Hospital cover that suits your needs

It’s entirely up to you. Many Australians initially get hospital cover to avoid government penalties like the Medicare levy surcharge, but the real value of private hospital insurance is in the freedom and control it gives you over your healthcare.

With hospital cover, you can go to a private hospital for treatment and your health fund will help cover some of your costs. You’ll be able to choose your specialist and avoid the public hospital waiting list.

If you don’t have hospital cover but choose to be treated in a private hospital, you will have to fund your own treatment. If you don’t have hospital cover and go to a public hospital for treatment, you won’t have a choice of specialist and will have to wait on the public hospital waiting list— this could mean months, or even years before you receive treatment.

While Australia has an excellent healthcare system, there are many benefits to having hospital cover.

Hospital cover helps cover some of the costs when you’re admitted to hospital. It can help cover some of the costs for things like doctors’ fees, accommodation and theatre fees.

With hospital cover, you’ll also be able to choose your preferred hospital and doctor to receive treatment from, avoid long public waiting lists and gain access to a private room*.

*Subject to availability.

Hospital insurance helps cover the cost of ‘inpatient’ services—these are treatments you receive when you’re formally admitted to hospital for care, e.g. for surgery.

The specific hospital procedures and services you’re covered for (e.g. chemotherapy, a colonoscopy, tonsil removal, knee reconstructions etc.) depends on the level of hospital cover you choose.

Generally, as your level of hospital cover goes up, so does the number of included services.

Your hospital insurance cannot cover ‘outpatient’ services—these are treatments you receive when you haven’t been formally admitted to hospital, for example, tests and examinations (like x-rays and blood tests). In most cases, Medicare will help cover these services.

If you visit your doctor or specialist at a hospital, without being admitted, this is classed as outpatient hospital treatment, for which your private health insurance cannot pay a benefit. Please call us to get a quote if you’re unsure.

Depending on your level of cover, you may also have exclusions and/or restrictions. If a service is excluded, it’s not covered at all. Restricted services receive the minimum default benefit, which generally means a large out-of-pocket.

Where your treatment is an included service on your hospital cover, your hospital costs will either be fully or partially covered depending on the type of agreement your health fund has with your specialists and hospital.

With HBF, when you’re admitted to hospital for treatment you will get 100% back for the cost of your hospital accommodation and specialists so long as you choose providers that have ‘no-gap’ (otherwise known as ‘fully covered’) agreements with your health fund.

Just be aware of out-of-pocket costs, which can include excess or co-payments, as well any outpatient services.

At HBF, the waiting periods for hospital services are as listed in the table below.

If you hold an HBF Overseas Visitor cover, you will have different waiting periods. Please refer to your product sheet for more information.

*Hospital psychiatric services, Rehabilitation and Palliative care are not considered pre-existing so only the two-month waiting period applies to these services.

Yes. With HBF, you can purchase hospital cover on its own. Hospital insurance helps cover some of the costs when you’re admitted to hospital. It can help cover some of the costs for things like doctors’ fees, accommodation and theatre fees.

Yes. As a couple, you have the option of getting couples health insurance (so you’re both covered on the same policy) or a singles health insurance policy each. It’s entirely up to you and what best suits your needs.

If you need pregnancy and birth cover, you can buy a singles health insurance policy with pregnancy and birth, and one without. When your baby arrives, you can then transition to family health cover, so you, your partner and your new baby can all be covered on the same policy.

It depends on your health fund and the health cover you choose. With HBF, a couples health cover policy just costs double the price of a singles health cover policy (before applying the Australian Government Rebate on Private Health Insurance or Lifetime Health Cover loading).

If you’re on your parents’ health cover, we will cover you on their policy until you turn 25 provided you’re not married or in a de-facto relationship and are either:

• studying fulltime, or;
• earning less than $24,500 per year.