HIF (Health Insurance Fund) Questions & Answers

Hello Glenville,

Thanks for your question. We certainly do pay a rebate on CPAP machines however it’s included on our Super or Premium Options Extras Covers (not Hospital cover) within the External Prosthesis / Medical Appliance category. Here's a quick overview of what can be claimed:

One machine can be claimed every 5 years from the previous supply (per person) and the benefit will be deducted from the Prosthesis annual limit of $1,500. The benefits payable are:
$300 for Members who've held Super or Premium Options for 3-5 years.
$600 for Members who've held Super or Premium Options for 5+ years.

It’s important to note though, that a 3-year waiting period would apply for this service should you wish to add Extras cover to your existing hospital cover. I hope this helps, however, if you have any further questions, or would like to speak with one of our Product Experts, feel free to email me directly at [email protected] and I can arrange this for you.

Take care, Lisa.

Hi Tina, thanks for getting in touch. If you’re an HIF Member and hold Super or Premium Options Extras Cover you will be eligible to claim a rebate for a back support brace under your prosthesis benefits. To do so, we’d simply need a letter of recommendation from your treating practitioner (along with your paid invoice) and you’d also need to have served the applicable 12-month waiting period. I hope that helps, but if you have any further queries please don't hesitate to get in touch with me directly. You can reach me on [email protected]. Thanks, Molly.

Hi Tania, thanks for your question. I believe you've just spoken to my colleague Sharon who was able to answer your queries regarding your HIF Membership. If I can ever be of assistance in the future though, please don't hesitate to contact us directly on [email protected]. Thanks, Molly.

Hi Tania, it’s Molly here again. Please accept my sincerest apologies for the delayed response to this question. I’m afraid we didn’t receive a notification from Product Review until this morning. I’m delighted to hear Sharon was able to answer your questions though, but as I mentioned above, please don’t hesitate to contact me directly if we can be of any assistance in the future. Warm regards, Molly.

Hi Glen, thanks for getting in touch. :)

You’ll be pleased to hear that all our Hospital policies except our Gold Star Hospital Cover option exclude maternity cover. Here’s a quick link for more info on our hospital cover options which may be useful: www.hif.com.au/hospital.

I’m afraid though, it’s a bit tricky to provide an accurate quotation straight away as our prices differ based on a number of variables (including your state, rebate eligibility, the type of cover you would like, e.g. Hospital only or Hospital and Extras etc).

Would it suit for one of our product experts to give you a quick call to confirm these details? That way, they’ll be able to discuss our policy options with you and provide a detailed quotation (obligation free of course!). If that sounds ok, please can you email your contact details to [email protected] and I’ll be happy to schedule that in for you. Alternatively, you can also obtain an online quote by visiting www.hif.com.au/quote.

Many thanks,
Carly.
(Digital Marketing Consultant)

Hello M&M,

Thanks for your question. Provided it has been deemed medically necessary by Medicare, skin removal is certainly included on your Gold Hospital policy. To confirm any out-of-pockets expenses though, I do need some additional information from you. Has your specialist given you a treatment plan, which includes the applicable Medicare item numbers and associated charges? If so, please can you email them directly to me on [email protected] and I’ll ensure a medical estimate is completed for you.

Many thanks,

Carly Stewart
(Digital Marketing Consultant)

Hi Hester,

Thanks for getting in touch. As requested, I forwarded your enquiry to our member experience team and a consultant will be in touch shortly to assist you.

Warm regards,

Lisa Chaperon
(Digital Marketing Consultant)

Hi Sue,

Thanks so much for getting in touch! I can certainly help you with this, but we do need a little more information first though.

Would you mind emailing me directly on [email protected] and I’ll ensure our Claims Manager gets in contact with you as soon as possible.

Thanks Sue, and I’ll look forward to hearing from you soon.

Kind regards
Carly Stewart
(Digital Marketing Consultant)

Hi Deep,

Thanks for getting in touch and its wonderful to hear you’re considering HIF for your Mum. For the services you’ve mentioned above, you’d need to purchase our Visitor Value Policy. This is our intermediate hospital and medical insurance option and would cover your Mum for a shared room in a public or contracted private hospital, plus some out of-hospital medical expenses such as x-rays, GP visits and outpatient pathology.

In terms of the benefits payable, HIF will pay 100% of the Government’s Medicare Benefit Schedule (MBS) amount for each medical item number. So, any out-of-pocket expenses would then depend on how much the doctor or specialist would charge you for their services.

It is important to note though Deep, that we can only offer overseas visitor cover to people aged 64 and under. If your Mum is over this age, then unfortunately we wouldn’t be able to cover her – sorry about that.
In case it helps, you can find a complete breakdown of the inclusions, exclusions and the applicable waiting period for each service on our Non-Working Visa Comparison Table here: www.hif.com.au/health-insurance/visitor-cover/non-working-visa

Alternatively, if it would help I’d be more than happy to put you in touch with one of our product experts? They’ll be able to provide you with some costs, plus answer any other questions you may have. If that sounds ok, please email me directly on [email protected] with your contact details and a convenient time to talk and I’ll schedule this in for you.

Many thanks,

Carly Stewart
(Digital Marketing Consultant)

Hi there,

Thanks for getting in touch.

With regards to weight loss surgery, this is certainly included on your Gold Hospital cover, providing it’s deemed medically necessary by Medicare and that you’ve served your 12 month waiting period with HIF on this level of cover.

As some out-of-pocket expenses may be incurred though, we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. As you've provided those details above, please feel free to email me your HIF Membership number on [email protected] and I’ll ensure a medical benefit estimate is generated for you.

I hope this helps, but if there’s anything else I can assist with, please do not hesitate to get in touch.

Kind regards,

Kelsey Donnelly
(Digital Marketing Consultant)

Hi Micheal, thanks for getting in touch.

We certainly do pay a benefit towards Sleep Apnea Machines (CPAP Machine). This service is included on our top two Extras Covers, Super and Premium Options, within the External Prosthesis / Medical Appliance category.

It’s important to note though, a 3 year waiting period would apply before you can claim for the machine, unless you’ve held cover for this service with another health fund previously.

Here's a quick overview of what can be claimed:

With regards to the annual limit: You can claim one machine every 5 years from the previous supply (per person) and the benefit will be deducted from the Prosthesis annual limit of $1,500.

The benefits payable are:
• $300 for members who've held Super or Premium Options for 3-5 years.
• $600 for members who've held Super or Premium Options for 5+ years.
• Please note that a benefit is only payable towards the CPAP machine itself (accessories like the mask and nose piece cannot be claimed from HIF).
• Waiting period: 3 years

In order to claim for the device, it must follow admission to hospital for sleep apnea and/or a letter recommendation from your treating practitioner must be provided in support of the claim.

If it would help Micheal, I’d be happy to arrange a quick call with one of our product experts to discuss this in more detail and provide you with a quote. If that sounds ok, please email your contact details and a convenient time to talk and I’ll schedule that in for you. Alternatively, you can get a quote online using our interactive product selector here: www.hif.com.au

I hope that helps, but please do let me know if there’s anything else I can assist with.

Kind regards,
Kelsey Donnelly

(Digital Marketing Consultant)

Hello Jude,

Thank you for getting in touch. So that I can investigate this for you, please can you email your member number to me on [email protected]?

Warm regards,
Nikki.

Hi Tammy,

Thanks for getting in touch.

May I ask if you hold Hospital cover with HIF? The reason being that a benefit may apply if you were treated as an inpatient (e.g. you were admitted into an approved hospital or day facility, allocated a bed and then discharged following the treatment). If you were treated as an outpatient however, the Medicare benefit you’ve received would only apply.

I hope that helps Tammy, but if you have any further questions please do not hesitate to email me direct on [email protected].

Warm regards,
Kelsey Donnelly

(Digital Marketing Coordinator)

Hello Diane,

Thanks for your question.

We did review the inclusion of laser eye treatment on our policies, however to do so would have required an increase in member premiums. As a member-owned health fund (and given the current economic climate) a decision was made not to progress this any further.

I hope that helps to answer your question, but if you’d like to discuss this further please don’t hesitate to get in touch. You can email me direct on [email protected].

Thanks,
Molly Kelly (Digital Marketing Team Leader)

Hi there,

Thanks for getting in touch.

Unfortunately this isn’t claimable under your ‘HIF Extras Cover’ as Gastroenterology is considered a medical service.

May I ask if you hold Hospital cover with HIF? The reason being that a benefit may apply if your son was admitted to hospital as an inpatient (e.g. he is admitted into an approved hospital or day facility, allocated a bed and then discharged following the treatment) and the relevant waiting periods have been served. If your son was treated as an outpatient however; a Medicare rebate would only apply.

I hope that helps Sandd, but if you have any further questions please do not hesitate to email me direct on [email protected].

Warm regards,

Kelsey Donnelly
(Digital Marketing Coordinator)

Hi Jesse,

Thank you for your question.

With regards to item number 942 (Intravenous Sedation), unfortunately we don’t pay benefits towards this on any of our levels of cover – sorry about that.

If you have any other dental item numbers you would like me to check for you, please feel free to send them directly to me on [email protected] and I’ll ensure a dental benefit estimate is generated for you.

I hope this helps, but if there’s anything else I can assist with, please do not hesitate to ask.

Kind regards,

Kelsey Donnelly
(Digital Marketing Consultant)

Hi Catherine,

Thank you for getting in touch.

With regards to weight loss surgery, this is certainly included on your GoldStar Hospital cover, providing it’s deemed medically necessary by Medicare and that you’ve served your 12 month waiting period with HIF on this level of cover.

In terms of your excess, this simply means that you’ve nominated a $500 excess on your policy, per person, per year. So this means you will be required to pay a $500 excess upon admission for your surgery. It’s also important to note that the excess only applies to overnight stays in hospital, so if you’re having day surgery the $500 excess wouldn't apply.

As some out-of-pocket expenses may be incurred though, we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. Your doctor should be able to provide you with this information so once you have this, please feel free to send it directly to me on [email protected] and I’ll ensure a medical benefit estimate is generated for you.

I hope this helps to answer your question Catherine, but if there’s anything else I can assist with, please do not hesitate to get in touch.

Kind regards,

Kelsey Donnelly
(Digital Marketing Consultant)

Hi Elaine,

Thanks for getting in touch and congratulations on your pregnancy.

To answer your question, yes - your HIF GoldSaver Hospital policy absolutely covers you for any inpatient obstetrician and labour fees (once you’re admitted to hospital). So when the time comes for you to be admitted to hospital to give birth, we’ll be there to help you with the medical bills.

Depending on the hospital and specialists you choose though, some out-of-pocket expenses may apply so we always advise our members to provide HIF with an itemised medical estimate prior to admission. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. Your obstetrician will be able to provide you with that estimate, so once you have a copy please feel free to send it directly to me on [email protected] and I’ll ensure a benefit estimate is generated for you as a matter of priority.

Please note that private hospital insurance only pays benefits on inpatient services though; so for any associated outpatient services such as planning fees, scans or consultations, you can only claim a rebate from Medicare.

Does that help to answer your question Elaine? If you need any further clarification though, please don’t hesitate to contact me and I can arrange for a consultant to give you a call to explain this in more detail.

Warm regards,

Kelsey Donnelly
(Digital Marketing Coordinator)

Hi Monica,

Thank you for your question.

With regards to the removal of a lapband and weight loss surgery, you’ll be happy to hear that this is included on your Gold Hospital cover (providing it’s deemed medically necessary by Medicare). It’s important to note however that a 12 month waiting period applies, so if you’ve been with HIF for 12 months on this level of cover, we will certainly pay a benefit.

You may incur some out-of-pocket expenses though Monica, which is we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to any hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets expenses are kept to a minimum. Your doctor or specialist will be able to provide you with this information so as soon as you receive this, please feel free to send it directly to me on [email protected] and I’ll ensure a medical benefit estimate is generated for you.

I hope this helps, but if there’s anything else I can assist with, please do not hesitate to ask.

Kind regards,

Kelsey Donnelly
(Digital Marketing Consultant)

Hello Karen,

Thanks for getting in touch, I’m delighted to hear you’re considering HIF.

We have five great-value Hospital products and Extras products to choose from.

The prices differ based a number of variables including your location, rebate eligibility and the type of cover you would like, e.g. Hospital, Extras or a combination of both. With this in mind, I can arrange for one of our product experts to give you a quick call to discuss some cover options? That way, they’ll be able to assess your circumstances in more detail and provide a comprehensive price and benefit comparison, (obligation free of course!).

Alternatively, you can get an online quote via our interactive product selector which you can access on our homepage here - www.hif.com.au

I hope that helps Karen, but if you have more questions please don't hesitate to ask. You can email me directly anytime on [email protected].

Kind regards,

Kelsey (HIF Digital Marketing Consultant).