COVID-19 member update
HBF have made the decision to cancel premium increases for 2020 which were due to take effect 1 April. For more information visit our member resource hub.
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Since 1941, HBF has been caring for the health of Australians by helping them get well in the moments that matter.
That means we can focus on giving our members more back.
Hospital insurance, also known as hospital cover, helps cover costs when you go to hospital for surgery and other types of medical treatment.
It helps cover the cost of doctors’ and anaesthetists’ fees, as well as other hospital costs like accommodation, prostheses and theatre fees.
With hospital insurance, you can go to a private hospital for treatment, choose your own specialist and time of treatment, and gain access to a private room (so long as it’s covered on your policy and there’s one available).
When you buy hospital insurance for the first time, if you’ve not had it for a long time, or you upgrade to include a new service or procedure, there will generally be a waiting period you need to serve before you can claim.
Waiting periods for hospital insurance generally fall into two buckets: 12 months for pre-existing conditions, pregnancy and birth and 2 months for most other procedures and services.
Where your treatment is an included service on your hospital cover, your hospital costs will either be fully or partially covered depending on the type of agreement your health fund has with your specialists and hospital.
With HBF, when you’re admitted to hospital for treatment you will get 100% back for the cost of your hospital accommodation and specialists so long as you choose providers that have ‘no-gap’ (otherwise known as ‘fully covered’) agreements with your health fund.
Just be aware of out-of-pocket costs, which can include excess or co-payments, as well any outpatient services.
Hospital insurance helps cover the cost of ‘inpatient’ services—these are treatments you receive when you’re formally admitted to hospital for care, e.g. for surgery.
The specific hospital procedures and services you’re covered for (e.g. chemotherapy, a colonoscopy, tonsil removal, knee reconstructions etc.) depends on the level of hospital cover you choose.
Generally, as your level of hospital cover goes up, so does the number of included services.
Your hospital insurance cannot cover ‘outpatient’ services—these are treatments you receive when you haven’t been formally admitted to hospital, for example, tests and examinations (like x-rays and blood tests). In most cases, Medicare will help cover these services.
Depending on your level of cover, you may also have exclusions and/or restrictions. If a service is excluded, it’s not covered at all. Restricted services receive the minimum default benefit, which generally means a large out-of-pocket.
An excess is a sum of money you pay upfront before you receive hospital treatment. Generally, the higher your excess, the lower your premium. The excess is paid once per member per calendar year (to a maximum of twice per couple or family policy) no matter how many times you may be hospitalised. The excess applies for day and overnight admissions. You won’t be required to pay an excess for any dependent children on your family policy. Silver Hospital has a $250, $500 or $750 excess option available.
How to manage out-of-pockets: Some HBF products have a lower excess option to reduce the amount you pay upfront when you go to hospital, but keep in mind a lower excess generally means a higher premium.
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