HCF health insurance review: Everything you need to know

Looking into taking out cover or switching private health insurance funds? HCF is one of the biggest health insurers in Australia, so it’s probably near the top of your list. As the largest not-for-profit health fund in the country, HCF serves more than 1.8 million residents.

Whether you’re in the market for hospital, extras or a combined policy, HCF has numeous options to suit your specific healthcare needs. Let’s dive right in.

HCF (Hospitals Contribution Fund) first got started back in 1932. Over the years it’s grown into Australia’s largest not-for-profit health insurer. Unlike for-profit companies, HCF operates with the goal of reinvesting its profits back into the business to improve member services and benefits.

Take a closer look and you’ll find hospital cover, extras cover and combined policies. They also give members access to a variety of offers and discounts. Think discounted e-Gift cards, cheaper pharmacy purchases, and free flu vaccinations with partner services. HCF is also part of the Members Health Fund Alliance, which is a group of non-profit and mutual health funds across the country.

HCF’s not-for-profit status could be an important consideration for you because it shows they value member benefits over delivering higher returns for their shareholders. If you want a fund that prioritises healthcare outcomes over profits then this could be a positive factor when you make your final decision.

As a not-for-profit organisation, HCF does not have shareholders. Instead, it’s owned by people just like you: its members. Having a member-owned model makes sure that profits are reinvested into more benefits and services for its policyholders, making HCF a popular choice for those who want value and transparency from their health insurer.

HCF is also part of an international group of non-profit health funds, which means it’s better able to stay competitive with its service offering and the type of healthcare it can deliver for its members.

Like most other health funds, HCF has a number of different coverage types to choose from – whether you’re after basic hospital cover, an extras-only policy or a combination of both. Let’s break down each type of cover:

Hospital cover with HCF will protect you if you ever need to go to a private or public hospital as a private patient. Hospital cover takes care of potentially costly expenses like accommodation, theatre fees and specialist consultations. With different tiers of coverage, ranging from Basic right through to Gold policies, you can choose a level of cover that best fits your needs and budget.

Services typically covered under HCF’s hospital policies include:

• Surgery (depending on your chosen tier)
• Rehabilitation and post-surgery care
• Palliative care
• Heart and vascular procedures (on higher tiers)

Extras cover, on the other hand, includes benefits for a wide range of health services that aren’t covered by Medicare or under standard hospital cover, such as:

• Dental check-ups and procedures
• Optical services like prescription glasses and contact lenses
• Physiotherapy and chiropractic services
• Dietitian and speech therapy services
• Alternative therapies

HCF members tweak their extras policy to suit their specific needs, which is helpful so that you only have to pay for the services you are most likely to actually use.

If you have a family or particular healthcare needs, or if you just want to get covered for pretty much everything, then with HCF you can also get a combined hospital and extras policy. These all-in-one packages let members enjoy all the benefits of both types of cover under a single policy – often at a more affordable rate than buying hospital and extras cover separately.

Combined cover is perfect for families, couples or singles who want peace of mind that they are fully covered for both in-hospital and out-of-hospital treatments.

HCF has relatively high levels of cover across most services. Below are some key statistics from the latest State of the Health Funds Report, which should give you an idea of how much you can expect HCF to cover:

• Hospital-related charges: HCF covers approximately 89.1% of hospital-related charges.
• Medical services with no gap: 86.7% of medical services have no gap for HCF members.
• Medical services with no gap or known gap payment made: 97.2% of medical services fall into this category, meaning members will pay little or no out-of-pocket expenses.
• General treatment (extras) charges covered: HCF covers around 50.3% of general treatment (extras) charges, which means members get a sizeable reimbursement for out-of-hospital services like dental and optical care.

As you’d expect from one of the biggest health funds in the country, HCF makes it very easy to claim for services. You can take your pick of making a claim:

• Online or through the HCF app: You can lodge claims for extras like dental, optical and physio online or through the HCF mobile app. This is the fastest and most convenient way to get your claim processed.
• At your healthcare provider: Many healthcare providers will have HICAPS (Health Industry Claims and Payments Service) machines on-site, which lets you make a claim on the spot using your HCF membership card.
• By mail: If online or on-the-spot claiming isn’t available, you can always fill out a physical claim form and send it to HCF’s processing department by mail.

Once you submit your claim, HCF typically processes payments quickly, meaning you’ll get reimbursed for your eligible expenses without having to deal with long delays.

If you wish to cancel your HCF health insurance policy, it’s a relatively straightforward process as well:

1. Contact HCF: You can cancel your policy by contacting HCF via phone, visiting one of their branches or emailing their customer service team.
2. Provide your details: You will need to give HCF your policy number, personal ID details, as well as the date you would like your cover to end.
3. Confirm cancellation: HCF will confirm your request and process the cancellation. Keep in mind that if you have pre-paid your premium, you might be entitled to a refund for the unused portion.

Bear in mind that cancelling your health insurance can affect your lifetime health cover (LHC) loading and Medicare levy surcharge (MLS) exemptions, so be sure to weight up the financial implications before making your final decision.

Being a not-for-profit health fund and having lots of different policy types to choose from, it’s no wonder HCF is so popular among everyday Aussies. But whether it’s the right fit for you will depend on your healthcare needs and your budget. Take your time to compare different policies and then get started with private health insurance.