Extras Cover Change FAQs

Find out what is changing, whether it affects you and what you can do next

What is changing?

We are making changes to our Extras products, which all come into effect on 1 January 2019. These include removing benefits for some Natural Therapies, adjusting benefits and limits for some Extras services, and introducing a new Member Plus Dental Arrangement.

Hospital cover will not be affected by these particular changes. Only Extras cover will be affected.

Not all changes will apply to all products. Depending on the product you have, the changes will vary. To find out how your product is changing, log into myHBF and navigate to My Inbox to download your personalised PDF comparison table, which shows your product before and after the changes.


How are Natural Therapies changing?

We are removing all benefits for some Natural Therapies, including Alexander technique, aromatherapy, Bowen therapy, feldenkrais, herbalism, homeopathy, kinesiology, naturopathy, pilates, reflexology, shiatsu, and yoga.

From 1 January 2019 onwards, you will no longer be able to claim on these services.

Removing benefits for the Natural Therapies listed above is something we must do to comply with Australian Government reforms to private health insurance.

Natural Therapies is an umbrella term for treatments that may support healing and wellbeing by stimulating the body’s ability to repair itself, without the use of drugs or surgery.

As part of Australian Government private health insurance reforms, all health funds must remove benefits for some Natural Therapies.

The complete list of Natural Therapies affected are: Alexander technique, aromatherapy, Bowen therapy, Buteyko, feldenkrais, homeopathy, iridology, kinesiology, naturopathy, pilates, reflexology, rolfing, shiatsu, tai chi, and yoga.

HBF does not currently cover all the Natural Therapies above. The only ones we currently cover (and will be removing) are: Alexander technique, aromatherapy, bowen therapy, feldenkrais, herbalism, homeopathy, kinesiology, naturopathy, pilates, reflexology, shiatsu, and yoga.

Additional Resource: The Department of Health; Private health insurance reforms: Changing coverage for some Natural Therapies

No. HBF is only removing benefits for Natural Therapies that the government mandates.

Private Health Insurers have until 1 April to make the changes but have the option to do it earlier.

We have decided to make the changes to Natural Therapies at the same time most annual limits refresh—on 1 January—so members have certainty around their coverage for the next calendar year.


How are benefits and limits changing?

Benefits and limits will change for some services—some will increase, others will decrease. The specific changes to benefits and limits vary between products. To find out how your product is changing, log into myHBF.

The savings generated will be channelled into improving benefits for other highly claimed services, such as physiotherapy on Standard Extras.

The new limits and benefits will be effective from and inclusive of 1 January 2019 onwards.

If you feel your product no longer suits your needs, get in touch and we will help you review your cover options.

If you would like to upgrade, waiting periods may apply before you are able to claim at a higher benefit or limit.

No. If you are already an HBF member, all past orthodontic claims made with HBF and/or other health funds will not contribute to your lifetime limit. The lifetime limit will only apply to claims from and inclusive of 1 Jan 2019.

If you switch to HBF after 1 January 2019, orthodontic claims made with your previous health fund will count towards your lifetime limit.

If you are in the middle of a course of treatment, you have probably already received your benefit—HBF generally pays this on the initial visit or the first date of service for your treatment.

If you commence a course of treatment on or after 1 January 2019, the new benefits and limits will apply.

If you have already started work for dental implant/s, you will receive the benefit you are eligible for on the treatment date for each stage. For example, if you receive stage 1 of treatment in 2018, you will receive your 2018 benefit; however, if you receive stage 2 in 2019, you will receive your 2019 benefit.

There is an exception for some orthodontic treatments (item numbers D825, D826, D831 and D832). If you are in the middle of orthodontic treatment, contact us to learn more about your benefits.

If you do not have a valid written quote then the new limits and benefits will apply for treatment on and after 1 January 2019.


How is the Member Plus Dental Arrangement changing?

We are introducing a new Member Plus Dental Arrangement to improve transparency and fairness when it comes to our dental benefits.

Under the current Member Plus Dental Arrangement, the dollar amount you get back when you claim can vary depending on whether you see a Member Plus or a Non-Member Plus dentist. Even amongst Member Plus dentists, there is chance you could get a different dollar amount back for the same service depending on the dentist.

Under the new Member Plus Dental Arrangement, you will get the same amount back when you claim regardless of whether you see a Member Plus or Non-Member Plus dentist.

The advantage in seeing a Member Plus dentist will be knowing the amount you need to pay out of your own pocket for Preventative Dental services. You will also get a free scale and clean for every member on your policy.

All existing agreements will terminate on 31 December 2018. The new agreement will come into effect on 1 January 2019.

A Member Plus dentist is a provider that has signed up to our Member Plus Dental Arrangement. From January 2019 onwards, Member Plus dentists will provide a free annual scale and clean for HBF members, and you will know the amount you need to pay out of your own pocket for Preventative Dental services, such as check-ups.

A Non-Member Plus dentist is a provider that has not signed up to our Member Plus Dental Arrangement. At Non-Member Plus dentists, you will get the same dollar amount back on services as you would at a Member Plus dentist—you just won’t know your out-of-pockets on Preventative Dental, or get a free annual scale and clean.

You can ask your dentist whether they plan on signing up to the new Member Plus Dental Arrangement, which comes into effect on 1 January 2019.

You can also use the ‘Find a Provider’ tool to figure out whether your dentist is Member Plus.

NOTE: The Member Plus dentists listed on the website on 1 January 2019 will not be a definitive list. Dentists may become Member Plus after this date, but this shouldn’t impact the accuracy of the information at the time of your search as the tool automatically updates to reflect any change to a dentist’s Member Plus status.

Probably not, but this is entirely up to you.

When the new dental arrangement comes into effect, you will get the same amount of money back on dental claims regardless of whether your dentist is a Member Plus or Non-Member Plus dentist. The advantage in seeing a Member Plus dentist will be known out-of-pockets for Preventative Dental treatment and a free annual scale and clean for every member on your policy.

Just be aware if your dentist is currently a Member Plus Dentist and chooses to opt out of the new Member Plus Dental Arrangement, you will no longer be eligible for Member Plus dental benefits.

Preventative Dental and General Restorative Dental are two types of dental treatments that fall under the category of ‘General Dental’.

Preventative Dental services are treatments that prevent future dental issues. Common Preventative Dental services include check-ups, scale and cleans, and fluoride treatment.

General Restorative Dental services are treatments that address existing minor dental issues. Common General Restorative Dental services include simple fillings and extractions.

Will these changes affect my premiums?

The calculation of premiums is complex and based on a range of factors. While these changes do not result in an immediate reduction in your premium, they will help support keeping future increases to an absolute minimum.

The aim of these changes is to provide greater value to a larger share of our member base—as part of the changes, we have also increased benefits on popular services such as dental, physiotherapy and chiropractic on some products.

For more information on how we calculate premiums please visit hbf.com.au/rate-review.

Premium increases for 2019 are not currently available. You will be notified of your premium increase around February 2019.

Why changes are happening

We are making changes to our Extras products for many different reasons:

  • The removal of some Natural Therapies, such as yoga, is something we must do to comply with Australian Government reforms to health insurance.
  • The introduction of a new Member Plus Dental Arrangement is to provide members with better choice of dentists and improved benefits for Preventative Dental.
  • The reduction in annual limits and benefits for some Extras services is in response to a review of our Extras products, which showed we are currently paying a large amount on claims made by a small group of members—the savings we make in this space will help us improve benefits in other highly claimed areas, such as physiotherapy on our Standard Extras product.

The sum of these changes will result in savings, and because we’re not-for-shareholders, we will be channelling that money back into improving our services, and making sure future premium increases come in at an absolute minimum.

For more information about how HBF is changing, visit our change hub.


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