Health Care Insurance Limited (HCI) Fund Review

HCi started out as a regional health fund in Tasmania and has since expanded across the nation, but still prioritises investing back into their local communities.

HCi isn't on our panel but we're confident we can get you a great deal on your health cover.

Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

HCi offers four straightforward hospital policies, ranging from Basic to Gold. All hospital cover comes with no excess for eligible dependent children under the age of 18.

Basic Hospital

HCi's Basic level of cover is a low cost option for members who want the absolute basics. Comes with a $500 and $750 excess.

Key inclusions:

• Rehabilitation

• Hospital psychiatric services

• Palliative care

Bronze Hospital

HCi's bronze level of cover provides peace of mind across a wide range of areas at an affordable price. Comes with $750 excess.

Key inclusions:

• Chemotherapy, radiotherapy and immunotherapy

• Gynaecology

• Joint reconstructions

Silver Plus Hospital

HCi's mid-tier hospital policy features some significant inclusions for people looking for a wider range of cover, although it doesn't include pregnancy-related items or insulin pumps. Comes with a $250, $500 and $750 excess.

Key inclusions:

• Heart and vascular system

• Lung and chest

• Back neck and spine

Gold

HCi's top tier Gold cover includes everything standard in a policy, as well as access to the Nourish Baby program for parents-to-be. Comes with a $250, $500 and $750 excess.

Key inclusions:

• Pregnancy and birth

• Assisted reproductive services

• Weight loss surgery

Ambulance cover

Unusually for a health insurer, you'll need to take out the Healthy Extras or Premier Extras package to receive ambulance cover, and there's a two month waiting period.

Extras cover

HCi's extras reset on January 1 every year. 

From dental, to optical, to chiro and more, extras insurance helps cover the bills and save on out of pocket costs for routine treatments with rebates of up to 100%.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with the health fund.

Take the time towork out what you need and what you're prepared to pay. 

If this feels a bit overwhelming, our experts are here to help.

HCi offers three straightforward extra plans, which we've detailed below.

Active Extras

This is the basic tier of extras available with HCi.

Key inclusions:

• General and major dental

• Optical

• Podiatry consultations, physiotherapy and osteotherapy

Healthy Extras

The Healthy Extras plan has a number of significant inclusions, such as ambulance cover, hearing aids, weight loss programs, quit smoking programs and pharmacy. This plan has higher annual limits than the Active Life cover.

Key inclusions:

• Hearing aids

• Medical appliances

• Diabetes education

Gold Hospital with Premier Extras

HCi's Premier extras package is only available in addition to Gold and Silver Plus Hospital Cover. It includes extra medical treatment and specialised health services.

Key inclusions:

• Laser eye surgery

• Travel and accommodation

• Weight loss programs

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

• 12 months for pre-existing conditions, pregnancy and birth

• 2 months for hospital psychiatric services, rehabilitation and palliative care as well as all other services and accident cover

Extra waiting periods

• 24 months for hearing aids

• 12 months for major dental, orthodontics, laser eye surgery, medical appliances and non-surgical prostheses

• 6 months for optical, travel and accommodation

• 2 months for all other services, including ambulance, general dental, chiropractic and home nursing

Member benefits

HCi has a range of programs available for members, including cancer support, private maternity services and a heart health program that aims to get members moving.

The Cancer Support program is available Australia-wide for members with any cancer diagnosis at no additional cost. The support that members have access to is provided by qualified nurses, dieticians, psychologists and more.

HCi have a partnership with Hatch Private Maternity in Brisbane to provide eligible members with access to high quality and private maternity care with no out-of-pocket expenses.

The Heart Health program is also available to eligible members at no charge and is delivered to any members Australia-wide. The program aims to improve day to day living and reduce overall cardiac risk.

How to claim

Claim on the spot through the HICAPS payment system at your provider.

You can also receive a copy of the invoice and claim through the HCi Claiming App, or fill out the claim form and send it via email or post.

Hospital agreements

HCi has agreements with most hospital and day surgery providers across Australia.

When comparing health insurance policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

HCi has received 0.1% of complaints in 2021, and has a market share of 0.5%^.

Frequently Asked Questions

Is HCi a not-for-profit fund?

Yes, HCi is a not-for-profit fund.

Who can apply? Are there restrictions?

HCi is open for all Australian residents to join.

Is it easy to switch to HCi?

HCi is not on Compare Club’s panel.

We’re confident we can find you a good deal from the other funds we compare.

Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits. Contact our team for further information.

Can I change my level of cover?

Yes, you can choose a lower or higher level of cover.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

Up to what age are children covered?

Dependent children are covered up to the extended ages now, and from 1 September 2022 HCi are permitting disabled dependants age 32 and older to remain on a family policy. 

^Private Health Ombudsman,HCi, accessed 13 January 2022.