HCF Health Insurance Questions & Answers

Hi Guini

That is correct, GP Consultations are covered under the “Short Stay” Overseas Visitors Cover.

You are covered for doctors’ services for items listed on the Australian Government Medicare Benefits Schedule (MBS) and where the service would be eligible for an MBS benefit if provided to an Australian resident:

For regular doctor visits, you will be covered with nothing to pay when you see a doctor through our network.

https://www.hcf.com.au/content/dam/hcf/pdf/OVHC/Overseas-Visitors-Short-Stay.pdf

Our Overseas Visitors Helpline is available 24 hours a day, 7 days a week on 13 68 42 (13 OVHC), option 2.

You can call the helpline to ask health questions* or to access providers and services through the HCF network, including:

• regular doctors (GPs)
• after-hours GPs
• emergency departments
• specialist doctors
• private hospitals.
• nurse triage

Hope this helps.
Regards
HCF Team

Hi Bernard

We hope you are recovering well after your procedure.

Private health insurance policies cover some or all the costs of being a private patient in either a Public or Private Hospital for in-hospital (from when you’re officially admitted to hospital to when you’re officially discharged) treatment costs such as accommodation, operating theatre and other associated costs.

If the consultations is deemed to be a outpatient service then health funds are not allowed to pay a benefit, this can only be claimed from Medicare.

We are more than happy to look into this further for you, if you could email us at [email protected].

Please include your membership number and mention “product review” in the subject of the email and also do let us know whether you were officially admitted to a hospital as an inpatient.

Alternatively you can call us on 13 13 34 and our Hospital Information Line staff will be glad to assist you.

Regards

HCF Team

Hi Anna,
We cannot offer loyalty bonuses on premium as it is not permitted by the Private Health Insurance Act.
To recognize the loyalty of our members such as yourself, HCF launched our HCF Thank You program.
If you would like any more information on this, please email [email protected]
Thank you
HCF Team

Thanks for your question Doris.
Can you please send an email to [email protected] with your membership number in the subject line? We will be able to provide you with further information.
The HCF Team

Thanks for your question, Joe.
The annual limits reset on the calendar year.
The HCF Team

Thanks for your question, Heather.
You can access the details of HCF recognised providers by visiting www.hcf.com.au/locations/find-a-participating-provider.
The HCF Team

Thank you for your message.
There are 2 aspects to claiming for inpatient hospital procedures, “Hospital bill” and “Doctors (Medical) bill”.
Hospital policies help cover the cost of in-patient services (from when you’re officially admitted to hospital to when you’re officially discharged) - costs such as accommodation, intensive care, drugs, dressings and other consumables, diagnostic tests, pharmaceuticals and so on.
In respect to the Doctor’s (Medical) bill, these are charged separately from Hospital Services. Medicare covers 75% of the Medicare Benefits Schedule (MBS) fee for these charges and HCF covers the remaining 25% (for eligible services). However, if your Doctor charges above the Medicare Benefits Schedule fee, then you may have to pay the extra amount (gap).
HCF has a medical gap scheme in place to help reduce or eliminate these gaps. HCF’s Medicover arrangements are designed to provide doctors with a fee above the MBS (extra benefits) in return for them accepting this fee in full and our members either not having any out of pockets (i.e. no gap) or limiting the gap to $500 per doctor per episode (i.e. a known Gap). However, doctors must elect to participate in this program by applying to HCF and are free to choose whether they participate in a medical gap arrangement for each of their locations which means we cannot guarantee that a member will have limited or no out of pockets.
HCF members can access the list of participating providers by visiting the Healthshare website: https://www.healthshare.com.au/directory/find-a-health-professional/
Unfortunately there is no regulatory body that can control how much a doctor is allowed to charge. The out of pocket medical expenses are not determined by the level of private health insurance cover held, but rather, it’s the Doctor’s prerogative to charge as little or as much they like for any particular medical procedure.
Nevertheless we remain very reliant on doctors providing our members with sufficient information about charges so that they can make their treatment decision with informed financial consent. This is endorsed by the government and the Australian Medical Association. If this advice was not given to you, the doctor has not satisfied the requirements for Informed Financial Consent. If you feel this has not been provided you will need to discuss this with the Doctor.
The HCF Team

Hi June,

Thanks for your question. If you’ve switched from another health fund, continuity of cover is granted and you may not need to serve waiting periods if your HCF cover includes the same benefits and services as your previous cover; and you’ve serviced the equivalent waiting periods with your previous fund.

Please call our team at 13 13 34 to discuss your specific level of cover. If you are planning to have a procedure, please make sure you have the 5-digit Medicare item number quoted to you by your treating doctor.

Many thanks,
Laura - HCF

Hi John,

Please contact our team at 13 13 34 with the 5 digit Medicare item noted by the treating medical practitioner. The team will be able to complete a "hospital eligibility check" based on this Medicare item number, to confirm if this will be covered.

Many thanks,
Laura