Health Care Insurance Limited (HCI) Fund Review
Established in 1938, Health Care Insurance Limited (HCI) is a non-profit fund owned entirely by its membership base of over 10,000 Australians.
by Gary Andrews
Last update 15 Apr 2021
HCI started out as a regional health fund in Tasmania and has since expanded across the nation, but still prioritise 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.COMPARE & SAVE
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 three straightforward hospital policies: bronze, silver and gold.
All hospital policies include:
HCI's cheapest level of cover provides peace of mind across a wide range of areas at an affordable price. Comes with $750 excess.
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.
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.
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.
If you're a Tasmanian or Queensland resident, your state covers the cost of ambulance trips.
From dental, to optical, to chiro and more, extras insurance helps cover the bills 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 to work out what you need and what you're prepared to pay.
If this feels a bit overwhelming, you can speak to one of our experts who can talk you through what's included in each extras policy.
HCI offers three straightforward extra plans, which we've detailed below.
HCI's budget extras option includes General Dental, Major Dental, Chiropractic, Acupuncture, Natural Therapy, Optical, Osteopathy and Physiotherapy.
The Healthy Extras plan has a number of significant inclusions, such as ambulance cover, hearing aids, weight loss programs, quit smoking programs and pharmacy.
The annual limits for items such as dental are significantly more than the Active Life policy.
Gold Hospital with Premier Extras
HCI's Premier extras package is only available in addition to Gold Hospital Cover. It includes laser eye surgery, travel and accommodation costs and a Diabetes Australia membership.COMPARE & SAVE
Waiting periods are there to stop people from signing up, claiming and then cancelling their cover.
It means once you take out a new plan, you may have to wait a certain amount of time before receiving your benefit.
When you switch to HCI from another provider, you won't have to re-serve your waiting periods, unless your new policy covers something you didn't have before or has improved annual extras benefits and/or limits.
Hospital Waiting Periods
Extras Waiting Periods
HCI partners with Best Doctors, giving all HCI members access to a second opinion from the world's leading medical specialists.
It's a confidential service which complements the care your own doctor is providing.
HCI also has a partnership with smile.com.au.
You can receive 15%-40% off dental treatments from a smile.com.au approved provider -- on top of your usual extras benefit.
There's also a Nourish Baby program for parents-to-be and new parents, including a sleep helpline for mums and dads who struggle to get their bub sleeping properly.
Simply tell the hospital you are a member of a HCI policy. Your hospital account will be sent directly to HCI for them to assess on your behalf.
You can swipe your membership card to claim directly on the spot with your provider's HICAPS or iSOFT terminal.
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.
In most cases, claims are processed on the same day they are received.
HCI has agreements with most hospital and day surgery providers across Australia.
When comparing policies, it's worth checking if your preferred local hospitals and clinics are covered.
From 1 January to 31 March 2020, the Private Health Insurance received just one complaint from an HCI member. HCI has a market share of 0.1%.
Source: Private Health OmbudsmanCOMPARE & SAVE
Is HCI a not-for-profit fund?
Yes – all profits go back into the fund and not into shareholders’ pockets.
Who can apply? Are there any restrictions?
HCI is open for all Australian residents to join.
Is it easy to switch to HCI?
Compare Club does not compare for HCI, so you'll need to contact them directly to switch.
However, if you're still interested in exploring your options, it's free to compare a broad range of funds with us.
Do I need to re-serve waiting periods?
You can switch to an equivalent or lower level of cover without re-serving waiting periods.
You will only be required to serve waiting periods if you have upgraded to a higher level of cover.
Can I change my level of cover?
Yes, you can modify your cover with HCI directly.
If you’re thinking of switching to a new provider, Compare Club can compare quotes for you and take care of the entire process, free of charge.
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).
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.
What age are children covered up to?
Dependent children are covered up to the ages of 23, or up to 25 if they are studying full-time.
How do I get in contact with HCI?
Call: 1800 804 950 Email: firstname.lastname@example.org Address: 25 Cattley Street, Burnie TAS 7320COMPARE & SAVE
This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.