We’re here to help you find the right cover

The Australian government classifies hospital cover into four tiers - Gold, Silver, Bronze and Basic. Basic hospital is the lowest level of cover, while Gold is the highest and provides cover for all hospital treatment categories. This tiered system helps you easily compare covers provided by different insurance providers, including HBF, to help you find your best cover match.

Each tier has a minimum list of hospital treatment categories that must be covered; the minimum requirements are set out by the Australian Government. Health funds can choose to offer additional coverage in the Basic, Bronze and Silver tiers. Products with additional coverage have a ‘Plus, or +” in the product name. For example, Silver Hospital Plus - this is a Silver tier product that includes more coverage than the minimum requirements for the Silver tier.

The good thing about HBF is that you can mix and match hospital and extras cover to suit your needs. This means that if you choose to get Basic Hospital Plus, you can match it with any level of extras cover.

Learn more about the hospital cover tiers.

An excess is a sum of money you pay upfront before you receive hospital treatment. Generally, the higher your excess, the lower your premium.

An 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. Excess applies for day and overnight admissions.

You won’t be required to pay an excess for any dependant children on your single parent or family policy^*.

A waiting period is a period of time during which you must hold continuous membership under a particular health cover before you are entitled to receive a benefit at the level payable on that cover. You can claim benefits applicable on your level of cover for services or treatment you receive after you have served your waiting periods.

Waiting periods applicable on your level of cover are listed on the relevant product sheet.

The Medicare Levy Surcharge (MLS) is a tax for higher‑income earners who don’t have an appropriate level of hospital insurance. It encourages use of the private hospitals to ease pressure on public hospitals. You may pay an extra 1% - 1.5% tax for any period without suitable hospital cover if you’re a single earning over $101,000, or a couple or family with a combined income over $202,000.

Lifetime Health Cover (LHC) loading is an extra cost on hospital insurance if you take cover after age 31. For each year without hospital cover after your 31st birthday, a 2% loading applies when you later join, capped at 70% (for example, 10% at age 36). The loading is removed after 10 continuous years of cover. To avoid LHC, take out hospital cover by 1 July after your 31st birthday.

The amount you can claim back on extras services depends on your benefits (the amount you get back when you claim) and your annual limits (the maximum amount you can claim in a year).

Nearly all extras insurance policies only cover services to a limited extent, which means you'll usually pay for some of the service out of your own pocket.

What makes extras insurance worthwhile is that Medicare generally doesn't cover extras services, so without extras insurance you'd have to cover the full cost of treatment every time you receive a service.

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 HBF. Just be aware of out-of-pocket costs, which can include excess or co-payments. Please note, outpatient services are not covered under hospital insurance.

Before you book hospital treatments, contact us and we’ll help you understand what you can claim, how much you can claim, and if any excess, co-payments or waiting periods apply. To ensure we give you accurate advice, please have a written cost estimate from your provider on-hand.