Your guide to health insurance that gives you more

Transcription

1 Your guide to health insurance that gives you more MARCH 2013 More benefits More cover More savings

2 We re committed to giving you more At HCF, everything we do is for the benefit of our members, so you get more. Contents You ll get more with HCF 4 Health and well-being programs and services 6 Singles & couples under 30 packages 8 Planning a family packages 10 Families with kids packages 12 Singles & couples 30 to 65 packages 14 Complete peace of mind packages 16 Stand alone covers 18 Cash Assist options 20 Loyalty benefits 22 Hospital benefits summary 24 Extras benefits summary 27 Rebates, surcharges and incentives 30 Things you need to know 33 How your rights are protected 36 Cash Assist 38 More insurance options 42 Your privacy is protected 43 Changes to products and pricing 43 Branches, Dental and Eyecare Centres 44 Application form 49

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 cover, you can reduce your health cover 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. Whatever excess level you choose, you pay less overall with us because: accident-related treatment dependent children day treatment on our top and mid-level hospital products 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. By choosing a doctor that will participate in our no-gap Medicover arrangements, you won t pay a gap. More cover hospital products services of any health fund in every State teeth, eyes, muscles, backs and feet under our More for you programs More than health insurance and well-being with our My Health Guardian online program My Home Doctor after-hours home doctor service in selected locations and new Fitness First gym memberships products 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 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 with the aim of encouraging members to seek early intervention for an injury, illness and to look after their health. More for teeth This program gives members a range of fully covered diagnostic and preventative dental services through our seven HCF Dental Centres in Sydney, and participating dental providers in regional/rural NSW, ACT, Queensland, Victoria and South Australia. From July 2013 Western Australia will also join the program. It is available with all extras covers and subject to available limits. More for eyes This program gives members 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 cover and subject to available limits. More for muscles This program gives members one fully covered initial consultation a year for a new health condition, or flare up of an existing condition, through our participating physiotherapy providers across Australia. It s available with all extras cover and subject to available limits. More for backs This program gives members 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 chiropractic and osteopathy providers across Australia. It s available with all extras cover and subject to available limits from April More for feet This program gives members 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 cover and subject to available limits from April More 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: (Doctors referral required) smoking programs Conditions and a six month waiting period apply. 10% off for members travel insurance and new Fitness First gym memberships. For more information on travel insurance see page 42. Fitness First terms, conditions and a start up fee apply. For more information visit hcf.com.au. 4

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 18 years and over with hospital or extras cover. 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 Make a plan and monitor your progress Helpful tools include: process to assess your lifestyle and overall health including focus areas to keep you on track information with hundreds of articles, exercises and recipes for you to access you have on diet, exercise and lifestyle 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 on 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? Just go to hcf.com.au/gethealthy Care at home My Home Doctor is a convenient, 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. Areas covered currently include Sydney and South-East Queensland. With the coverage areas expanding, please visit hcf.com.au/mhd or contact us to see if you re in an area that s covered. 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. 6 7

5 Singles and couples under 30 packages Much, Much More Much More Hospital Advanced Savings * with Multicover Extras Hospital excess options: $250 or $450 Want an even higher level of cover? Check out our Complete peace of mind packages on page 16. Young Singles and Couples Hospital * with Hospital excess option: $450 Young Singles and Couples Extras Cover for the essentials without blowing your budget More Budget Hospital with General Extras Plus Hospital excess option: $450 Some Exclusions and Minimal Benefits apply. See Hospital benefits summary table on page 24 and Things you need to know on page 33 for details. 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 20. *Some Minimal Benefits apply. See Hospital benefits summary table on page 24 and Things you need to know on page 33 for details. These are suggestions only. To compare our products and learn more about what is covered refer to pages Joining is easy too! Choose from one of these options Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 8 9

6 Planning a family packages Top Plus Hospital with Super Multicover Extras Much, Much More (e.g. IVF, GIFT) Cover (see page 39) and more Hospital excess options: Nil, $250 or $450 Top Plus Hospital with Multicover Extras Much More More Top Plus Hospital with General Extras Plus Accident Cover (see page 39) Cover for when you re having kids Choose this Cash Assist option: Cash Back Cover gives even more peace of mind. See page 20. See Hospital benefits summary table on page 24 and Things you need to know on page 33 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 Joining is easy too! Choose from one of these options Go to hcf.com.au 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. Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 10 11

7 Family with kids packages Much, Much More Top Plus Hospital with Super Multicover Extras (e.g. IVF, GIFT) Cover (see page 39) and more Hospital excess options: Nil, $250 or $450 Top Plus Hospital with Multicover Extras Cover for everyone in the family Much More More Hospital Advanced Savings * with General Extras Plus Hospital excess options: $250 or $450 Choose this Cash Assist option: Kids Accident Cover for your little daredevils See page 20. *Some Minimal Benefits apply. See Hospital benefits summary table on page 24 and Things you need to know on page 33 for details. These are suggestions only. To compare our products and learn more about what is covered refer to pages Joining is easy too! Choose from one of these options Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 12 13

8 Singles & couples 30 to 65 packages Much, Much More Top Plus Hospital with Multicover Extras Cover (see page 39) and more Cover for wherever life takes you Choose this Cash Assist option: Permanent Disability Benefit Plus See page 20. Hospital excess options: Nil, $250 or $450 Fit & Free Hospital * with Fit & Free Extras Much More under 75 s (see page 42) and more Hospital excess options: Nil or $250 Hospital Advanced Savings * with General Extras Plus More Hospital excess options: $250 or $450 *Some Minimal Benefits apply. See Hospital benefits summary table on page 24 and Things you need to know on page 33 for details. These are suggestions only. To compare our products and learn more about what is covered refer to pages Joining is easy too! Choose from one of these options Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 14 15

9 Complete peace of mind packages Much, Much More Top Plus Hospital with Super Multicover Extras Cover (see page 39) and more Hospital excess options: Nil, $250 or $450 Cover for anyone wanting complete peace of mind Top Plus Hospital with Multicover Extras Much More Top Plus Hospital with General Extras Plus More Accident Cover (see page 39) These are suggestions only. To compare our products and learn more about what is covered refer to pages Joining is easy too! Choose from one of these options Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 16 17

10 Stand alone covers Want protection for certain healthcare costs, but not for others? Cover type Product options Covers you for Hospital only Top Plus Hospital excess options: Nil or $450 (e.g. IVF, GIFT) Budget Hospital Hospital excess options: $450 Important notes: services. See pages for details Overseas Visitors Overseas Visitors Health Cover (Also available with extras options) We have top level hospital cover designed for visitors to Australia with the right to work. It meets the requirements for health insurance for working visa applicants as set by the Department of Immigration. Talk to us about our cover options for overseas visitors. Extras only Multicover Only Ambulance only Ambulance Cover with State Government road or air services where you require hospital or on-the-spot treatment in Australia for State Government medically necessary non-emergency ambulance services where your doctor requests ambulance transport because your condition requires monitoring and support in transit management programs and more Important notes: osteopathy and exercise physiology combined annual limit is $500 and sublimits apply & exercise physiology apply from 1 July 2013 cover to residents of NSW, ACT, VIC, NT and SA Government schemes If you d like more information on any of the above product options go to hcf.com.au, visit a branch or call

11 Cash Assist options Kid s Accident Cover Only 90 cents per child per week or permanent disability may receive For more details please refer to page 38. Financial cover for accidents and illnesses Cash Back Cover Only $1 per week for singles or $2 per week for families resulting in surgery specified medical condition for singles and $20,000 for family cover For more details please refer to page 39. Permanent Disability Benefit Plus Only $1 per week for singles or $2 per week for families in a specified disablement For more details please refer to page 39. These products are issued by HCF Life Insurance Company Pty Ltd. Please read the Product Disclosure Statement on page 38 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! Choose from one of these options Go to hcf.com.au Call between 8am and 8pm, Monday to Friday or 9am to 5pm on weekends (AEST) Fill in the form Complete the attached application and send it to us Visit a branch Find your nearest HCF branch on page 44 of this brochure or visit hcf.com.au 20 21

12 Loyalty benefits More rewards for members 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. 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. Sublimits apply for chiropratic, ostepathy and exercise physiology. Multicover Extras (when packaged with hospital cover) Service Orthodontics Physiotherapy Loyalty limits orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies. Limit starts at $600 and accrues at $120 per year up to $1,200 per person per year. Super Multicover Extras Service Loyalty limits Chiropractic, osteopathy & exercise physiology Combined limit starts at $600 and increases by $100 per year up to $1,000. Sublimits apply. per year up to $1,200. Sublimits apply Orthodontics Crowns, bridges & implants Optical When taken with Top Plus: ($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 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. Hearing aids Length of membership Loyalty limits 2-5 years 6-9 years years years 20+ years Nil $600 $800 $1,000 $1,200 $1,600 Physiotherapy Chiropractic, osteopathy & exercise physiology 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. Hearing aids Length of membership Loyalty limits 2-5 years 6-9 years years 15+ years Nil $800 $1,100 $1,400 $1,800 Multicover Only Extras Service Orthodontics Loyalty limits orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies. Hearing aids Length of membership Loyalty limits 2-5 years 6-9 years years years 20+ years Nil $600 $800 $1,000 $1,200 $1,600 General Extras Plus Service Orthodontics Loyalty limits orthodontist ($1,000 sublimit for a general dentist). Lifetime limit applies

13 Hospital benefits summary Top Plus Fit & Free Hospital Advanced Savings Young Singles & Couples Budget Hospital Excess options Nil, $250 or $450 Nil or $250 $250 or $450 $450 $450 Available as hospital cover only (no 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) Surgical removal of wisdom teeth in hospital Cancer related services (e.g. chemotherapy) Government approved prostheses for covered services Heart surgery ^ 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 Total & partial 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) Covered MB Minimal Benefits. See page 33 for definition # Excluding experimental and high cost non-pbs drugs ^ Diagnostic and therapeutic cardiac procedures are excluded on Budget Hospital * 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 for details Not recommended for families 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 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 Current as at 1 March Benefits shown are valid until 30 June months 2 months 2 months 2 months 6 months 2 years 2 months 1 day 2 months

14 DENTAL OPTICAL THERAPIES OTHER 27 Extras benefits summary SERVICES Diagnostic Preventative DETAILS WAITING PERIOD SUPER MULTICOVER MULTICOVER FIT & FREE GENERAL EXTRAS PLUS YOUNG SINGLES & COUPLES Benefits Limits Benefits Limits Benefits Limits Benefits Limits Benefits Limits 2 services 2 services 2 services 2 services 2 services $32 - $76 $30 - $55 $30 - $55 $30 - $55 $30 - $55 1 service 1 service 1 service 1 service 1 service $29/$25 No limit $25/$18 No limit $25/$18 No limit $25/$18 No limit $25/$18 No limit 2 months Remove plaque & calculus $36 - $63 2 services $33 - $57 2 services $33 - $57 2 services $33 - $57 2 services $33 - $57 2 services Application of fluoride $25 1 service $25 1 service $25 1 service $25 1 service $25 1 service Fillings Metallic & tooth coloured (direct) $97 - $156 $550 $73 - $118 $550 $73 - $118 $550 $61 - $115 $400 $61 - $115 $400 Orthodontics Oral surgery Occlusal therapy E.g. braces to straighten teeth. Lifetime limit applies Accrues at $440 per year. Accrues at $440 per year. (Sublimit of $1,000 for general dentist). Lifetime limit applies (Sublimit of $1,000 for general dentist).lifetime limit applies Accrues at $250 per year. (Sublimit of $1,000 for general dentist). Lifetime limit applies Surgical extractions $160 - $260 $140 - $220 $140 - $220 $100 - $170 $100 - $170 $300 Extractions 2 months $100 - $130 $80 - $100 $80 - $100 $60 - $80 $60 - $80 $300 Treatment to improve bite $35 - $300 $500 $35 - $250 $500 $35 - $250 $500 Endodontic services Treatment of root canals $60 - $170 $50 - $150 $50 - $150 $38 - $130 Periodontic services Treatment of tissue around teeth $15 - $305 $10 - $260 $10 - $260 Complete dentures & components $25 - $800 $800 over 3 years $18 - $800 $800 over 3 years Dentures Maintenance & repair $37 - $200 $200 $29 - $120 $120 Crowns, bridges & implants Preparation & placing $55 - $635 $800 - $1,200 $50 - $625 $800 $50 - $625 $800 Spectacles & contacts First/subsequent visits (unless otherwise specified) First/subsequent visits Travel & accommodation for hospital treatment Spectacle frames $135 $250 - $500 $85 $85 $75 $75 2 months $130 - $250 Sublimit of $250 for $92 - $180 $220 $92 - $180 $250 $80 - $140 $180 $80 - $140 $140 - $250 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 services $38/$34 $400 $33/$25 $200 $38/$34 $300 Audiology $58/$40 $350 $52/$35 $500 $52/$35 Sublimit of $200 (Sublimit of for foot orthotics Speech therapy (ST) $83/$51 $500 $60/$40 $200 audiology) $60/$40 $40/$30 Occupational therapy (OT) 2 months $72/$50 $600 $62/$40 $500 $62/$40 $40/$30 Chiropractic $42 visits 1-2, $33 visits 3-11, $600 - $1,200 $32 visits 1-2, $28 visits 3-11, $600 - $1,000 $40 first visit, $35 visits 2-6, $28 visits 1-2, $20 visits 3-11, $500 $30 first visit, $20 visits 2-6, $18 visits 12+ $14 visits 12+ $20 visits 7+ $10 visits 12+ $10 visits 7+ Sublimit of $600 each Sublimit of $375 Sublimit of $250 Osteopathy $45 visits 1-2, $35 visits 3-11, $35 visits 1-2, $29 visits 3-11, $40 first visit, $35 visits 2-6, $600 $30 visits 1-2, $20 visits 3-11, $30 first visit, $20 visits 2-6, $18 visits 12+ for chiro & osteo $14 visits 12+ each for chiro, $20 visits 7+ $10 visits 12+ each for chiro, osteo and $10 visits 7+ Exercise physiology (EP) $40/33 $400 for EP (1) $30/$28 osteo & EP (2) $30/$28 $25/$20 EP, $200 combined for OT $25/$20 Physiotherapy $53 visits 1-2, $38 visits 3-11, $45 visits 1-2, $32 visits 3-11, $45 first visit, $40 visits 2-6, $33 visits 1-2, $20 visits 3-11, and ST.$100 combined $30 first visit, $25 visits 2-6, $18 visits 12+ $600 - $1,200 $17 visits 12+ $600 - $1,200 $22 visits 7+ $10 visits 12+ remedial massage, $10 visits 7+ myotherapy, acupuncture and CHM (3) $200 Acupuncture/Chinese herbal medicine consultation (CHM) Sublimit of $100 $600 $30/$17 for CHM $22/$10 $25/$20 Remedial massage/myotherapy 2 months $40/$25 Sublimit of $250 $27/$20 $300 Naturopathy/nutrition consultation per therapy (max. $100 for CHM) $200 Alexander technique $27/$20 Homoeopathy $27/$17 200km + return trip 2 months per membership ($30 per night accomm.) $400 ($200 accomm. sublimit) per membership ($30 per night accomm.) $400 ($200 accomm. sublimit) Benefits and annual limits (annual limits per person per calendar year, unless otherwise specified) $180 $350 Sublimit of $150 for remedial massage, myotherapy, acupuncture and CHM HCF approved pharmacy After PBS equivalent co-payment subtracted $700 $600 $500 $500 $200 Artificial aids Approved appliances $20 - $500 $600 $20 - $500 $500 Hearing aids Every 5 years (depending on length of membership) 24 months $ $600 - $1,600 Health management programs 6 months $200/$400 $150/$300 $200/$400 School accident cover Approved ancillary services only 2 - $800 $800 $400 Loyalty benefits. See pages (1) = EP sublimit of $300 applies until 30 June (2) = Limit of $600 - $1,200. Sublimit of $600 each for chiro and osteo and $250 for EP apply until 30 June (3) = Limit of $500. Sublimit of $200 combined OT and ST, $200 EP and $100 combined remedial massage, myotherapy, acupuncture and CHM apply until 30 June *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.

15 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. The 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: Have you nominated an appropriate rebate tier? You can use the table below as a guide to nominating your rebate tier, or consult your accountant, financial advisor or the ATO at ato.gov.au or When calculating your income you need to include taxable income, fringe benefits, reportable superannuation contributions, net financial investment loss and more. Please consult the ATO at ato.gov.au for more information on what counts as declarable income. Members are strongly advised to seek independent financial taxation advice when calculating which tier you are in. What is the Medicare Levy Surcharge? The Medicare Levy Surcharge is an Australian Government initiative designed to encourage high-income earners to take responsibility for their health care. You can avoid having to pay this simply by having HCF hospital cover. It applies to people earning a taxable income $84,001 or more per year for singles and $168,001 and over for couples/families where they don t have eligible private hospital cover. Income Type of member No Tier Tier 1 Tier 2 Tier 3 Singles < $84,000 $84,001-97,000 $97, ,000 > $130,001 Families* < $168,000 $168, ,000 $194, ,000 > $260,001 Medicare Levy Surcharge If you don t have private hospital cover and you re classified as a higher income earner, you may be your taxable income) on your Medicare levy when your tax return is assessed (refer to the table below). Please consult your accountant, financial advisor or the ATO at ato.gov.au or in relation to the Medicare Levy Surcharge and your individual circumstances. All ages This table shows the threshold amounts as at 1 July *For families with more than one dependent child, the relevant threshold is increased by $1,500 for each child after the first child. Income Type of member No Tier Tier 1 Tier 2 Tier 3 Singles < $84,000 $84,001-97,000 $97, ,000 > $130,001 Families* < $168,000 $168, ,000 $194, ,000 > $260,001 Rebate < Age 65 Age Age 70+ This table shows the threshold amounts as at 1 July *For families with more than one dependent child, the relevant threshold is increased by $1,500 for each child after the first child. When calculating rebate ages for families, the eldest family member s age is taken. 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. Who pays LHC? If you do not have 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 you are aged over 30. For example, if you take out hospital cover at age took out hospital cover at age 30. The maximum Once you have paid a LHC loading on your private hospital insurance 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. Overseas Visitors Health Cover, Overseas Student Health Cover and international forms of insurance are not considered to be hospital cover for Lifetime Health Cover purposes. For more information on: Visit privatehealth.gov.au and look for Lifetime Health Cover. Alternatively contact us and we can help

16 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. 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 pages before purchasing your cover. What s not covered? There are a number of situations where our health insurance doesn t cover you: date of service 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 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: covered services ward charges There are also some services where doctor s charges aren t payable (for example, elective cosmetic surgery and surgery by an accredited podiatrist)

17 within waiting periods period where your payment is in arrears, your membership is suspended or you re within waiting periods reasonable, after receiving independent medical or clinical advice the standards in the Private Health Insurance Accreditation Rules 2011 or as amended online or telephone consultations, unless you re participating in one of our chronic disease management or health improvement programs like My Health Guardian recognised by us which don t meet the requirements under the Private Health Insurance Act (2007) In addition, our hospital cover doesn t include: covered items or procedures and/or when the claim isn t approved for payment by Medicare same-day procedures surgery or as an outpatient benefits set by the Commonwealth Department of Health and Ageing Donated blood and blood products and donated blood collection and storage benefits in non-participating private hospitals benefits) and other sundry supplies not directly associated with the reason for admission and drugs newspapers, magazines and beauty salon services non-hospital providers of benefits in a hospital, any associated items (e.g. medical gap, prosthesis, pharmacy) are also not covered non-participating private hospitals prostheses items In addition, our extras cover doesn t include: 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 except for eligible oral surgery 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 provided at time of claim e.g. pre-payment purchased from overseas including items sourced over the internet treated or in the absence of symptoms, illness or injury mass immunisations by the same provider in any one day health services e.g. the co-payment for PBS items. private practice. 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, please make sure you understand who can be covered under your policy. Detailed information of who can be covered under your policy can be found in the HCF Member Guide or at hcf.com.au. Follow the link to the 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 Extended family cover is available with Hospital Advanced Savings or Top Plus

18 How your rights are protected Private Health Insurance Code of Conduct We support the Private Health Insurance Code of Conduct by ensuring: information about private health insurance dispute resolution procedures your purchase through informative policy documentation 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 us directly so that it can be resolved as quickly as possible. An Internal Dispute Resolution Officer has been appointed to independently review complaints. 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

19 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 options. They offer you cash assistance to help you 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 Benefits $100,000 Maximum Broken or fractured bones Skull Compound or depressed fracture $2,000 Hairline fracture $1,000 Spine Fractured vertebrae $2,000 Chipped vertebrae $400 Neck $2,000 Hip, pelvis or jaw $1,500 Leg, ankle or knee Compound (open) $1,000 Simple (closed) $500 Shoulder or cheekbone $600 Arm, elbow or wrist Compound (open) $500 Simple (closed) $250 Ribs $500 Nose or collarbone $400 Foot (other than toe) $200 Hand (other than finger or thumb) $200 Burns Second degree $400 Third degree $650 Wounds (requiring more than three stitches) Per stitch $10 Internal injuries Rupture of internal chest or $500 abdominal organ Permanent disabilities Total & permanent paralysis $100,000 of all limbs Total & permanent paralysis of $50,000 both legs & the lower part of the body Permanent loss of all sight $50,000 in both eyes Permanent loss of all sight $3,000 in one eye Permanent & total loss of use $30,000 of both hands or both feet Permanent & total loss of use $3,000 of one hand or one foot Permanent loss of all hearing $50,000 in both ears Permanent loss of all hearing $3,000 in one ear Permanent & total loss of use $500 of one thumb of either hand 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. 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 Benefit Contributor Other or spouse persons Total & permanent $100,000 $10,000 paralysis of all limbs Total & permanent $100,000 $10,000 paralysis of both legs & the lower part of the body Permanent loss $100,000 $10,000 of all sight in both eyes Permanent loss $50,000 $5,000 of all sight in one eye Permanent & total $100,000 $10,000 loss of use of both hands or both feet Permanent & total $50,000 $5,000 loss of use of one hand or one foot Permanent loss of all $100,000 $10,000 hearing in both ears Permanent loss of all $50,000 $5,000 hearing in one ear Permanent & total $40,000 $4,000 loss of use of one thumb 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: drug or alcohol abuse, professional sport or deliberate self-injury compensation or third party liability insurance group plan Totally and permanently disabled means the disablement has lasted for at least 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.

20 Exclusions For all these Cash Assist products, benefits are not paid for: private aviation or insurrection 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 below. In addition to the above exclusions, the contributions component of the Permanent Disability Benefit Plus benefits is not paid for: procedures and related conditions illegal acts and drugs or alcohol the first two months of cover of cover your employer 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 Event/Reason For Claim 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 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 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 AIDS 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: 1 March 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 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. 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: 1 March

21 More insurance options More financial protection for you and your family 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. HCF Medical Trauma Insurance is a simple, low-cost policy that pays you an extra cash lump sum your choice of $25,000 or $50,000 in the event of serious illness or accident. Medical Trauma Insurance includes: examinations aged health cover and Medicare Get the details We recommend you read the Medical Trauma Insurance Product Disclosure Statement which is available by calling or visiting hcf.com.au/medicaltrauma before deciding to buy or continue to hold this product. Medical Trauma Insurance is issued by HCF Life Insurance Company Pty Ltd. (ABN ) Travel Insurance When you travel overseas, Australian health cover doesn t protect you. travel insurance. It provides: hospital expenses Get the details 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 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 document must be reviewed to make sure that the overseas travel insurance meets your needs. hcf.com.au/fitandfree or by calling Your privacy is protected HCF Privacy Policy HCF is committed to best practice privacy protection. We collect your personal information so we can: with you and services to you lifestyle needs serve your needs and services The types of organisations we disclose personal information to include: 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 your opinion on improving our service, benefits or product offerings 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: 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

22 Your Branches Adelaide Shop 1 49 Gawler Place Adelaide SA 5000 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 Belconnen Shop 138 Westfield Belconnen Belconnen NSW 2617 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 Brisbane Shop G7/8 MacArthur Central Cnr Queen and Edward Street Brisbane QLD 4000 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 Canberra 128 Bunda Street, Civic Canberra NSW 2601 Castle Hill Shop 459 Castle Towers Castle Hill NSW 2154 Chadstone* Chadstone Shopping Centre 1341 Dandenong Road Chadstone ViC 3148 Charlestown Level 1, Shop 121A Charlestown Square Charlestown NSW 2290 Chatswood Level 2, Shop 254 Westfield Chatswood Chatswood NSW 2067 Chermside* Level 1, Westfield Chermside Cnr Gympie and Hamilton Roads Chermside QLD 4032 Coffs Harbour 3 Harbour drive Coffs Harbour NSW 2450 Deniliquin 1B 344 Cressy Street Deniliquin NSW 2710 Doncaster* Ground Level Westfield Doncaster 619 Doncaster Road Doncaster VIC 3108 Dubbo 244 Macquarie Street Dubbo NSW 2830 Erina Shop T62 Erina Fair Erina NSW 2250 Garden City* Lower Ground Cnr Logan & Kessels Roads 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 Marion* Level 2, 297 Diagonal Road Oaklands Park Marion SA 5046 Melbourne 330 Collins Street Melbourne ViC 3000 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 Robina* Level 3 Robina Town Centre Robina Town Centre Drive Robina QLD 4226 Southland* Level 1 Westfield Southland 1239 Nepean Highway Cheltenham VIC 3192 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 Woden Shop 35 Westfield Woden Woden NSW 2606 Wollongong 140 Crown Street Mall Wollongong NSW 2500 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) *These branches do not accept cash payments for premiums or pay cash for claims

23 How to join Get more benefits, cover and savings at an affordable price Join HCF today To apply: We re open 8am-8pm, Monday to Friday, 9am-5pm weekends (AEST) hcf.com.au representatives to visit your workplace by ing 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

24 You get more with HCF More benefits compared to an average of 85 cents for other health funds in the 2012 financial year value health insurance 4 years in a row More savings hospital products excess is applicable More cover More for you programs More than health insurance My Health Guardian online program My Home Doctor after hours home doctor service in selected locations relief from illness or accidents The Hospitals Contribution Fund of Australia Limited. ABN Head Office: 403 George Street, Sydney NSW MAR13_HCF0002_PB