While HCF prides itself on being Australia’s largest not-for-profit health fund and on the many awards it has won over its 90 years, its data shows that it is falling behind in comparison to other health insurance providers. At current, HCF is best for hospital-only policies, but is lacking in terms of customer satisfaction.
Pros
- Good member retention rate on hospital-only policies
- Customer service is available on weekends
- 90.8% of hospital-related charges covered by HCF
Cons
- Some policies can only be taken out in conjunction with others
- All pre-existing medical conditions, including extras, have a 12-month waiting period
- High proportion of complaints investigated by the Ombudsman in comparison to market share
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About HCF Health Insurance
HCF positions itself as Australia’s largest not-for-profit health fund, occupying a market share of 11.9% at the time of writing–equating to around 1.8 million members nationwide.
Operating since 1932, HCF has celebrated 90 years in business as of 2022. In that time, it has worked to provide “quality cover and healthcare” to its members, and has the “ability to focus on what matters” thanks to having no shareholders, it explains online.
Along with health insurance, HCF also offers life, pet, and travel insurance. Its health insurance policies have received an average ranking of 2.9 stars out of 5 on Product Review, with poor customer service often noted as the reason behind low review scores.
What is covered?
As with any health insurance, what is covered by HCF will depend predominantly on the type of cover you choose, and the tier of coverage you take out.
HCF’s most basic hospital-only policy provides cover for a range of hospital treatments, including those relating to brain, eyes, ears, nose and throat. While the basic policy also covers miscarriage or termination of birth, policyholders must have HCF Hospital Premium Gold for pregnancy and birth cover, or a related ‘My Family’ policy.
The My Family policies, however, are conditional to also having extras cover taken out in conjunction with the hospital cover. For example, the HCF My Family Silver Plus Hospital can is only available to those who also have HCF My Family Silver Plus Extras cover.
Many other policies also include this condition, whether for family-related needs or not. It is therefore essential that an individual checks they are not paying for two separate policies due to this clause, when they might be paying for cover they don’t need or want.
Additionally, while emergency ambulance services are covered by all hospital policies, HCF also has ambulance-only policies available for members.
Wait time
A waiting period applies when you take out a health insurance policy, which is a period of time before you can make claims to the provider. In line with the usual industry standard, HCF has a waiting period of two months for most services–whether hospital or extras.
However, pre-existing conditions that require hospital treatment or services that fall under an extras policy have a 12-month waiting period. Pregnancy and childbirth also have a 12-month wait, as does major dental work.
While some health insurance providers will waive these waiting periods via promotions, HCF does not currently offer such a discount.
No gap policy
While a health insurer will often cover some or even majority of a service fee, you will still have to pay something out of your own pocket–known as a gap payment.
A ‘no gap policy’, however, refers to the amount that your private health insurer will pay on your behalf for a consultation, treatment or surgery, thereby leaving you with no out-of-pocket costs.
At HCF, 88.8% of its services have a no-gap policy, after accounting for insurer benefits, schemes and agreements. Additionally, HCF has a list of ‘More for You’ extras providers, which allows eligible members to receive 100% back on selected extras services such as dental, optical and physio.
Will HCF cover me for the hospital?
Yes. If you have HCF hospital cover, you will be covered for the hospital–depending on how the tier of coverage you have relates to your condition.
As mentioned earlier, pregnancy and birth cover is only covered on certain, higher-tiered policies. The same is true for many other conditions and procedures, such as rehabilitation or joint replacements.
However, in comparison to other health insurance providers, HCF’s most basic hospital-only policy covers a much wider range of conditions than most, varying from palliative care to lung and chest ailments.
When it comes to hospital-only policies, HCF has a member retention rate of 88%. Additionally, out of all of the hospital-related charges claimed by HCF members Australia-wide, a total of 90.8% were covered.
What about dental, physio or optical?
Most Australians expect dental, physio and optical services to be included in their extras cover when taking out health insurance.
Unfortunately, at HCF, its most basic ‘Starters Extra’ policy does not include these three services. It also doesn’t cover some general dental treatments, such as indirect fillings or surgical extractions.
HCF’s Top Extras policy, in comparison, includes podiatry, speech pathology, hearing aids and more.
Regardless of the tier, out of all general treatment services available to claim from HCF, 52.6% are covered by the insurer’s benefits.
Are there any further discounts?
HCF is not currently offering any further discounts to its existing members or new members. It is, however, giving new members a chance to win prizes if they take out a HCF policy, such as a $10,000 holiday voucher or a $7500 grocery voucher.
HCF Complaints
Of all complaints investigated by the Ombudsman across the entire health insurance industry, a total of 17.8% were complaints regarding HCF. When viewed in comparison to HCF’s market share (11.9%), it is clear that members of HCF are more likely to complain about HCF–and escalate these complaints to the Ombudsman–than they would be about a health insurance provider of a similar size.
Customer Service
HCF prides itself on its customer service, acknowledging on its website the many awards it has received in this field. Unlike many other providers, HCF is also open for customer service queries on the weekends between 9-5, and during the week from 8am-8pm.
As mentioned, however, a lot of the negative reviews from HCF customers are in regards to poor customer service.
Frequently Asked Questions (FAQs)
Is HCF private health insurance?
Yes, HCF is an unlisted public company that offers private health insurance.
Are HCF and HBF the same health insurance provider?
No, HBF and HCF are two different private health funds.
Back in 2018, WA-based HBF had planned to merge with HCF on the east side of Australia to “make the company one of the nation’s biggest industry funds”, in a deal tipped to be worth as much as $4 billion.
According to the ABC, HBF and HCF planned to retain their individual identities and continue to be run under individual management, which would sit under a new umbrella company guided by a common board of 10 directors.
“The merger is a logical fit, given both funds’ not-for-profit structure and member-first approach,” a media release on the proposed merger read.
However, by June 2018, HBF pulled out of the planned merger.
What is HCF’s contact number?
HCF can be contacted for general enquiries at 13 13 34 between the hours of 8am-8pm Monday to Friday, or 9am-5pm on weekends. To make a payment over the phone, members can call 13 14 39 during the same time frames.
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