Why refer to a fully covered medical provider
HBF has a large network of full cover medical specialists. Medical specialists registered under the full cover arrangement with HBF are no gap providers. This means 100 percent of the members’ bill for inpatient medical services included on their policy will be covered by HBF and Medicare, and they won’t pay anything out of their own pocket for those services, except where treatment is in relation to items listed on the HBF Limited Surgical Items List*.
Referring to a full cover provider has a number of member benefits including:
- No gap experience for inpatient treatment*
- No upfront payments
- The account is submitted directly to HBF by the provider
Please note that HBF has a “HBF Limited Surgical Items List” (HBF List), which is subject to change from time to time. Where the members’ treatment involves an item on the HBF List, HBF will not pay a benefit greater than the Medicare Benefit Schedule (MBS) fee for that item and any services they receive from an anaesthetist associated with that item. This applies regardless of whether the provider is a full cover provider or not. The HBF List can be found here.