Health Care Insurance: Everything You Need To Know

Are you considering purchasing health insurance with Health Care Insurance (HCI)? Here’s what you need to know about this Australian insurer, and its products.

About Health Care Insurance (HCI)

HCI is all about giving the best level of health care for its members. HCI is dedicated to making health insurance easy to understand and offering affordable yet comprehensive health care¹.

As a not-for-profit private health insurer, HCI’s focus is on the health services it provides to members. Its mission is to provide the very best in hospital and general health care services. HCI also offers extensive extras cover, for services such as dental, optical, physio, chiro, and much more¹.

Health Care Insurance: Fast facts¹

• Based in Burnie, Tasmania
• Launched in 1938 and has been operating for 80 years
• Offers access to more than 500 private hospitals and day surgery facilities in Australia
• Provides access to more than 16,000 doctors in Australia
• Part of the Australian Health Services Alliance (AHSA)²

What health insurance packages does HCI offer?

HCI offers three primary levels of hospital and extra cover³:

• Gold Hospital with Premier Extras
• Bronze Hospital with Healthy Extras
• Active Life Package

Each package comes with the Gold Hospital package, which is the top tier level of cover provided by HCI for hospital cover. Each option has a different level of extras cover depending on your needs.Alternatively, you can choose just hospital cover, or just extras cover with HCI⁴.

What does Health Care Insurance Hospital Cover include?

HCI Premier Hospital Cover provides up to 100% of the hospital accommodation costs, provided you’ve served the waiting periods and no other conditions apply⁵.

The cover includes prostheses, private room stay (if available), prescriptions relating to the surgery, and surgical tooth extractions¹.

HCI’s Premier Hospital Cover provides 100% of the cost of the difference between the Medicare refund, and the Commonwealth Medical Benefit Scheme (CMBS) fee, for medical services provided during a hospital admission.

What does HCI hospital cover not include?

HCI hospital cover does not include¹:

• Cosmetic surgery
• Personal expenses
• Extra services beyond the hospital treatment plan
• Hospital benefits where the professional service performed is not eligible for Medicare benefits
• Pharmaceutical items supplied or prescribed on discharge
• Medical gap
• Surgically implanted prosthesis gap
• Medical treatment provided in doctors’ rooms out of hospital
• Medical treatment provided overseas

What are HCI’s hospital cover excess options?

HCI offers a variety of excess options as a way to reduce your premiums. If you need to go to hospital, you contribute a payment towards your costs (the excess). Customers can choose from an excess of $250, $500,¬ or $1,000. There is no excess payable for children under 18 in family policies. Also, no excess is charged for day admissions¹.

What are Health Care Insurance’s waiting periods for hospital procedures?

Like all private health insurance providers, waiting periods apply to certain types of cover.

HCI waiting periods for hospital treatments are¹:

• No waiting period for accidents
• Two months for psychiatric services, with the option to immediately upgrade to higher levels of cover to access psychiatric services (available once in the customer’s lifetime)
• 12 months for pre-existing conditions (a condition or illness you’ve had for the past six months or more whether you knew about the illness or not)
• 12 months for pregnancy services, including IVF and assisted reproduction procedures
• 12 months on sterilisation and sterilisation reversals
• Two months on all other hospital treatment services

Waiting periods apply to new members, and existing members upgrading to higher levels of cover. However, if you switch from a health insurer with a similar level of cover, HCI will waive your waiting periods. If you transfer from another fund to a higher level of cover with HCI, waiting periods will apply.

What are the waiting periods for HCI extras?

HCI’s extras cover provides reimbursement for a variety of out of hospital health care services, and different waiting periods do apply. Some of the waiting periods for the major services include:
Extras service HCI waiting period

For the full list of waiting periods on HCI extras, see page 17 of its Guide to Cover¹.

Is ambulance cover included with HCI extras cover?

Ambulance cover is only included as part of HCI’s premier package of extras, and there is a two month waiting period for ambulance services.

Who can be included on a policy with Health Care Insurance?

You can choose from four levels of cover:

• For me: cover for singles⁶
• For we: cover for couples ⁷
• For us: cover for families – covering children up to the age of 25 and still studying⁸
• For all of us: cover for families with children aged 23-25⁹

Why choose HCI?

HCI offers numerous benefits to its customers, including¹:

• Quick online quotes
• Simple and easy claims process
• Australian call centre based in Burnie, Tasmania
• 30 day cooling off period for new members: if you haven’t made a claim within 30 days of joining you can cancel and get a full refund
• Online ‘my HCI’ membership portal
• Benefits paid by direct debit or cheque
• Membership suspensions due to overseas travel or financial hardship (conditions apply)
• HCI app for smartphone and android
• Easy payment via direct debit, payroll deduction, BPAY, over the phone, online, via cheque, via credit card, or in person

How do I join HCI?

It’s easy to join, simply complete the online application form or contact HCI:

• telephone:03 6432 1199
• email: enquiries@hciltd.com.au
• address: 25 Cattley Street, Burnie, TAS

Ready to find the right health insurance?

Although iSelect does not compare policies from Health Care Insurance, you can compare policies side by side from our range of providers. Click here to start comparing health policies, or call us on 13 19 20 today.

iSelect does not compare all policies or providers in the market. Not all policies are available at all times.

iSelect does not compare or sell Health Care Insurance products. Health Care Insurance is not an iSelect partner, nor is iSelect commercially affiliated with Health Care Insurance in any way. For a full list of the providers iSelect does compare, please visit our partners page.

Sources:
1. https://hciltd.com.au/source-assets/documents/brochures/guide_to_cover_book.pdf
2. https://www.ahsa.com.au/web
3. https://hciltd.com.au/packaged-cover
4. https://hciltd.com.au/extras-cover
5. https://hciltd.com.au/hospital-cover
6. https://hciltd.com.au/me
7. https://hciltd.com.au/we
8. https://hciltd.com.au/us
9. https://hciltd.com.au/all-of-us