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Joint Procedure Claims

HBF has become aware that we inadvertently informed two members that they were not eligible to claim for certain types of joint surgery, when they may have been eligible to claim. Based on our analysis we believe only a small number of members were impacted and we have taken steps to fix the issue to prevent it from occurring again.

After becoming aware of the issue, we are getting in touch with relevant policyholders to identify any other members who were impacted. If you believe you were affected by this issue, please consider the information below.

We would like to speak with members who held a policy referred to in the table below between 1 January 2009 and 30 January 2020 and may have been affected in relation to a joint procedure. Please contact us as follows:

As a not-for-profit health insurer, we have a strong commitment to do the right thing by our members, and we want to ensure that we speak with anyone who may have been impacted.

The policies that may have been affected are set out in the table below.

Original Name
Current Name (if changed)
Young Saver Hospital
Bronze Hospital Plus
Healthy Saver Hospital
Healthy Saver Bronze Plus
Healthy Saver Twin Pack
Mid Hospital
Silver Hospital
Mid Family Hospital
Mid Family Silver Plus
Smart Saver Twin Pack
Smart Package Basic Plus
Standard Overseas Visitors
Young Singles Saver Twin Pack
Saver Hospital
GMF Lite Hospital
GMF Mid No Maternity
GMF Mid Hospital
GMF Mid Silver Plus

Frequently asked questions

What should you do if you think you were impacted?

If you believe this affects you or another member on your policy, please call our dedicated phone line on 1300 365 099 or email us at jointclaims@hbf.com.au.

We will investigate your situation carefully. Our Clinical Investigation Team may need to talk to you and the treating specialist or surgeon to verify the procedure. We will then contact you to let you know the outcome of that investigation.

We are committed to resolving these issues for our members as quickly as possible and we ask that you contact us if you believe you or another member on your policy may have been affected.

When did the communications go out?

HBF began communicating with members from 16 September 2020. We contacted people by letter, email or phone depending on the contact information we had for them.

I did not get an email or letter from HBF about this issue, do I need to take any action?

If you required a joint procedure and held one of the affected policies listed here between 1 January 2009 and 30 January 2020, you may have been impacted by this issue. If you’re in doubt, please contact us on 1300 365 099 or email us at jointclaims@hbf.com.au to check.

What information will HBF need if I contact you?

When you contact us, we will ask you to provide us with the following information:

  • Your HBF policy number
  • The impacted member’s full name
  • Type of procedure required
  • Date of procedure (if applicable)
  • Treating specialist or surgeon who performed or would have performed the procedure
  • The hospital where the procedure was performed or would have been performed

What sort of procedures were impacted by this issue?

This issue relates to certain joint procedures. If you had or enquired about having a joint procedure during the impacted period, please call us.

I’m not sure if I, or someone on my policy, was affected. Can you give me an example of how I may have been impacted?

We would like to talk to you if, at the time, you or another member on your policy:

  • had a joint procedure in the private system and was not paid a benefit or only received a partial benefit from HBF;
  • had a joint procedure in the public system;
  • needed a joint procedure but decided not to have the procedure on the belief that your HBF policy would not cover the joint procedure; or
  • upgraded your policy or switched health funds in order to be covered for the joint procedure.

Once I contact you, what happens next?

We will investigate your situation carefully. Our Clinical Investigation Team may need to talk to you and the treating specialist or surgeon, to verify the procedure. We will then contact you to let you know the outcome of that investigation.

How long will the investigation take?

We are committed to resolving these issues for our members as quickly as possible and we ask that you contact us if you believe you or another member on your policy may have been affected.

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