Health Insurance Packages

In Australia there are two types of private health insurance: Hospital cover and Extras cover (also known as ancillary cover). Packaged cover combines both Hospital and Extras as a predesigned product offering.

Hospital component of the cover includes cover if you need overnight or same-day treatment in hospital as a private in-patient. Depending your level of cover, it helps cover the costs of treatment in hospital such as accommodation, and theatre fees. We recommend that you contact the hospital prior to treatment, to confirm what out of pocket expenses to expect. In relation to medical bills, you can complete a Medical Estimate Form via our website or contact us if you’d like more information. 

Extras component covers you for everyday ‘non-hospital’ healthcare and medical services and treatments that aren’t covered by Medicare like optical, dental, physio, chiro, and healthy lifestyle services (plus other natural therapies like remedial massage and acupuncture).

Waiting periods in Australian health funds exist to protect members from individuals who join only to make large claims and leave, ensuring fairness and sustainability in the private health system. In the Hospital component of packaged cover, there is a 12-month waiting period for pre-existing conditions that applies. This is to prevent immediate high-cost claims that could impact the system for all members. But there is some good news if you are joining us from another fund, we’ll take your previous membership into account, so you won’t have to re-serve waiting periods on an equivalent level or lower level of health cover. Please note, to ensure you don’t re-serve waiting periods on equivalent level of cover products, you will need to join HIF within 2 months of leaving your previous health insurer. 

For HIF Hospital cover, the waiting periods are as follows:

• 1 day: Emergency ambulance
• 30 days: Non-emergency ambulance
• 2 months: General hospitalisation
• 2 months: Psychiatric care, rehabilitation & palliative care (regardless of whether it's pre-existing or not).
• 12 months: All pregnancy and birth related services
• 12 months: Pre-existing conditions or ailments

 
For HIF Extras cover, the waiting periods are as follows:

• 2 months: General Dental, optical, physio, exercise physiology, chiro, osteo, complementary therapies, podiatry, pharmacy, speech therapy, eye therapy, occupational therapy, dietary, healthy lifestyle, psychology and diabetes education
• 12 months: Major dental, orthodontics, hearing aids, breathing appliances, health aids, appliances and external Prosthesis, blood glucose monitor and blood pressure monitor

Lifetime Health Cover (LHC) loading applies to the hospital component of the packaged cover. (LHC) loading was designed by the Government to encourage Australians to take out private hospital insurance at a younger age and encourage them to maintain it. Essentially, if you don't have private hospital insurance before the 1st of July following your 31st birthday and then decide to join later in life, you’ll have to pay an additional 2% loading on your premiums for every year you were over the age of 30 and didn’t have private Hospital cover; up to a maximum of 70%! LHC will later be removed from your hospital insurance premium once you’ve paid it for 10 continuous years. To check your LHC eligibility, use our handy online calculator.

We have contracts in place with hundreds of private hospitals in Australia. Under these contracts, a schedule of fees for treatments and services is already agreed upon. In most cases, the hospital will send the invoices directly to HIF and we’ll pay the account on your behalf. Of course, your level of cover and what’s included will depend on the Hospital policy you hold. Please call us at 1300 134 060 to check if the hospital you are being treated at is contracted with HIF.

In a nutshell, Hospital Cover includes cover for surgeries or unexpected events that require hospitalisation. By contrast, Extras Cover is for health ‘maintenance’ costs, such as dental care, optical, physiotherapy and chiro.

HIF's packaged cover provides you with peace of mind in the event of a hospital admission, while also giving you access to money-back on commonly used Extras services such as General Dental, Optical and Physio – packaged cover gives you the essentials to manage your health needs.

Australian residents who earn over the annual income threshold for MLS purposes (set each year by the ATO) and don’t have private hospital cover will the Medicare Levy Surcharge (MLS). Depending on your income, the MLS can be as high as an additional 1.5% of your annual income.

The Australian government introduced the MLS to give people an incentive to take out private hospital insurance. If you earn over the income threshold for MLS purposes, having Hospital cover for the entire tax year could potentionally reduce your MLS. To estimate your tax savings, use our interactive online calculator.

If your doctor charges more than the Medicare Benefits Schedule (MBS) and does not opt-in to participate in Access Gap, you may incur significantly more out-of-pocket expenses. That’s why we always encourage our Members to ask their doctors or specialists if they’re treating them as an Access Gap patient. We have arrangements in place with more than 30,000 doctors. Find out more about gap cover here.

If you choose Hospital Cover with an excess, you’ll only need to pay the excess once per-person per calendar year (to a maximum of twice per couple or family policy) if admitted to hospital. For some covers, the excess does not apply for same-day admissions and/or dependent children under the age of 18. Please refer to the individual product factsheets for more detail on the excesses that apply.

The Australian Government offers a Private Health Insurance Rebate to help people pay for their private health insurance. It’s intended to reduce the strain on Medicare (our public health care system) whilst making premiums more affordable.

Eligibility for the rebate is determined on a tiered system that is based on your age and taxable income. Claiming the rebate can be done in your annual tax return or we can make it easy for you by deducting it straight from your health insurance premium.

Learn more about the rebate here.

Get a quote

The Pre-Existing Condition waiting period applies to new members and existing members who upgrade the Hospital component of their cover to access higher-level benefits. The test applied under the law relies on the presence of signs or symptoms of the illness, ailment or condition, not on a diagnosis (i.e. it’s not necessary for the member or their doctor to know what their condition is or for it to be diagnosed).

In forming an opinion about whether or not an illness is a pre-existing condition, an HIF-appointed medical practitioner will
take into account information provided by the member’s treating doctor.

A pre-existing condition is defined as: ‘Any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness, ailment or condition existed at any time in the period of six months ending on the day on which the person became insured under the policy.’

All HIF packaged cover products cover the cost of emergency and non-emergency ambulance. Emergency transport covers situations that require urgent attention and admission to the emergency department of a hospital. If your call-out is “non-urgent” you’ll still be covered and will only need to make a $50 co-payment. Basic Extras is a little different, though – non-urgent call-outs aren’t covered and you’ll receive 100% back for one emergency ambulance service per person per calendar year.

Learn more about our Ambulance Only Cover.