HCF

HEALTHMATE ULTIMATE GOLD

$803.83 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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: Two adults & dependants (3 or more people, only 2 of whom are adults).

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/J15/NACF2D

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

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 corporate hospital and extras cover designed for families. No excess for accident related treatment and dependants under 25. Includes involuntary unemployment assistance, travel and accommodation benefits for hospital admissions 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: $35
Subsequent visit: $20

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 & other services

Initial visit: $35
Subsequent visit: $22

Dietetics/dietary advice 2

$700 per person

combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $40
Subsequent visit: $29

Endodontic* 12

$400 per person

sub-limits apply

Filling of one root canal: $147

Exercise physiology 2

$350 per person

combined limit for chiropractic, exercise physiology, osteopathy & other services

Initial visit: $30
Subsequent visit: $25

General dental* 2

$400 per person

sub-limits apply

Fluoride treatment: $27
Scale & clean: $60
Periodic oral examination: $32

Health management / Healthy lifestyle 2

$150 per person up to $300 per policy

Health management: $150

Major dental* 12

$700 per person

sub-limits apply

Surgical tooth extraction: $167
Full crown veneered: $650

Non PBS pharmaceuticals 2

$600 per person

Per eligible prescription: $50

Occupational therapy 2

$700 per person

combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $44
Subsequent visit: $30

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 & other services

Initial visit: $40
Subsequent visit: $32

Physiotherapy 2

$700 per person

combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $35
Subsequent visit: $28

Podiatry 2

$200 per person

Initial visit: $33
Subsequent visit: $27

Psychology* 2

$300 per person

Initial visit: $26
Subsequent visit: $26

Remedial massage 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

Initial visit: $35
Subsequent visit: $20

Speech therapy 2

$700 per person

combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $45
Subsequent visit: $35

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: $35}

{Subsequent visit: $20}

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 & other services}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $22}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $29}

Endodontic*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $147}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $25}

General dental*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{sub-limits apply}

Examples of maximum benefits

{Fluoride treatment: $27}

{Scale & clean: $60}

{Periodic oral examination: $32}

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

{$700 per person}

{sub-limits apply}

Examples of maximum benefits

{Surgical tooth extraction: $167}

{Full crown veneered: $650}

Non PBS pharmaceuticals

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

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, occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $44}

{Subsequent visit: $30}

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 & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $32}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $28}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $27}

Psychology*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: $26}

{Subsequent visit: $26}

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: $35}

{Subsequent visit: $20}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{combined limit for dietetics/dietary advice, occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $35}

Preventative & diagnostic dental have service limits which are not included in the annual limit. Basic fillings, extractions and Occlusal therapy have a combined limit of $400. Endodontic, periodontic & oral surgery have a combined limit of $400. Crowns and bridges have a combined limit of $700. Orthodontic accrues at $400 per calendar year, up to lifetime limit of $1,800 for Orthodontist ($1,500 for General Dentist). Includes mental health services (psychology, HCF-approved counselling, accredited mental health social worker and HCF-approved online cognitive behavioural therapy courses).

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Eye therapy (orthoptics)

Hearing aids

Home nursing

Vaccinations

Other features of this general treatment cover: Range of no-gap services delivered through participating dentists, chiropractors, osteopaths, physiotherapists, podiatrists and optical providers in selected states, depending on level of cover. Includes Health Management Programs to a limit of $150 per person / $300 per family policy. Health Dollars Loyalty Rewards accrue for 4 years up to a max of $150 per person /$300 per family policy, per year. Health Dollars can be used to reduce hospital excess or top up current extras benefits. A higher psychology benefit ($45) may apply after Medicare Mental Health Treatment Plan is used up for the remainder of the calendar year.

Ambulance cover

In NSW & ACT 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: Cover for unlimited air, land and sea emergency ambulance trips and treatment by paramedics in Australia for services provided by recognised Ambulance Service Providers. Benefits are not payable when covered by another third party or other funding arrangement, such as a State government scheme. See fund rules for more information.

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

Insurer Details

HCF

HEALTHMATE ULTIMATE GOLD

$803.83 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

13 13 34 Sponsor link

Go to site Sponsor link

HCF

http://www.hcf.com.au

service@hcf.com.au

13 13 34

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/J15/NACF2D

HEALTHMATE ULTIMATE GOLD

Policy ID: HCF/J15/NACF2D

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

HCF

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