Things to keep in mind
Hospital cover: Pre-existing conditions
A pre-existing condition is an illness or condition which, in the opinion of an independent medical practitioner (appointed by HBF), was known to exist, or where signs or symptoms were evident during the six-month period before you became an HBF member, including on the day you joined. This also applies if you transfer to a level of cover with higher benefits or reduce your excess level.
If you proceed with a hospital admission without confirming what benefits you’re eligible for and your condition is determined to be pre-existing, you will be required to pay all outstanding hospital and medical charges not covered by Medicare. It is not necessary for the ailment, illness or condition to have been diagnosed in the six-month period – only that signs or symptoms were, or would have been, evident.
If our appointed medical practitioner confirms that you have a pre-existing condition, before you can make a claim relating to that condition you’ll have to serve a 12-month waiting period from the date you joined HBF, or from the date your cover for that condition started.
Using the mental health waiver
The Mental Health Waiver allows a person with eligible hospital cover to upgrade from restricted to full benefits for Hospital psychiatric services without serving the usual two month waiting period.
How does it work?
If you have held an eligible hospital cover for two months with restricted benefits for Hospital psychiatric services, you can upgrade your cover so you will be fully covered for these services. If you do, HBF will waive the usual two month waiting period* on Hospital psychiatric services. This mental health waiver can only be used once in your lifetime – even if you cancel your cover and re-join in the future, or switch health funds.
For more information on the Mental Health Waiver, please visit the Australian Government Department of Health’s website.
Level of cover change or switching from another fund
Where you have continuous hospital cover and change your level of cover or switch to HBF hospital cover, we’ll honour any waiting periods you served on your previous health cover. This means there will be no waiting period for those services that you have previously served waiting periods for. If you are part-way through a waiting period, you’ll just have to serve the remainder before you can claim.
It’s important to note that all health funds have different types of products, so while we will honour waiting periods you’ve already served on similar services included on your new HBF product, there are some waiting periods you may still need to serve. If you’re unsure of what waiting periods you need to serve, or what you’re eligible to claim on, please call us on 133 423.
Adding a baby to your policy
You will need to add your newborn to your policy within three months of your baby’s birth. This way, your baby will be covered from their birth and won’t have to serve any waiting periods that you have already served.
If you’re currently on a single or couple policy with HBF and want your newborn to be covered, an increase to an HBF Parent Plus or HBF Family policy will apply from your baby’s date of birth. If you’re already on an HBF family policy, you won’t need to pay anything additional to add your newborn to your policy.