HBF Health Insurance Guide

HBF (Hospital Benefit Fund) is a WA-based not-for-profit health fund established in 1941. After acquiring GMF Health in 2015, it now has over one million members and makes up 8% of the private health insurance market. HBF’s focus is on members’ health and wellbeing. On average, the fund spends $9 on health insurance claims for every $10 paid.

In February 2018, HBF and HCF signed an agreement to agree on key principles of a proposed merger. If the merger goes through, the combined fund would be the third largest private health insurer in Australia, with a market share of 18.4 percent. The fund would remain not-for-profit.

  • HBF is a not-for-profit health fund with over one million members.
  • HBF offers four levels of hospital-only cover and two levels of extras-only cover.
  • Gap Saver is a unique product that can be added to any hospital or extras cover. Your premium can be stored up and applied to out-of-pocket ‘gap’ expenses as they arise.

HBF offers four types of hospital cover and two types of extras cover, which can be purchased separately or bundled together. The fund also offers a unique product called GapSaver, which can be added to a policy and applied to out-of-pocket expenses at a later date.

Hospital Cover

Each level of HBF hospital cover builds on the level before it. Lower-cost products exclude costly services such as maternity cover and heart treatment, so you can choose the level of cover that matches your life stage.

  • Super Saver Hospital: Budget policy that covers accidents only. This includes hospital accommodation, urgent ambulance services, and treatment associated with an accident.
  • Saver Hospital: Basic hospital cover. Same level of cover as Super Saver, but also includes thousands of hospital procedures.
  • Mid Family Hospital: Same cover as Saver, but also includes benefits for heart treatment, reproductive services, and maternity.
  • Top hospital: Comprehensive hospital cover. All the benefits of Mid Family cover plus additional procedures such as surgical weight loss, dialysis, joint replacement, and cataract surgery.

Extras cover

HBF’s two levels of extras cover can both be customised, so you can choose the extras you prefer. Extras cover offers benefits for regular health care services that aren’t usually covered by Medicare.

  • Saver Flexi Extras: Select four services of your choice such as general dental, optical, chiropractic, podiatry, remedial massage, and physiotherapy.
  • Flexi Extras: Select ten services of your choice. Includes all the options from Saver Flexi plus additional services like dental implants & orthodontics, nutritionist, natural therapies, and speech therapy.

GapSaver

This product can be added to most hospital and extras policies and there are four levels to pick from. If there is a gap between the cost of your treatment and the amount covered by your policy, your GapSaver premium can help you avoid out-of-pocket expenses.

Singles can choose from the following four premium levels:

$100
$200
$400
$600
Couples and families can choose from the following four premium levels:

$200
$400
$800
$1200

Your GapSaver balance builds each year until it is used. The balance does not expire and can only be used while you hold HBF insurance. There are two options for using your GapSaver balance.

  1. Choose to get your GapSaver benefits automatically. Your GapSaver balance will be used towards any out-of-pocket expenses when making a claim.
  2. Use your GapSaver benefits at your discretion. Decide on a claim-by-claim basis when to use the balance. Just notify HBF at the time of making a claim, and if you forget, you can even apply the balance retroactively.

The following services are eligible for GapSaver:

  • Extras services like physio and optical
  • Medical gaps for hospital admission
  • Dental surgery
  • Excesses and co-payments for hospital accommodation
  • Non-PBS and PBS in-hospital pharmaceuticals
  • Sundry hospital charges like television or surgical slings
  • Wellness services like health programs or certain massage treatments

Note that GapSaver can only be applied to eligible services that are covered by your policy.

According to the Private Health Insurance Ombudsman (PIHO), here’s how HBF stacks up against other funds in the industry.

  • Hospital Related Charges Covered
    HBF is slightly above industry average
  • Medical Services with No Gaps
    HBF is below industry average
  • Medical Services with No or Known Gaps
    HBF is above industry average
  • General Treatment (Extras) Covered
    HBF is slightly below industry average

HBF Compared to Industry

Share of Private Health Insurance Ombudsman complaints

Reference: http://www.ombudsman.gov.au/publications/state-of-the-health-funds-report
(2017 State of the Health Funds Report)

HBF members have plenty of options when they need to make a claim. In most cases, claims for hospital procedures are submitted straight to the fund. When claiming for extras, members can choose from the following claim methods:

  • On-the-spot rebates from health service providers with HICAPS
  • Claim online through your myHBF account
  • Use the HBF Health app, submit a photo of your receipt, and upload to claim.
  • Visit a HBF branch and claim in person.
  • Download a claim form and post the completed form to HBF.

Online extras claims are processed within two days and hospital claims within ten working days. After processing is complete, direct credit benefits are paid within two working days. If you request a cheque it will take seven working days.

Members can find out more information about their claims and claim history by logging into myHBF.

HBF members have access to a range of Momentum member benefits, which provide discounts on products and services.

Discounts may include:

  • Discounted movie tickets at Event, Hoyts, Village, and Moonlight Cinemas
  • Discounts on combining travel, home, or health insurance through HBF
  • Discounts on sunglasses at OPSM, Sunglass Hut, and Laubman & Pank
    Optometrists
  • 15% off online running gear from Running Warehouse
  • Discounts at SeaWorld Melbourne, Madame Tussauds, Wet ‘n’ Wild Sydney, Taronga Zoo, and more

myHBF

Members also gain access to HBF’s online account service myHBF. It allows members to make a claim, learn more about their cover, and update personal details. myHBF also provides up-to-date information on the fund and any policy changes. Learn exactly what you’re covered for and explore the range of member benefits.

Address: GPO Box C101, Perth WA 6839
Phone: 133 423
Website: hbf.com.au
Twitter: @hbfhealth

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