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How HCF rates for member complaints, gap cover and ambulance cover.
Last updated: 13 May 2024
Who is HCF?
Established in 1932, HCF is Australia’s largest nonprofit health fund with almost 1.9 million members. HCF has several dental and eyecare centres in Sydney, and offers health and wellbeing services such as quit smoking programs and swimming lessons. It’s also part of Members Health, an alliance of nonprofit and mutual health funds.
Phone: 131 334
Website: hcf.com.au
Does HCF get many complaints from members?
HCF has a Medium complaints rating.
When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don’t get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.
How good is HCF’s gap cover?
A medical gap is the difference between Medicare’s recommended fee and what your doctor actually charges for a treatment or service.
Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called ‘no gap agreements’, or part of that gap, which are called ‘known gap agreements’ (these will have lower out-of-pocket costs, usually less than $500).
Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.
Rating scale
- Well above average
- Above average
- Average
- Below average
- Well below average
Text-only accessible version
Australian Capital Territory
Average.
New South Wales
Average.
Northern Territory
Below average.
Queensland
Average.
South Australia
Average.
Tasmania
Average.
Victoria
Average.
Western Australia
Below average.
How many hospital agreements does HCF have in each state?
The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you’re treated.
The table below shows how many hospital agreements HCF has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don’t have agreements with specific funds and are generally treated as though they’re agreement hospitals.
Text-only accessible version
HCF hospital agreements
In the Australian Capital Territory this fund has…
5 private hospital agreements out of an industry maximum of 6.
7 day hospital agreements out of an industry maximum of 9.
In New South Wales this fund has…
90 private hospital agreements out of an industry maximum of 92.
88 day hospital agreements out of an industry maximum of 105.
In the Northern Territory this fund has…
1 private hospital agreement out of an industry maximum of 1.
1 day hospital agreement out of an industry maximum of 2.
In Queensland this fund has…
48 private hospital agreements out of an industry maximum of 58.
39 day hospital agreements out of an industry maximum of 54.
In South Australia this fund has…
19 private hospital agreements out of an industry maximum of 20.
19 day hospital agreements out of an industry maximum of 31.
In Tasmania this fund has…
8 private hospital agreements out of an industry maximum of 8.
6 day hospital agreements out of an industry maximum of 9.
In Victoria this fund has…
66 private hospital agreements out of an industry maximum of 71.
53 day hospital agreements out of an industry maximum of 80.
In Western Australia this fund has…
18 private hospital agreements out of an industry maximum of 23.
16 day hospital agreements out of an industry maximum of 29.
Does HCF offer ambulance cover?
All HCF extras, hospital and combined policies have emergency ambulance cover. Cover is capped for extras cover at one service per person / two per policy a year.
Do you need ambulance cover?
Depending on where you live, you may not need a policy with ambulance cover.
- Queensland or Tasmania: Emergency ambulance services are covered by your state government.
- NSW and the ACT: All hospital policies come with emergency ambulance cover – so you’ll be covered with any hospital or combined policy you select.
- South Australia, Victoria and the Northern Territory: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover.
- Rural Western Australia: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover.
- Metropolitan Western Australia: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.
Does HCF offer family policies that cover adult children?
- Adult children are covered on family policies for free until they turn 22.
- Full-time students are covered on family policies for free until they turn 31.
- Adult children younger than 31 can be covered on extended family policies for an extra cost.
Does HCF let you claim online or in-app?
Online claiming is available for dental, physio, therapies, pharmacy and artificial appliances, and there’s an app (iOS and Android) for extras claiming.
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