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HCF

HealthClub Silver Plus

$767.54 / month

(Before Rebate, Discount & Loading)

Available in SA

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading or an insurer discount. Check with your insurer for details.

This policy covers: One adult & dependants (2 or more people, only one of whom is an adult).

Children (0 - 17), non-classified* dependant (18 - 21) and students (22 - 30), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: Dependent aged 18-21 inclusive

Policy ID: HCF/J13/SFIR1D

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
This policy does not include cover for
Weight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $250 per person and $500 per policy per year.

Excess payments do not apply to hospital admissions for accidents and dependants.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members Waiting periods:
  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments
Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Comprehensive hospital cover packaged with a wide range of extras. No excess for accident related treatment and dependants under 25. Includes travel and accommodation benefits for hospital stays and cover for unlimited emergency ambulance trips. See fund rules for more information. Access to over 100 exclusive offers through HCF Thank You program. For more information visit: www.hcf.com.au/thankyou.

Extras Cover

Our nationwide network of No-Gap participating providers gives you access to comprehensive extras cover at an affordable price. Find out more See https://www.hcf.com.au/locations/find-a-participating-provider.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $40
  • Subsequent visit: $30
Chinese medicine 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $35
  • Subsequent visit: $20
Chiropractic* 2

$350 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $37
  • Subsequent visit: $32
Dietetics/dietary advice 2

$700 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy

  • Initial visit: $45
  • Subsequent visit: $45
Endodontic 12

$400 per person

  • Filling of one root canal: $148
Exercise physiology 2

$350 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $32
  • Subsequent visit: $32
Eye therapy (orthoptics) 2

$700 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy

  • Initial visit: $40
  • Subsequent visit: $32
General dental* 2

$400 per person

  • Fluoride treatment: $27
  • Scale & clean: $67
  • Periodic oral examination: $33
Health management / Healthy lifestyle 2

$150 per person up to $300 per policy

  • Health management: $150
Major dental 12

$750 per person

  • Surgical tooth extraction: $210
  • Full crown veneered: $650
Non PBS pharmaceuticals 2

$600 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $50
Occupational therapy 2

$700 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy

  • Initial visit: $62
  • Subsequent visit: $62
Optical* 2

$200 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$400 per person

$1,800 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $400
Orthotics (podiatric orthoses) 12

$120 per person

  • Orthotics supply & fit: $120
Osteopathy* 2

$350 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $47
  • Subsequent visit: $39
Physiotherapy* 2

$700 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy

  • Initial visit: $51
  • Subsequent visit: $47
Podiatry* 2

$200 per person

  • Initial visit: $36
  • Subsequent visit: $30
Remedial massage 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $40
  • Subsequent visit: $30
Speech therapy 2

$700 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy

  • Initial visit: $60
  • Subsequent visit: $60
Vaccinations 2

$600 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $50
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $20}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $32}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

Examples of maximum benefits

{Filling of one root canal: $148}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $32}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $32}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

Examples of maximum benefits

{Fluoride treatment: $27}

{Scale & clean: $67}

{Periodic oral examination: $33}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person up to $300 per policy}

Examples of maximum benefits

{Health management: $150}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

Examples of maximum benefits

{Surgical tooth extraction: $210}

{Full crown veneered: $650}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $50}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $62}

{Subsequent visit: $62}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{$1,800 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $400}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$120 per person}

Examples of maximum benefits

{Orthotics supply & fit: $120}

Osteopathy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $47}

{Subsequent visit: $39}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $51}

{Subsequent visit: $47}

Podiatry*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $36}

{Subsequent visit: $30}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $60}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $50}

General dental includes basic fillings & preventative dental. Preventative & diagnostic dental have service limits which are not included in the annual limit. In chair teeth whitening treatment provided by a dentist, endodontic, periodontic & oral surgery have a combined limit of $400. A service limit of an in-chair treatment -max 8 teeth/session; applies every 36 months. Crowns, bridges & dentures have a combined limit of $750. Dentures limit renews every 3 years from the date of service. Orthodontic accrues at $400 per calendar year, up to lifetime limit of $1,800 for Orthodontist (Accrues $300 per calendar year, up to lifetime limit of $1500 for General Dentist). HCF-approved Online Cognitive Behavioural Therapy courses with a separate annual limit per person/ per policy.

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Hearing aids
Home nursing
Psychology

Other features of this general treatment cover: Health Dollars Loyalty Rewards accrue for 4 years up to a max of $150 per person /$300 per family policy, per anniversary year. Health Dollars can be used to reduce hospital excess or top up current extras benefits.

Ambulance cover

In SA this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: If you are a resident of SA and you don't have an ambulance subscription with your state ambulance service and aren't offered cover under another arrangement, you have unlimited emergency ambulance services provided by state Ambulance Service Providers.

For further information about this policy see: https://www.hcf.com.au/faqs/faqs-cover#what-is-ambulance-cover

Insurer Details

HCF

HealthClub Silver Plus

$767.54 / month

(Before Rebate, Discount & Loading)

Available in SA

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/HCF/J13/SFIR1D

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