Health insurance that gives you more. October 2013
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- Margaret Spencer
- 10 years ago
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1 Health insurance that gives you more October
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 well-being programs 6 Singles & couples under 30 packages 8 Planning a family packages 10 Family with kids packages 12 Singles & couples 30 to 65 packages 14 Complete peace of mind packages 16 Stand-alone covers 18 Cash Assist covers 22 Loyalty benefits 24 Hospital benefits summary 26 Extras benefits summary 29 Rebates, surcharges and incentives 32 Things you need to know 34 How your rights are protected 38 Cash Assist Combined Product Disclosure Statement and Financial Services Guide 40 More insurance options 44 Our privacy policy 47 Changes to products and pricing 47 Branch, Dental and Eyecare Centre locations 48 How to join 50
3 You ll get more with HCF We provide health insurance 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 cents in the dollar in benefits compared to an average of 85 cents for other health funds in the 2012 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 four 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 accident-related treatment You won t pay a hospital excess for dependent children You won t pay a hospital excess for same day treatment, except on Budget Hospital You pay only one hospital excess amount per person per calendar year if an excess is applicable. You ll save even more by choosing a doctor who participates in our no-gap Medicover arrangements. Many doctors charge above the Medicare Benefits Schedule fee which can lead to significant out-of-pocket expenses for in-hospital medical services. More cover You'll get the best full coverage for medical services of any health fund in Australia You get a range of fully covered services for teeth, eyes, muscles, backs and feet under our More for you programs. More than health insurance You ll find it easier to look after your health and well-being with our My Health Guardian program You can access our My Home Doctor after-hours home doctor service in selected locations You get a 10% discount on travel insurance, pet insurance and new Fitness First gym memberships You can get a range of affordable life insurance cover from HCF Life to provide financial relief from illness or accidents You ll get high quality service. In 2012 we became the first Australian health fund to achieve accreditation to the International Customer Service Standard, an internationally accredited assessment and certification program. Again in 2013, we have been reaccredited for the second year in a row for our continued excellent customer service. More for you programs Want more fully covered services? Want to get back on your feet faster? Our More for you programs include a range of fully covered services. These programs aim to encourage you to seek early intervention for an injury or illness and to look after your health. More for teeth This program gives you a range of fully covered diagnostic and preventative dental services. These services are available through our seven HCF Dental Centres in Sydney, and participating dental providers in regional/rural NSW, ACT, Queensland, Victoria, South Australia and Western Australia. It is available with all extras covers and subject to available limits. More for eyes This program gives you a range of fully covered glasses and access to free digital retinal photography through our participating optical providers across Australia and seven HCF Eyecare Centres in Sydney. It s available with selected extras covers and subject to available limits. More for muscles This program gives you one fully covered initial consultation a year for a new health condition, or flare up of an existing condition, through our participating physiotherapists across Australia. It s available with all extras covers and subject to available limits. More for backs This program gives you one fully covered initial consultation a year for eligible musculoskeletal conditions; whether for a new health condition or flare up of an existing condition, through our participating chiropractors and osteopaths across Australia. It s available with all extras covers and subject to available limits. More for feet This program gives you one fully covered initial consultation a year for a new health condition, or flare up of an existing condition, through our participating podiatry providers across Australia. It s available with selected extras covers and subject to available limits. 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: Weight management programs Healthy Weight for Life Exercise and gym membership for a specific health problem (Doctor's referral required) Childbirth education Lactation consultant Learn to swim Stress management and quit smoking programs Faecal occult blood test A six month waiting period and conditions apply. 10% off for members You get a 10% discount on HCF travel insurance, pet insurance and new Fitness First gym memberships. For more information on travel insurance and pet insurance, see page 44. For more information on Fitness First visit hcf.com.au/memberoffer. Terms, conditions and a start up fee apply. 4 5
4 Health and well-being programs We give you access to easy-to-use health and well-being management tools, exclusive home care and support for a number of specific health conditions. Two of these services, My Home Doctor and My Global Specialist are a first for Australia s health insurers. Health and well-being My Health Guardian is our unique online health and well-being management program, that lets you create an easy and effective well-being plan. It s like having your own health coach 24/7. Want more energy? To lose weight? Or to simply feel healthier? My Health Guardian can help you achieve your health goals with a wide range of innovative online planning and monitoring tools. It s a fully covered service for members aged 18 years and over with hospital or extras cover. Make a plan and monitor your progress Helpful tools include: Well-being assessment a simple, guided process to assess your lifestyle and overall health Well-being action plan put together your plan, including focus areas to keep you on track Online resource library a wealth of information with hundreds of articles, exercises and recipes for you to access Your personal health coach ask any questions you have on diet, exercise and lifestyle Exercise and diet plans create personalised plans using the Get Fit and Eat Fit tools. Our new mobile app To help keep you motivated and on target to achieve your health goals, you can track your health and well-being wherever you are with the My Health Guardian mobile app, Well-being Plus. Available for iphone and Android. Daily Challenge Improve your health and well-being one step at a time with the Daily Challenge. It encourages healthy behaviours that boost emotional and physical health. 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 Care at home 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 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 a specialist medical information service. It is available to members on our highest level of hospital cover, Top Plus with nil excess, with either Multicover or Super Multicover Extras. You will have access to a global network of 50,000 medical experts to review your medical records and provide you with a report on your diagnosis and treatment plan. We have engaged Best Doctors, the world s leading resource for specialist medical advice founded by doctors from the Harvard Medical School in 1989, to provide this innovative new service. Please visit hcf.com.au/mgs or contact us for more information
5 Singles & couples under 30 packages Cover for the essentials without blowing your budget Much, Much More Hospital Advanced Savings Accident related treatment Removal of tonsils Removal of appendix Back surgery Rehabilitation services Shoulder reconstruction Emergency ambulance and more Excess options: $250 or $450 Want an even higher level of cover? Check out our Complete peace of mind packages on page 16. with Multicover Extras Optical Exercise physiology Remedial massage and acupuncture Travel vaccinations and more Young Singles and Couples Hospital with Young Singles and Couples Extras Much More Accident related treatment Removal of tonsils Removal of appendix Back surgery Shoulder reconstruction Emergency ambulance and more Excess: $450 Optical Exercise physiology Travel vaccinations and more Budget Hospital* with General Extras Plus Choose this Cash Assist option: Get added protection, with $2,500 cash back if you suffer an accident or serious illness. Add Cash Back Cover for just $1 per week for singles. See page 22. More Accident related treatment Removal of tonsils Removal of appendix Shoulder reconstruction Emergency ambulance and more Excess: $450 This cover is designed for young, fit and healthy singles and couples. See notes below. Optical Exercise physiology Remedial massage and acupuncture Travel vaccinations and more *Some Exclusions apply. Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au 8 Fill in the form Complete the attached application and send it to us 8 9
6 Planning a family packages Cover for when you re having kids Much, Much More Top Plus Hospital Pregnancy and birth related services Assisted reproductive services (e.g. IVF, GIFT) Accident related treatment Hip and knee joint replacement surgery Rehabilitation services Emergency ambulance Bonus Permanent Disability from Accident Cover (see page 41) and more Excess options: Nil, $250 or $450 with Super Multicover Extras Orthodontics Optical with flexible two year limit Antenatal classes Remedial massage, acupuncture and other therapies HCF approved health management programs Travel vaccinations and more Top Plus Hospital with Multicover Extras Choose this Cash Assist option: Cash Back Cover gives even more peace of mind. See page 22. Much More Same comprehensive hospital cover as above Top Plus Hospital Orthodontics Optical Antenatal classes Remedial massage and acupuncture HCF approved health management programs Travel vaccinations and more with General Extras Plus More Same comprehensive hospital cover as above but excludes Bonus Permanent Disability from Accident Cover (see page 41) Optical Exercise physiology Remedial massage and acupuncture Travel vaccinations and more Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages If you are thinking of becoming pregnant, please check that your cover includes pregnancy and birth related services and ensure that you have served any relevant waiting periods. If you are currently on a single or couples membership, you will need to transfer to a family membership at least two months prior to your baby s birth. This will ensure that your baby is covered under your membership from their date of birth. 10 Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 11
7 Family with kids packages Cover for everyone in the family Much, Much More Top Plus Hospital Pregnancy and birth related services Assisted reproductive services (e.g. IVF, GIFT) Accident related treatment Hip and knee joint replacement surgery Rehabilitation services Emergency ambulance Bonus Permanent Disability from Accident Cover (see page 41) and more Excess options: Nil, $250 or $450 with Super Multicover Extras Orthodontics Optical with flexible two year limit Selected natural therapies Learn to swim Exercise physiology Speech pathology and more Top Plus Hospital with Multicover Extras Much More Same comprehensive hospital cover as above Orthodontics Optical Selected natural therapies Learn to swim Exercise physiology Speech pathology and more Hospital Advanced Savings with General Extras Plus Choose this Cash Assist option: Kids Accident Cover for your little daredevils. See page 22. More Back surgery Shoulder reconstruction Removal of tonsils Removal of appendix Rehabilitation services Emergency ambulance and more Excess options: $250 or $450 Orthodontics Optical Exercise physiology Travel vaccinations and more Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 13
8 Singles & couples 30 to 65 packages Cover for wherever life takes you Much, Much More Top Plus Hospital Accident related treatment Back surgery Digestive disorders Kidney and gall stone removal Hip and knee joint replacement surgery Cataract and other lens surgery Rehabilitation services Emergency ambulance Bonus Permanent Disability from Accident Cover (see page 41) and more Excess options: Nil, $250 or $450 with Multicover Extras Dentures Optical Selected natural therapies Hearing aids and health appliances HCF approved health management programs Travel vaccinations and more Fit & Free Hospital with Fit & Free Extras Much More Accident related treatment Back surgery Digestive disorders Kidney and gall stone removal Hip and knee joint replacement surgery Cataract and other lens surgery Rehabilitation services Emergency ambulance Bonus Overseas Travel Insurance for under 75 s (see page 45) and more Optical Podiatry HCF approved health management programs Travel vaccinations and more Excess options: Nil or $250 Hospital Advanced Savings with General Extras Plus Choose this Cash Assist option: Permanent Disability Benefit Plus. See page More Accident related treatment Back surgery Digestive disorders Kidney and gall stone removal Emergency ambulance and more Excess options: $250 or $450 Optical Exercise physiology Remedial massage and acupuncture Travel vaccinations and more Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 15
9 Complete peace of mind packages Cover for anyone wanting complete peace of mind Much, Much More Much More Top Plus Hospital Cataract and other lens related surgery Hip and knee joint replacement surgery Heart surgery Rehabilitation services Emergency ambulance Bonus Permanent Disability from Accident Cover (see page 41) and more Excess options: Nil, $250 or $450 Top Plus Hospital Same comprehensive hospital cover as above with Super Multicover Extras Dentures Hearings aids Optical with flexible two year limit Chiropractic, osteopathy and exercise physiology Podiatry Selected natural therapies HCF approved health management programs Travel vaccinations and more with Multicover Extras Dentures Hearing aids Optical Podiatry Selected natural therapies HCF approved health management programs Travel vaccinations and more Top Plus Hospital with General Extras Plus More Same comprehensive hospital cover as above but excludes Bonus Permanent Disability from Accident Cover (see page 41) Optical Exercise physiology Remedial massage, acupuncture and more Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 17
10 Stand-alone covers Hospital Top Plus Hospital Accident related treatment Pregnancy and birth related services Assisted reproductive services (e.g. IVF, GIFT) Hip and knee joint replacement surgery Heart surgery Back surgery Digestive disorders Kidney and gall stone removal Cataract and other lens surgery Rehabilitation services Emergency ambulance Excess options: Nil or $450 Budget Hospital* Accident related treatment Removal of tonsils Removal of appendix Shoulder reconstruction Emergency ambulance and more Excess: $450 This cover is designed for young, fit and healthy singles and couples. See notes below. *Some Exclusions apply. Some Minimal Benefits apply. See Hospital benefits summary table on page 26 and Things you need to know on page 34 for details. These are suggestions only. To compare our products and learn more about what is covered, refer to pages Quality cover when you need it Are you visiting from overseas? Talk to us about cover options on or visit a branch. 18 Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 19
11 Stand-alone covers Extras and Ambulance Multicover Extras Only Orthodontics Optical Selected natural therapies Exercise physiology Learn to swim Speech pathology and more For this stand-alone cover: annual limit is $600 Chiropractic, osteopathy and exercise physiology combined annual limit is $500. Sublimits of $375 each for chiropractic, osteopathy & exercise physiology apply Loyalty benefits don't apply Ambulance Cover Cover for State Government emergency ambulance services where you require hospital or on-the-spot treatment in Australia Up to $5,000 per person per calendar year for State Government medically necessary non-emergency ambulance services where your doctor requests ambulance transport because your condition requires monitoring and support in transit Notes: Ambulance Cover is available without hospital or extras cover to residents of NSW, ACT, VIC, NT and SA This cover is not available to QLD, TAS and WA residents Are you visiting from overseas? Talk to us about cover options on or visit a branch. 20 Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 21
12 Cash Assist covers Financial cover for accidents and illnesses Kid s Accident Cover Only 90 cents per child per week Cover for children under 17 Pays up to $100,000 for accidental injury or permanent disability Paid in addition to any other benefits you may receive Covers broken bones, burns and stitches For more details please refer to page 40. Cash Back Cover Only $1 per week for singles or $2 per week for families Cover for Australian residents aged Pays $2,500 if you suffer an accident resulting in surgery Pays $2,500 if you suffer a serious specified medical condition Can claim multiple times up to $10,000 for singles and $20,000 for family cover For more details please refer to page 41. Permanent Disability Benefit Plus Only $1 per week for singles or $2 per week for families Pays cash if you have an accident resulting in a specified disablement Pays up to $100,000 for you or your spouse Pays up to $10,000 for your children For more details please refer to page 41. These products are issued by HCF Life Insurance Company Pty Ltd. Please read the Product Disclosure Statement on page 40 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. Joining is easy too! Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Visit a branch Find your nearest HCF branch on page 48 or visit hcf.com.au Fill in the form Complete the attached application and send it to us 22 23
13 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) 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. After 12 months you can claim up to $500 over two consecutive calendar years (applies to current and previous calendar years). Sublimit of $250 for contact lenses per year. 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 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 Under 2 years 2-5 years 6-9 years years 15+ years Nil $800 $1,100 $1,400 $1,800 General Extras Plus Service Orthodontics Loyalty limits 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
14 Hospital benefits summary Key features Top Plus Fit & Free Hospital benefits summary Hospital Advanced Savings Young Singles & Couples Excess (per person per calendar year) Nil, $250 or $450 Nil or $250 $250 or $450 $450 $450 No excess for accident related treatment No excess for kids NA NA No excess for same day treatment Available as hospital cover only (without extras) Yes (Nil or $450) No No No Yes Budget Hospital Hospital waiting periods Palliative care Psychiatric services Rehabilitation services Pre-existing ailments or conditions Pregnancy & birth related services All other hospital services 2 months 12 months 2 months 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 MB MB Rehabilitation services MB MB Psychiatric services MB MB MB Gastric banding & obesity surgery MB Assisted reproductive services (e.g. IVF, GIFT) MB MB MB Pregnancy & birth related services MB MB MB Hip & knee joint replacement surgery MB MB Cataract & other lens related surgery MB MB Elective cosmetic surgery MB MB MB MB Podiatric surgery by an accredited podiatrist MB MB MB MB Emergency ambulance Non-emergency ambulance (up to $5,000) 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 6 months 12 months 24 months 2 months 1 day 2 months 12 months Covered MB Minimal Benefits. See page 34 for definition Exclusions. See page 35 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
15 OTHER THERAPIES OPTICAL DENTAL Extras benefits summary Current as at 30 September Benefits shown are valid until 30 June Benefits and annual limits (annual limits per person per calendar year, unless otherwise specified) Services Details Waiting Super Multicover Multicover Fit & Free General Extras Plus Young Singles & Couples Period 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 $32 - $55 $32 - $55 $32 - $55 $32 - $55 Diagnostic 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 Preventative 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 Accrues at $440 per year. Accrues at $440 per year. Accrues at $250 per year. Orthodontics E.g. braces to straighten teeth. Up to $2,6 40* for orthodontist Up to $2,640* for orthodontist Up to $1,500* for orthodontist Lifetime limit applies 12 months (Sublimit of $1, 000 for general dentist). (Sublimit of $1,000 for general dentist). (Sublimit of $1,000 for general dentist). Lifetim e limit applies Lifetime limit applies Lifetime limit applies Surgical extractions $210 - $330 $165 - $240 $165 - $240 $150 - $215 $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 $38 - $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 - $500 $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 $38/$34^ $300 Sublimit of $200 Audiology $58/$40 $350 $52/$35 $500 $52/$35 (Sublimit of for foot orthotics Speech pathology (SP) $83/$51 $500 $60/$40 $200 audiology) $60/$40 $40/$30 First/subsequent visits (unless otherwise specified) Occupational therapy (OT) $72/$50 $600 $62/$40 $500 $62/$40 2 months $42 visits 1-2, $32 visits 1-2, $40 first visit, Chiropractic $33 visits 3-11, $28 visits 3-11, $35 visits 2-6, $18 visits 12+ $600 - $1,200 $14 visits 12+ $600 - $1,000 $20 visits 7+ $45 visits 1-2, Sublimit of $600 each $35 visits 1-2, Sublimit of $375 $40 first visit, Osteopathy $35 visits 3-11, for chiro & osteo $29 visits 3-11, each for chiro, $35 visits 2-6, $18 visits 12+ $400 for EP $14 visits 12+ osteo & EP $20 visits 7+ $600 $40/$30 $30 first visit, $20 visits 2-6, $10 visits 7+ $28 visits 1-2, $20 visits 3-11, $10 visits 12+ $30 visits 1-2, $20 visits 3-11, $10 visits 12+ $500 Sublimit of $250 each for chiro, osteo and EP, $200 combined for OT and SP. $100 combined remedial massage, myotherapy, acupuncture and CHM Exercise physiology (EP) $40/$33 $30/$28 $30/$28 $25/$20 $25/$20 Physiotherapy $53 visits 1-2, $38 visits 3-11, $18 visits 12+ $600 - $1,200 $45 visits 1-2, $32 visits 3-11, $17 visits 12+ $600 - $1,200 $45 first visit, $40 visits 2-6, $22 visits 7+ $33 visits 1-2, $20 visits 3-11, $10 visits 12+ $30 first visit, $25 visits 2-6, $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 Up to $1,600 $600 - $1,600 Health management programs HCF approved single/couple or family 6 months Up to $200 $200/$400 Up to $150 $150/$300 Up to $200 $200/$400 School accident cover Approved ancillary services only 2-12 months Up to $800 $800 Up to $800 $800 Up to $400 $400 $30 first visit, $20 visits 2-6, $10 visits 7+ $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 upper 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.
16 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. 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 are happy to help with general information about rebate tiers. However for personal advice specific to your circumstances, you are advised to seek independent advice from your accountant, financial advisor or the ATO at ato.gov.au or on 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 $88,001 or more per year for singles and $176,001 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. 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 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. 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 contact us Changes to LHC and the Australian Government Rebate From 1 July 2013 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. Income thresholds for the 2013/14 income tax year Income Type of member Unchanged Tier 1 Tier 2 Tier 3 Singles < $88,000 $88, ,000 $102, ,000 > $136,001 Families* < $176,000 $176, ,000 $204, ,000 > $272,001 Rebate < Age 65 30% 20% 10% 0% Age % 25% 15% 0% Age % 30% 20% 0% Medicare Levy Surcharge All ages 0.0% 1.0% 1.25% 1.5% *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
17 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. 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. 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 Exclusions list on page 26 before purchasing your cover. 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
18 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 and Ageing 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 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). 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. 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. Once on our website follow the link to the Frequently Asked Questions (FAQ s) section and look under Who s covered by my membership? Cover for your dependants Your children are automatically covered at no extra cost 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 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 of about 25% of your existing premium. Extended family cover is available with Hospital Advanced Savings or Top Plus
19 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 2202, 580 George St Sydney NSW
20 Cash Assist Cash Assist provides greater cover 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. They offer you cash assistance to help you and your family recover from accidents and illnesses. You can choose an option that protects your kids, too. 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 between with the exception of Kids Accident Cover which is available for children under 17. 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 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. 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. 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 of either hand Bonus $10,000 Permanent Disability from Accident Benefit If you choose a 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. 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. Contributor Or Spouse $100,000 $100,000 $100,000 $50,000 $100,000 $50,000 $100,000 $50,000 $40,000 Benefit Other Persons $10,000 $10,000 $10,000 $5,000 $10,000 $5,000 $10,000 $5,000 $4,
21 Exclusions For all these Cash Assist products, benefits are not paid for: Pre-existing conditions Events on or before the first day of cover Events that occur outside Australia Professional sport, military service, racing or private aviation War, hostility, civil commotion, terrorism or insurrection Events resulting from intentional self-injury, illegal acts and drugs or alcohol. For each of these products, benefits are not paid for certain additional events. These events are marked with a cross in the table on the below. In addition to these exclusions, the contributions component of the Permanent Disability Benefit Plus benefits is not paid for: The first 30 days you re not working Pregnancy, childbirth, infertility, contraceptive procedures and related conditions AIDS Events resulting from intentional self-injury, illegal acts and drugs or alcohol Events that occur outside Australia or within the first two months of cover Pre-existing conditions in the first 12 months of cover Unemployment in the first 12 months with your employer. When cover ceases Cash Assist policies and Bonus Permanent Disability from Accident Benefit expire when the Event/Reason For Claim 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. Premiums Premiums may only increase if this applies to all policy holders for the product and we will provide one month s notice to you. Your premium will also include any stamp duty charged by your State Government, as well as any taxes that may be levied by State and Federal Governments. Additional information Select any of these options on your HCF application and you will promptly receive a Policy Document with full details on your benefits. A copy is available upon request. Your cover is automatic once we receive your application and payment instructions. You have 30 days to review your policy. Should it not meet your needs, simply advise us in writing to cancel the policy and you ll receive a full refund, provided you have not made a claim. Taxation Usually premiums aren t tax deductible and benefits are paid free of personal tax. This is a general statement based on present laws and their interpretation. Individual circumstances may vary and you should consult a professional tax adviser in relation to your individual circumstances. Kids Accident Cover Cash Back Cover Condition within first two months of cover Conditions covered by workers compensation, third party insurance or social security benefits Surgery for diagnostic purposes or not in an operating theatre AIDS 42 Intentional act by adult person living with child Permanent Disability Benefit Plus Event resulting in death within seven days HCF Life Insurance Company Pty Limited ABN , AFSL George Street, Sydney NSW 2000 Telephone Dated: 30 September 2013 Financial Services Guide This Financial Services Guide (FSG) relates to the services provided by HCF (we, us or our) in relation to the Cash Assist options and the Bonus $10,000 Permanent Disability from Accident Benefit issued by HCF Life Insurance Company Pty Limited (HCF Life). This guide is designed to assist you in deciding whether to use any of the services offered by us relating to the HCF Life products as set out in this FSG. It contains information about remuneration paid to us and our staff for the services offered and how complaints against us in relation to these services are dealt with. If we offer or arrange to issue you with any of these products we will provide you with a Product Disclosure Statement (PDS) relating to that product. This sets out the significant features of the product and will assist you to compare and make informed decisions about the product. We provide general advice about the suitability of these products for the needs of members. This means we don t take into account of individual objectives, financial situation or needs. You should, before acting on that advice, consider the appropriateness of the advice, having regard to your objectives, financial situation or needs. Please read the PDS before deciding to purchase any of these products. We are licensed to provide general advice about, and arrange the issue of, life and general insurance products. HCF Life is a wholly owned subsidiary of ours. When we issue you with a policy for a Cash Assist option, we do so under a binder that authorises us to enter into that contract of insurance on behalf of HCF Life. The Bonus $10,000 Accident Benefit is provided by HCF Life through a group policy issued to us. You don t pay a premium in respect of the Bonus $10,000 Accident Benefit as this benefit is provided at no extra cost as part of Multicover and Super Multicover. HCF Life receives the premiums paid for the Cash Assist options. We receive monthly commissions from HCF Life in relation to the Cash Assist options: 40% of the first year s premium, plus an additional commission of 80% of HCF Life s underwriting profit each financial year, calculated as premiums less claims and expenses. Our staff receive an incentive depending on the number of Cash Assist option policies they sell. This will not exceed 20% of the first year s premium. HCF Life receives an annual premium of $2.34 per single and $4.68 per family from us for the bonus $10,000 Accident Benefit. This is paid by us and is not an extra cost to you. HCF is a not-for-profit organisation and all the income it receives is applied for the benefit of our members. Both HCF and HCF Life are each responsible for the entire contents of this combined Financial Services Guide (FSG) and Product Disclosure Statement. We hold Professional Indemnity insurance that complies with the compensation requirements of section 912B of the Corporations Act. This includes cover for claims in relation to the conduct of representatives and employees who no longer work for us, but who did at the time of the relevant conduct. Should you have a complaint about any of the services we offer in relation to the HCF Life products in this FSG, please contact us on or [email protected] and we will endeavour to resolve it as quickly as possible. If we have not resolved your complaint within 45 days or you re not satisfied with our response, you can contact the Financial Ombudsman Service on or by post at GPO Box 3, Melbourne VIC This is an independent body available to you free of charge. The Hospitals Contribution Fund of Australia Limited ABN , AFSL George Street, Sydney NSW 2000 Telephone Dated: 30 September
22 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 and more. 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 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 Medical Trauma Insurance When a serious accident or illness strikes, the cost goes far beyond medical care. You want cash in hand to keep bills at bay, hold on to what s precious, and concentrate on getting better. Medical Trauma Insurance includes: Cover for over 40 major medical conditions No complex questionnaires or medical examinations Available to Australian permanent residents aged An ideal complement to your HCF private health cover and Medicare. Consider the Medical Trauma Insurance Product Disclosure Statement available by calling or visiting hcf.com.au/medicaltrauma and your financial situation, objectives and needs before deciding on this product as the information provided does not take these into account. Medical Trauma Insurance is issued by HCF Life Insurance Company Pty Ltd. (ABN ) 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 XX 45
23 Our privacy policy HCF is committed to best practice privacy protection We collect your personal information so we can: Comply with laws Manage our relationship with you Record your treatment Provide health insurance, related products and services to you Assess your insurance, health and related lifestyle needs Investigate fraudulent or improper claims Develop products and services that may better serve your needs Assess your possible interest in such products and services. The types of organisations we disclose personal information to include: Third party organisations who deliver services on our behalf or to us Health service providers, e.g. where it s used 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 Government agencies. Each of these organisations are required to keep your personal information confidential. You may request information we have collected about you by calling us on We reserve the right to charge a reasonable cost for processing your request including photocopying, administration and postage. How we collect, use and keep your personal information secure is described in the HCF Privacy Policy. To view the HCF Privacy Policy: Visit hcf.com.au Visit your local branch. All new Policyholders will receive a copy of the Privacy Policy with their membership card and should ensure other members of the policy are aware of it. 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
24 Branch, Dental and Eyecare Centre Locations ACT Belconnen Shop 138 Westfield Belconnen Belconnen ACT 2617 Canberra 128 Bunda Street Civic Canberra ACT 2601 Woden Shop 35 Westfield Woden Woden ACT 2606 NSW Albury Shop Dean Street Albury NSW 2640 Armidale 186 Beardy Street Armidale NSW 2350 Bankstown Level 2, Centro Bankstown Stacey Street Bankstown NSW 2200 Bathurst 117 George Street Bathurst NSW 2795 Bega 201 Carp Street Bega NSW 2550 Blacktown Shop 3005 Westpoint Shopping Centre Blacktown NSW 2148 Bondi Junction 438 Oxford Street Bondi Junction NSW 2022 Bowral Shop 3 Corbett Plaza 14 Wingecarribee Street Bowral NSW 2576 Brookvale Shop Warringah Mall Brookvale NSW 2100 Burwood 99 Burwood Road Burwood NSW 2134 Campbelltown Shop 69 Campbelltown Mall 271 Queen Street Campbelltown NSW 2560 Castle Hill Shop 459 Castle Towers Castle Hill NSW 2154 Charlestown Level 1, Shop 121A Charlestown Square Charlestown NSW 2290 Chatswood Level 2, Shop 254 Westfield Chatswood Chatswood NSW 2067 Coffs Harbour 3 Harbour Drive Coffs Harbour NSW 2450 Deniliquin 1B 344 Cressy Street Deniliquin NSW 2710 Dubbo 244 Macquarie Street Dubbo NSW 2830 Erina Shop T62, Erina Fair Erina NSW 2250 George Street 403 George Street Sydney NSW 2000 Grafton Shop T68, Shoppingworld (The Link) Fitzroy Street Grafton NSW 2460 Griffith 370 Banna Avenue Griffith NSW 2680 Hornsby Shop 2 16 Hunter Street Hornsby NSW 2077 Hurstville 237 Forest Road Hurstville NSW 2220 Leeton 76 Pine Avenue Leeton NSW 2705 Lismore 89 Molesworth Street Lismore NSW 2480 Liverpool Shops 21 & 22 Liverpool Plaza 165 Macquarie Street Liverpool NSW 2170 Maitland 411 High Street Maitland NSW 2320 Miranda Shop 1005, Westfield Miranda The Kingsway Miranda NSW 2228 North Ryde Shop 50, Macquarie Centre Herring Road North Ryde NSW 2113 North Sydney P47, Northpoint Centre 100 Miller Street North Sydney NSW 2060 Nowra Shop 2 Nowra Mall Kinghorne Street Nowra NSW 2541 Orange Cnr Summer & Anson Streets Orange NSW 2800 Pagewood Shop 179 Westfield Eastgardens Eastgardens NSW 2035 Parramatta Shop 1139/1140 Westfield Parramatta Parramatta NSW 2150 Penrith Shop 86, Ground Floor Westfield Penrith 585 High St Penrith NSW 2750 Port Macquarie Shop 50 Port Central Horton Street Port Macquarie NSW 2444 Tamworth Shop 3, City Plaza Peel Street Tamworth NSW 2340 Tweed Heads Shop 26, Tweed Mall Tweed Heads NSW 2485 Wagga Wagga Shop 28, Sturt Mall Wagga Wagga NSW 2650 Wollongong 140 Crown Street Mall Wollongong NSW 2500 QLD Brisbane Shop G7/8 MacArthur Central Cnr Queen and Edward Street Brisbane QLD 4000 Chermside* Level 1, Westfield Chermside Cnr Gympie and Hamilton Roads Chermside QLD 4032 Garden City* Lower Ground Cnr Logan & Kessels Roads Upper Mt Gravatt QLD 4122 Robina* Level 3, Robina Town Centre Robina Town Centre Drive Robina QLD 4226 SA Adelaide Shop 1 49 Gawler Place Adelaide SA 5000 Marion* Level 2 Westfield Marion Shopping Centre 297 Diagonal Rd Oaklands Park SA 5046 VIC Chadstone* Chadstone Shopping Centre 1341 Dandenong Road Chadstone VIC 3148 Doncaster* Ground Level Westfield Doncaster 619 Doncaster Road Doncaster VIC 3108 Melbourne 330 Collins Street Melbourne VIC 3000 Southland* Level 1 Westfield Southland 1239 Nepean Highway Cheltenham VIC 3192 HCF Dental and Eyecare Centres Blacktown Dental: (02) Eyecare: (02) Bondi Junction Dental: (02) Eyecare: (02) Brookvale Dental: (02) Eyecare: (02) Chatswood Dental: (02) Eyecare: (02) Hurstville Dental: (02) Eyecare: (02) Parramatta Dental: (02) Eyecare: (02) Sydney Dental: (02) Eyecare: (02) * Please note, these branches do not accept cash or cheque payments for premiums or pay cash for claims
25 How to join Australia's largest not-for-profit health fund To apply: Call We re open 8am - 8pm, Monday to Friday, 9am - 5pm weekends (AEST) Visit one of our 53 branches Go to hcf.com.au Mail the attached application form Ask one of our corporate sales representatives to visit your workplace by ing [email protected] Want more from your current fund? Switching to HCF is easy We ll take care of all the paperwork for you. Say goodbye to your current health fund, and say hello to the benefits of HCF cover with no additional waiting periods for similar levels of cover. Call us on now to find out more
26 You get more with HCF More benefits You get more because we re Australia s largest not-for-profit health fund You get more returned in benefits we returned 91 cents in the dollar in benefits compared to an average of 85 cents for other health funds in the 2012 financial year You get more value with HCF we ve won Canstar s top national award for outstanding value health insurance 4 years in a row You get generous dental, optical and physiotherapy benefits You can make extras claims at all our branches. More savings You won t pay a hospital excess for accidentrelated treatment You won t pay a hospital excess for dependent children You won t pay a hospital excess for same day treatment, except on Budget Hospital You pay only one hospital excess amount per person per calendar year if an excess is applicable. More cover You get the best full coverage for medical services of any health fund in Australia You get a range of fully covered services for teeth, eyes, muscles, backs and feet under our More for you programs. More than health insurance You ll find it easier to look after your health and well-being with our My Health Guardian online program You can access our My Home Doctor after-hours home doctor service in selected locations You get a 10% discount on travel insurance, pet insurance and new Fitness First gym memberships You can get a range of affordable life insurance covers from HCF Life to provide financial relief from illness or accidents. The Hospitals Contribution Fund of Australia Limited. ABN Head Office: 403 George Street, Sydney NSW OCT13_VAL0014_PB
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