HCF

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About HCF

What is HCF? 

HCF is a private health insurer that operates as an open health fund. 

It is Australia’s largest not-for-profit health fund and claims to have almost 1.8 million members.

Background 

HCF began as the Metropolitan Hospitals Fund, which was established in Sydney in 1932. Its original objective was to insure the local community for the cost of hospital care. In 1942, HCF expanded to offer hospital cover to anyone living in NSW and changed its name to the Hospital Contributions Fund of NSW. 

In the 1960s, HCF extended to Queensland, Victoria and Tasmania and became the Hospital Contributions Fund of Australia.

The insurer merged with rt health, Australia’s oldest health fund, in 2021.

In 2022, HCF entered a 5-year agreement with Ramsay Health Care to make health care more accessible and affordable for HCF members.

Who can join HCF?

Anyone can join HCF because it is an open health fund.

What products does HCF offer?

HCF offers:

• Hospital Cover
• Extras Cover
• Combined Hospital and Extras Cover
• Ambulance Only Cover
• Overseas Visitors Health Cover (OVHC)

Do HCF policies include Ambulance Cover?

For residents of NSW and ACT, Hospital and Extras Cover includes emergency Ambulance Cover.

For residents of NT, SA, VIC and WA, you need to take out Ambulance Only Cover or subscribe with your local ambulance service.

For residents of QLD and TAS, you are already covered by your local state-based ambulance service.

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Is HCF a not-for-profit health insurer?

Yes. HCF is a not-for-profit health insurer.

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Does HCF operate in all Australian states and territories?

Yes. HCF operates in all Australian states and territories.

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How does HCF Hospital Cover compare with other insurers?

Benchmarks	HCF	Industry average
Member retention for Hospital Cover	98.6%	88.6%
% hospital-related charges covered	90.1%	90.6%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022

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Does HCF have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. HCF has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

Location	Number of private Agreement Hospitals	Industry maximum
ACT	5	6
NSW	89	98
NT	1	2
QLD	49	60
SA	19	23
TAS	5	9
VIC	65	76
WA	18	24

HCF also has agreements with a number of day hospitals allowing it to provide services at low cost or with no out-of-pocket costs:

Location	Number of day Agreement Hospitals	Industry maximum
ACT	7	9
NSW	87	103
NT	1	2
QLD	39	57
SA	19	30
TAS	6	8
VIC	53	79
WA	16	24

Source: HCF: performance

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How does HCF Extras Cover compare with other insurers?

Benchmark	HCF	Industry average
% Extras Cover charges covered	51.5%	52.0%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022

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How does HCF compare with other private health insurers?

Benchmarks	HCF	Industry average
Market share	12.4%	–
% services with no gap	87.8%	88.8%
% services with no gap or where known gap payment made	98.0%	97.4%
Market share of complaints to the PHIO	18.1%	–
% complaints investigated by the PHIO	23.8%	–
Benefits as a % of contributions	86.7%	83.1%
Management expenses as a % of contribution income	10.3%	9.9%
Management expenses per average policy	$419	$375

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022

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Is HCF a member of any industry associations?

Yes. HCF is a member of Private Healthcare Australia (PHA), a body that represents 20 registered health insurers and 97% of people covered by private health insurance.

It is also a member of the Members Health Fund Alliance, an alliance of not-for-profit, member-owned, regional or community-based health insurers.

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Does HCF let me claim online or via an app?

Yes. HCF allows you to make a claim online using your HCF member login. You can upload your extras or ambulance claim with the HCF My Membership app or in online member services. With most providers, you can claim on the spot with your physical or digital membership card.

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How to contact HCF

Phone:

13 13 34

Website:

https://www.hcf.com.au/

Email:

Online form

Address:

Head Office:
1/403 George Street
SYDNEY NSW 2000

Postal address:

GPO Box 4242
SYDNEY NSW 2001

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