the table opposite. Kids Accident Cover Benefits Impairments Broken or fractured bones Skull Compound or depressed fracture Hairline fracture Spine Fractured vertebrae Chipped vertebrae Neck Hip, pelvis or jaw Leg, ankle or knee Compound (open) Simple (closed) Shoulder or cheekbone Arm, elbow or wrist Compound (open) Simple (closed) Ribs Nose or collarbone Foot (other than toe) Hand (other than finger or thumb) Burns Second degree Third degree Benefits $100,000 Maximum $2,000 $1,000 $2,000 $400 $2,000 $1,500 $1,000 $500 $600 $500 $250 $500 $400 $200 $200 $400 $650 Wounds (requiring more than 3 stitches) Per Stitch $10 Internal injuries Rupture of internal chest or abdominal organ $500 Permanent disabilities Total & permanent paralysis of all limbs Total & permanent paralysis of both legs & the lower part of the body Permanent loss of all sight in both eyes Permanent loss of all sight in one eye Permanent & total loss of use of both hands or both feet Permanent & total loss of use of one hand or one foot Permanent loss of all hearing in both ears Permanent loss of all hearing in one ear Permanent & total loss of use of one thumb of either hand $100,000 $50,000 $50,000 $3,000 $30,000 $3,000 $50,000 $3,000 $500 Permanent Disability Benefit Plus Only $1 per week for singles or $2 per week for families. Pays you a cash benefit in the event you or any person covered by your membership has an accident which results in one of the disablements listed in the following table. Up to $100,000 is paid for you and your spouse, and up to $10,000 is paid for each of your children. A maximum of $100,000 for singles and $200,000 for families is payable during the life of the policy. The disablement must occur within six months of the date of the accident. Plus, your HCF contributions will be paid up to $1,000 for singles and $2,000 for families if you are unable to work due to accident, sickness or involuntary unemployment. Bonus $10,000 Permanent Disability from Accident Benefit If you choose a hospital and extras package with Multicover or Super Multicover, you ll be covered for a benefit of $10,000 if you re permanently and totally disabled in an accident that occurred after your cover commenced. Cover is provided by a group policy issued by HCF Life and copies are available on request. Permanent Disability Benefit Plus Benefits Disablement Total & permanent paralysis of all limbs Total & permanent paralysis of both legs & the lower part of the body Permanent loss of all sight in both eyes Permanent loss of all sight in one eye Permanent & total loss of use of both hands or both feet Permanent & total loss of use of one hand or one foot Permanent loss of all hearing in both ears Permanent loss of all hearing in one ear Permanent & total loss of use of one thumb of either hand To be able to claim, at the time of the accident you must: Be in paid employment Be under the age of 65 Not have suffered the disablement as a result of drug or alcohol abuse, professional sport or deliberate self-injury Not be covered for the accident by workers compensation or third party liability insurance Not be receiving a discount under a corporate group plan. Totally and permanently disabled means the disablement has lasted for at least 12 months and will completely prevent you, for the rest of your life, from engaging in any occupation for which you re suited by your education, training or experience. You don t pay a premium in respect of the bonus $10,000 Accident Benefit as this benefit is provided at no extra cost. When cover ceases Cash Assist policies and Bonus Permanent Disability from Accident Benefit expire when the total amount payable has been paid or when your premiums fall two months in arrears. With the exception of Kids Accident Cover, where benefits expire at age 17, all Cash Assist policies and the Bonus Permanent Disability from Accident Benefit provide cover up to age 65. Benefit Contributor Or Spouse Other Persons $100,000 $100,000 $100,000 $50,000 $100,000 $50,000 $100,000 $50,000 $40,000 $10,000 $10,000 $10,000 $5,000 $10,000 $5,000 $10,000 $5,000 $4,