As with any health insurance, what is covered by HCF will depend predominantly on the type of cover you choose, and the tier of coverage you take out.
HCF’s most basic hospital-only policy provides cover for a range of hospital treatments, including those relating to the brain, eyes, ears, nose and throat. While the basic policy also covers miscarriage or termination of birth, policyholders must have HCF Hospital Premium Gold for pregnancy and birth cover, or a related ‘My Family’ policy.
The My Family policies, however, are conditional to also having extras cover taken out in conjunction with the hospital cover. For example, the HCF My Family Silver Plus Hospital can only be available to those who also have HCF My Family Silver Plus Extras cover.
Many other policies also include this condition, whether for family-related needs or not. It is therefore essential that an individual checks they are not paying for two separate policies due to this clause, when they might be paying for cover they don’t need or want.
Additionally, while emergency ambulance services are covered by all hospital policies, HCF also has ambulance-only policies available for members.
wait time
A waiting period applies when you take out a health insurance policy, which is a period of time before you can make claims to the provider. In line with the usual industry standard, HCF has a waiting period of two months for most services–whether hospital or extras.
However, pre-existing conditions that require hospital treatment or services that fall under an extras policy have a 12-month waiting period. Pregnancy and childbirth also have a 12-month wait, as does major dental work.
While some health insurance providers will waive these waiting periods via promotions, HCF does not currently offer such a discount.
No gap policy
While a health insurer will often cover some or even the majority of a service fee, you will still have to pay something out of your own pocket – known as a gap payment.
A ‘no gap policy’, however, refers to the amount that your private health insurer will pay on your behalf for a consultation, treatment or surgery, thereby leaving you with no out-of-pocket costs.
At HCF, 88.8% of its services have a no-gap policy, after accounting for insurer benefits, schemes and agreements. Additionally, HCF has a list of ‘More for You’ extras providers, which allows eligible members to receive 100% back on selected extras services such as dental, optical and physio.