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 member health insurance claims for every $10 paid in premiums.

  • HBF is a not-for-profit health fund with over one million members.
  • HBF currently offers five levels of hospital-only cover and five levels of extras-only cover.
  • You can bundle your hospital and extras policies together under most packages to save on both products.

HBF currently offers five types of hospital policies and five types of extras policies, which can be purchased separately or bundled together. You can mix and match your cover or use the purchasing tool to find a bundle option that fits your lifestyle.

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.

  • Basic Hospital Plus – includes coverage for your own private room at selected hospital, accident cover, ambulance rides, dental surgery, knee and joint reconstruction and a limit number of other services.
  • Bronze Hospital Plus – Includes coverage for all Bronze-category services plus ear, nose and throat surgery, tonsils, adenoids, and grommets, and cancer treatments.
  • Silver Hospital – Includes coverage for all services in the Silver tier of health insurance. Comes with $200, $500, and $750 excess options.
  • Silver Hospital Plus – Total coverage. The only exclusions include dialysis for chronic kidney failure, pregnancy and birth, reproductive services, and weight loss surgery.
  • Gold Hospital – Complete coverage for all clinical categories. Excess options include $0, $250, $500, or $750.

Extras Cover

Choose from five extras cover options offered by HBF. Extras cover offers benefits for regular health care services that aren’t usually covered by Medicare.

  • Basic Extras: Includes coverage for general dental, optical, physiotherapy, chiropractic, osteopathy, and healthy living programs.
  • Saver Flexi: Includes general dental with the choice of two of the following: major dental, optical, physiotherapy, chiropractic, osteopathy, healthy living programs, pharmacy, podiatry, and remedial massage.
  • Standard Extras: Benefits for general dental, major dental, optical, physiotherapy, chiropractic, osteopathy, healthy living programs, pharmacy, podiatry, appliances, hearing aid, eye therapy, occupational therapy, speech therapy, clinical psychology, and dietetics.
  • 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.
  • Top Extras: Benefits for nearly all services covered under traditional extras policies with no annual limit on preventative dental and a fully covered pair of glasses every year.

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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