Frequently Asked Questions

Private Health Insurance can be broken up into two parts. Firstly there is hospital cover which gives you access to private hospital, your choice of doctor and control over the timing of surgery, whether it is urgent or elective. Secondly there is General cover (commonly known as extras or ancillary). Ancillary helps with cost of services Medicare don’t pay for - such as dental, optical and ambulance.

Hospital insurance is the cover we hope never to use but have because we want the best for ourselves and our families when it really matters. There can also be financial advantages to taking out hospital insurance.

Ancillary cover is not only there to help you with day to day health costs for things such as dental and optical, but encourages us to use services that may stop little niggles becoming big expensive ones such as physiotherapy, complementary therapies and healthy lifestyle services.

The Federal Government introduced the rebate to assist Australians meet their health cover costs. If you currently hold a green or blue Medicare card you are entitled to claim the rebate on both hospital and ancillary products for Private Health Insurance.

Most HIF members claim the rebate as a reduced contribution:

• 30% If you are under 65
• 35% If your membership includes a person between 65-69
• 40% If you membership includes a person aged 70 or over

Some members choose to pay the full contributions through the year and claim the rebate back at the end of the financial year through their tax return.

The Medicare Levy Surcharge (MLS) is levied on Australian taxpayers who do not have private hospital cover and who earn above a certain income. The MLS is a Federal Government initiative to encourage individuals to take out private hospital cover, and where possible, to use the private hospital system to reduce the demand on the public system.

The surcharge is calculated at the rate of 1% of taxable income. It is in addition to the Medicare Levy of 1.5%, which is paid by most Australian taxpayers. The MLS is imposed on individuals earning over the threshold who do not have an appropriate level of hospital insurance. The threshold is $73,000 for individuals and $146,000 for families or couples.

HIF’s domestic hospital covers meet the Federal Government requirements for avoiding the MLS. See Pay Less Tax for more information.

The Federal Government introduced the Medicare levy surcharge to encourage high income earners to join Private Health Insurance. Currently if you earn over $73,000 per year as a single or $146,000 for a couple or a family then you will pay an extra 1% Medicare levy surcharge at tax time. You can avoid this by taking out hospital cover with an excess of no more than $500.

All HIF hospital covers meet the requirement to avoid the Medicare levy surcharge.

The Federal Government introduced the lifetime health cover loading to encourage Australians to take out Private hospital insurance at a younger age. For every year over the age of 30 that you don’t have private hospital insurance a 2% loading is applied to the cost of the insurance. For example a single 37 year old would pay 14% lifetime health cover loading. Loading does not apply to ancillary cover.

The loading can become complicated and can vary due to different circumstances such as adding a partner, previous covers, being overseas and new immigrants. We recommend you contact HIF if you have any questions relating to calculating your lifetime health cover loading.

Waiting periods are the time you will need to be a member before you can claim a benefit. Members coming from other recognised Australian health funds will not have to re-serve any waiting periods already served. Waiting periods are there to protect the fund and its members.

Private Health Insurance doesn’t cover you for outpatient services. These services include visits to your GP, consultations with specialists, and X-Rays and blood tests taken when not admitted to hospital.

There are several user friendly ways to claim a benefit from HIF.  Read about the various claiming options here.

The easiest way to update your contact details is to logon to the Members area.

Alternatively you can contact HIF by phone or email.

If you need to change your name on your membership simply advise HIF in writing and include a copy of your marriage certificate.

If there is any incorrect information in regards to spelling, date of birth or title please contact HIF.

There are several ways to pay for your HIF membership - you can view the options here.

With the exception of credit card expiry dates, all account changes need to be made using the direct debit form.

You can advise us of credit card expiry date changes by simply ringing or emailing HIF.

To order a new membership card for yourself or your partner please contact HIF.

Cards take between 2-3 weeks to arrive.

If you feel you have all the information needed to change your level of cover you will need to complete a variation form and return it to HIF.   Please keep in mind that waiting periods may apply.

We do however recommend that you contact HIF if you have any queries about changing cover.

To add or remove someone from your membership you will need to complete a variation form and return it to HIF.

Only the primary member can add or remove persons from their membership.

If you are not the primary member you can however remove yourself from the membership.

Dependants can stay on your membership until their 21st birthday or for full time students up until their 25th birthday.

Dependants are not means tested and do not have to live at home.  However dependents can not be married or in a defacto relationship and remain on the membership.

To register a dependant as a student please complete a student declaration form and return it to HIF. Dependants will be automatically removed from the membership on their 21st birthday without a student declaration.

You may suspend your membership if you are traveling overseas for more than 2 months and less than 2 years.  HIF currently require that you have held at least 12 months continuous membership.

If you hold overseas visitors cover please contact HIF for more information.

To apply to suspend your membership please complete a suspension form and return it to HIF before you depart.

Your membership will need to be paid up to your departure date.

To reactiviate your membership, please complete a reinstate after suspension form.  Please note you will require a copy of your boarding pass or passport stamp for verification.

If you decide to cancel your HIF membership we will need to be informed in writing. You can complete the cancellation form and return it to HIF.

The cancellation date will be considered as the date we received the cancellation form, unless you would like to cancel from a future date.

Generally monies paid in advance of the cancellation date will be refunded.