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HCF

TOP ADVANCED HOSPITAL GOLD $250 EXCESS & MULTICOVER

$656.57 / month

(Before Rebate, Discount & Loading)

Available in QLD

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/J19B/QBML1D

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 of $250 per 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, dependants and day surgery.

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

Top hospital cover for peace of mind. No excess for accident related treatment, dependants under 25 and same day procedures. Includes involuntary unemployment assistance, travel and accommodation benefits for hospital admission 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

$200 per person

combined limit for acupuncture & chinese medicine

sub-limits apply

  • Initial visit: $32
  • Subsequent visit: $25
Audiology 2

$500 per person

sub-limits apply

  • Initial visit: $52
  • Subsequent visit: $35
Blood glucose monitors* 12

$500 per person

  • Per monitor: $150
Chinese medicine 2

$200 per person

combined limit for acupuncture & chinese medicine

  • Initial visit: $32
  • Subsequent visit: $25
Chiropractic* 2

$375 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $35
  • Subsequent visit: $28
Dietetics/dietary advice 2

$300 per person

  • Initial visit: $50
  • Subsequent visit: $40
Endodontic* 12

$2,220 per person

combined limit for endodontic, major dental & other services

sub-limits apply

  • Filling of one root canal: $164
Exercise physiology 2

$375 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $32
  • Subsequent visit: $30
General dental* 2

$550 per person

sub-limits apply

  • Fluoride treatment: $27
  • Scale & clean: $69
  • Periodic oral examination: $34
Health management / Healthy lifestyle 2

$150 per person up to $300 per policy

  • Health management: $150
Hearing aids* 12

$600 per person

  • Hearing aid: $600
Major dental* 12

$2,220 per person

combined limit for endodontic, major dental & other services

sub-limits apply

  • Surgical tooth extraction: $182
  • Full crown veneered: $580
Non PBS pharmaceuticals 2

$600 per person

  • Per eligible prescription: $50
Occupational therapy 2

$500 per person

  • Initial visit: $62
  • Subsequent visit: $40
Optical 2

$220 per person

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

$440 per person

$2,640 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $440
Osteopathy 2

$375 per person

combined limit for chiropractic, exercise physiology & osteopathy

  • Initial visit: $40
  • Subsequent visit: $30
Physiotherapy* 2

$600 per person

  • Initial visit: $46
  • Subsequent visit: $36
Podiatry 2

$200 per person

  • Initial visit: $35
  • Subsequent visit: $27
Psychology* 2

$300 per person

  • Initial visit: $44
  • Subsequent visit: $44
Remedial massage 2

$200 per person

  • Initial visit: $32
  • Subsequent visit: $25
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture & chinese medicine}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $25}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $52}

{Subsequent visit: $35}

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Per monitor: $150}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture & chinese medicine}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $25}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$375 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $28}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2,220 per person}

{combined limit for endodontic, major dental & other services}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $164}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$375 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $30}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person}

{sub-limits apply}

Examples of maximum benefits

{Fluoride treatment: $27}

{Scale & clean: $69}

{Periodic oral examination: $34}

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}

Hearing aids*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Hearing aid: $600}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2,220 per person}

{combined limit for endodontic, major dental & other services}

{sub-limits apply}

Examples of maximum benefits

{Surgical tooth extraction: $182}

{Full crown veneered: $580}

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

{$500 per person}

Examples of maximum benefits

{Initial visit: $62}

{Subsequent visit: $40}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$220 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

{$440 per person}

{$2,640 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $440}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$375 per person}

{combined limit for chiropractic, exercise physiology & osteopathy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Initial visit: $46}

{Subsequent visit: $36}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $35}

{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: $44}

{Subsequent visit: $44}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $25}

General dental includes dental check-ups with service limits not in annual limit. Endodontic, periodontic, oral surgery & occlusal treatment - combined limit of $500. Dentures - $800 every 3 yrs. Ortho accrues at $440 per calendar year up to lifetime limit of $2,640 for Orthodontist ($1,000 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
Eye therapy (orthoptics)
Home nursing
Orthotics (podiatric orthoses)
Speech therapy
Vaccinations

Other features of this general treatment cover: $200 limit per person applies to Audiology. Combined Chiropractic limit increases at $100 per year, up to $1,000. A sublimit of $375 per person applies to chiropractic, osteopathy and exercise physiology. Hearing aid limit increases from $600 to $1,600 based on tenure. Per hearing aid benefit is the total payable for hearing aids. Health Management Program limit of $150pp / $300 per family. Lower benefits apply for physio, chiro & osteo after 11th visit. A higher psychology benefit ($75) may apply after Medicare Mental Health Treatment Plan is used up for the remainder of the calendar year.

Ambulance cover

Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au). This includes cover whilst interstate.

Other features of this ambulance cover: 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

TOP ADVANCED HOSPITAL GOLD $250 EXCESS & MULTICOVER

$656.57 / month

(Before Rebate, Discount & Loading)

Available in QLD

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/J19B/QBML1D

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