HCF

TOP ADVANCED HOSPITAL GOLD $500 EXCESS & EXTRA BENEFITS

$922.82 / 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, including non-student dependants (3 or more people, only 2 of whom are adults).

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

Policy ID: HCF/J24D/NDFA2Y

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 $500 per admission. This is limited to a maximum of $500 per person and $1000 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

$400 per person

combined limit for acupuncture, chiropractic & osteopathy

Initial visit: $30
Subsequent visit: $20

Blood glucose monitors 12

$500 per person

Per monitor: $150

Chiropractic* 2

$400 per person

combined limit for acupuncture, chiropractic & osteopathy

Initial visit: $35
Subsequent visit: $28

Dietetics/dietary advice 2

$150 per person

Initial visit: $50
Subsequent visit: $40

Endodontic* 12

$1,870 per person

combined limit for endodontic, major dental & other services

sub-limits apply

Filling of one root canal: $164

General dental* 2

$300 per person

sub-limits apply

Fluoride treatment: $27
Scale & clean: $69
Periodic oral examination: $34

Health management / Healthy lifestyle 2

$100 per person up to $200 per policy

Health management: $100

Hearing aids* 12

$500 per person

Hearing aid: $500

Major dental* 12

$1,870 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

$500 per person

Per eligible prescription: $50

Occupational therapy 2

$600 per person

combined limit for occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $62
Subsequent visit: $40

Optical* 2

$200 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

$400 per person

combined limit for acupuncture, chiropractic & osteopathy

Initial visit: $40
Subsequent visit: $30

Physiotherapy 2

$600 per person

combined limit for occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $46
Subsequent visit: $36

Podiatry* 2

$200 per person

Initial visit: $35
Subsequent visit: $25

Speech therapy 2

$600 per person

combined limit for occupational therapy, physiotherapy, speech therapy & other services

Initial visit: $60
Subsequent visit: $40

Acupuncture*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $20}

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}

Chiropractic*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chiropractic & 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

{$150 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

{$1,870 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $164}

General dental*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$300 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

{$100 per person up to $200 per policy}

Examples of maximum benefits

{Health management: $100}

Hearing aids*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Hearing aid: $500}

Major dental*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,870 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

{$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

{$600 per person}

{combined limit for occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $62}

{Subsequent visit: $40}

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

{$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

{$400 per person}

{combined limit for acupuncture, chiropractic & 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}

{combined limit for occupational therapy, physiotherapy, speech therapy & other services}

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: $25}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for occupational therapy, physiotherapy, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $40}

General dental $300 limit is for direct fillings. Cover also includes dental check ups with service limits, that are not part of the general dental annual limit. Endodontic, periodontic, oral surgery & occlusal treatment - combined limit of $400. Crowns and Bridges - $750 annual limit. Dentures - $600 every 3 years from the date of service. Orthodontic accrues at $250 per calendar year, up to lifetime limit of $1,500 for Orthodontist ($1,000 for General Dentist). Hearing aid limit renews every 3 years from the date of service. 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

Chinese medicine

Exercise physiology

Eye therapy (orthoptics)

Home nursing

Orthotics (podiatric orthoses)

Psychology

Remedial massage

Vaccinations

Other features of this general treatment cover: $500 combined annual limit for artificial aids (low vision aids, blood glucose monitors, foot orthotics). Foot orthotics is included under the artificial aids limit and has a sub-limit of $200 (1 pair per person per year). Cover for Health Management Programs such as weight management, with a limit of $100 per person/ $200 per family policy. Hearing aid limits increase from $500 to $1,200 based on tenure and renew every 3 years from the date you received them. Travel and accommodation limit of $400 applies and $800 annual limit for school accident benefit.

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 HOSPITAL GOLD $500 EXCESS & EXTRA BENEFITS

$922.82 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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Go to site Sponsor link

HCF

http://www.hcf.com.au

service@hcf.com.au

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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/J24D/NDFA2Y

TOP ADVANCED HOSPITAL GOLD $500 EXCESS & EXTRA BENEFITS

Policy ID: HCF/J24D/NDFA2Y

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

HCF

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