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HCF

TOP ADVANCED SHARED HOSPITAL GOLD & GENERAL EXTRAS

$720.88 / 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 (and no-one else).

Policy ID: HCF/J23E/NDAV20

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: No excess

Co-payments: Every time you go to hospital you will have to pay:

  • $50 per day for a private room for overnight admissions
  • The maximum co-payment is $500 per year
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 for peace of mind. Includes involuntary unemployment assistance and access to over 100 exclusive offers through HCF Thank You. For more information visit: www.hcf.com.au/thankyou. Includes Travel and Accommodation benefits for hospital stays and cover for unlimited emergency ambulance trips. No excess for Accident related treatment, dependents and same day procedures (waiting periods may apply). Excludes cover for elective cosmetic surgery. See fund rules for more information

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

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $22
  • Subsequent visit: $10
Chinese medicine 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $22
  • Subsequent visit: $10
Chiropractic* 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $30
  • Subsequent visit: $21
Endodontic* 12

$300 per person

combined limit for endodontic & major dental

  • Filling of one root canal: $115
Exercise physiology 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $25
  • Subsequent visit: $20
General dental* 2

$400 per person

sub-limits apply

  • Fluoride treatment: $27
  • Scale & clean: $57
  • Periodic oral examination: $30
Major dental* 12

$300 per person

combined limit for endodontic & major dental

  • Surgical tooth extraction: $150
  • Full crown veneered: $0
Non PBS pharmaceuticals 2

$500 per person

  • Per eligible prescription: $50
Occupational therapy 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $40
  • Subsequent visit: $30
Optical 2

$180 per person

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

$250 per person

$1,500 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $250
Osteopathy 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $30
  • Subsequent visit: $22
Physiotherapy* 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $33
  • Subsequent visit: $23
Remedial massage 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $22
  • Subsequent visit: $10
Speech therapy 2

$500 per person

combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services

  • Initial visit: $40
  • Subsequent visit: $30
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $22}

{Subsequent visit: $10}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $22}

{Subsequent visit: $10}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $21}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $115}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $20}

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: $57}

{Periodic oral examination: $30}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: $150}

{Full crown veneered: $0}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 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}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$180 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

{$250 per person}

{$1,500 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $250}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $22}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $23}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $22}

{Subsequent visit: $10}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, exercise physiology, occupational therapy, osteopathy, physiotherapy, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

General dental $400 limit is for direct fillings. Cover also includes dental check ups with service limits, that are not part of the general dental annual limit. Occlusal therapy, periodontics, crowns, bridges, implants and dentures are not covered. Orthodontic accrues at $250 per calendar year, up to lifetime limit of $1,500 for Orthodontists ($1,000 lifetime limit for General Dentist). HCF-approved Online Cognitive Behavioural Therapy courses are included with a separate annual limit per person/ per policy. Sub-limit of $250 each for chiro, osteo and exercise physiology. Combined sub-limit of $200 for speech and occupational therapy. Combined sub-limit of $100 for acupuncture, Chinese herbal medicine, remedial massage and myotherapy. Lower benefits for physio, chiro and osteo after the 11th visit.

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Dietetics/dietary advice
Eye therapy (orthoptics)
Health management / Healthy lifestyle
Hearing aids
Home nursing
Orthotics (podiatric orthoses)
Podiatry
Psychology
Vaccinations

Other features of this general treatment cover: Orthodontic accrues at $250 per calendar year, up to lifetime limit of $1,500 for Orthodontist ($1,000 for General Dentist).

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

TOP ADVANCED SHARED HOSPITAL GOLD & GENERAL EXTRAS

$720.88 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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/J23E/NDAV20

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