Af
for
dable Private Hospital and Ancillary Insurance Cover
Visit
hif.com.au
or call
1300
13 40 60
to get a quote and join (or switch) today.
Australia’s first certified Carbon Neutral health fundHIF health
cover.
Your easy-as
guide to
What’s
inside?
Why choose HIF ...2
Ancillary cover options ...4
SmartTeeth dental benefits ...8
Hospital cover options ...12
Get a quote and join ...17
Ways to pay and claim ...19
SmartClaim for mobile ...20
Waiting periods ...22
Why HIF is
the smart choice
for health cover
We’re guessing that
choosing health insurance
probably isn’t high on your
‘Things I really want to do
with my spare time’ list.
Frankly, it can be a bit of a
chore. But it’s important too.
Who wants to be worrying
about public hospital
waiting lists or the cost of
dental treatment when you
or someone in your family
needs health care?
So, we’re here to make choosing
the smartest health insurance
as quick, simple and painless
as possible, starting with the
reasons why it makes sense to
choose HIF
in the first place.
Reason
1
More choices and less confusion
Choose the hospital you want. Choose your doctor or specialist. Choose your dentist, chiropractor, optometrist, physiotherapist and more. You even have a great choice of easy ways to make a claim (see page 19). And because we’ve simplified things with four hospital cover options and four ancillary options to choose from, selecting the smartest cover for your situation and budget is easy, especially with our online product selector. Try it out at
hif.com.au
Reason
2
Small premiums, but BIG benefits
We offer some of the most competitive and affordable private health insurance products in Australia. Our benefits are some of the best around, yet our average premium increases are consistently ranked among the lowest in the country. But how come our premiums are lower? Good question. Here’s how...
Reason
3
You get low premiums because we’re highly efficient
We don’t pay income tax or dividends to shareholders – we’re a not-for-profit health fund. We don’t have a vast network of expensive branches. We don’t spend massive amounts on advertising. Instead, we keep our costs low by working smart and hard, with innovations like our SmartClaim mobile app providing another easy and efficient way to claim (see page 20) that keeps our overheads and your premiums down.
Reason
4
We’ve got Australia covered
With us, you have access to over 500 private hospitals throughout Australia. That means, if you’re going to be away from home, or you plan to relocate, we’ll still be there to help you during your time of need. A reassuring thought, isn’t it?
Reason
5
We make switching easy
If you want to switch to HIF (a smart choice), don’t let the paperwork put you off. We’ll take care of it all for you and we’ll even honour the length of your membership with your previous fund, so (in most cases) you won’t have to serve new waiting periods (see page 18 for more details).
Reason
6
No anonymous off-shore call centres
When you speak to one of our member service representatives, you’re talking to a real HIF team member, right here in Australia – a professional who works solely for you. Call us on 1300 13 40 60 and see for yourself.
Reason
7
Get your money back if you’re not satisfied
We know we have the best health cover in Australia, but if you decide within 30 days of taking our cover that it isn’t right for you (and you haven’t claimed), we’ll give you a full refund of any premiums you have paid.
To see even more reasons, visit hif.com.au
Why HIF is
the smart choice
for health cover
Claiming is easy with SmartClaim. SmartClaim is our free mobile app that makes it simple to submit ancillary claims when you’re out and about. Turn to page 20 to find out more.
Af
for
4
AncIllAry HeAltH cover optIons
High quality, low cost ancillary health cover.
Mention ancillary health insurance or ancillary costs and people tend to glaze over. It can seem a bit dull. But it’s not. Ancillary insurance is a wonderful thing, providing cover for a range of everyday health services like dental, physiotherapy, optical, chiropractic, healthy lifestyle, ambulance and pharmacy. And, with some of the lowest premiums in Australia, our ancillary options are great value for money too.
5 In fact, there are a whole bunch of everyday health
care needs that aren’t covered by Medicare. But fear not, our popular ancillary options have you covered for all those services you’re likely to need on a regular or even emergency basis. Services such as: • Dental • Optical • Chiropractic • Physiotherapy • Pharmacy • Podiatry • Complementary therapies • Emergency ambulance • And more...
All you have to do is choose the most suitable level of ancillary cover from our four options.
What does our ancillary cover include?
Medicare’s great, but it only goes so far.
Saver Options
Just need cover for the essentials? No worries. saver options offers great value, entry-level ancillary cover – ideal for younger people who want affordable cover for common services including (but certainly not limited to) general dental, optical, physio, chiro, pharmacy and emergency ambulance. Special
Options
If it’s intermediate ancillary health cover you’re after, we have just the product.
special options includes major dental services, plus many other essential
services like emergency ambulance, optical, chiro, physio, osteo, pharmacy, acupuncture, naturopathy and healthy lifestyle.
Super Options
Drum roll please... Introducing our most popular ancillary health cover option.
super options has practically everything you could wish for – major dental,
chiro, physio, optical to name just a few, plus it covers a host of other services like orthoptics (eye therapy), podiatry consultations and speech therapy. Premium
Options
Here it is, the ancillary health cover option to top all ancillary health covers.
premium options has it all. It’s the very definition of comprehensive, including
all the services we mentioned for Super Options, as well as first aid courses, larger rebates and higher annual limits.
6
Use the cover comparison table below to help find an ancilary cover option that suits your need and your budget:
Type of Service Saver Special Super Premium
Ambulance (urgent) ✓ ✓ ✓ ✓
Assisted Reproduction Drugs ✗ ✗ ✓ ✓
Asthmatic Spacers ✗ ✗ ✓ ✓
Auxiliary Home Nursing ✗ ✗ ✓ ✓
Blood Glucose/Pressure Monitor ✗ ✗ ✓ ✓
Chiropractic ✓ ✓ ✓ ✓
Complementary Therapies ✓ ✓ ✓ ✓
Dental - General Unlimited ✓ ✓ ✓ ✓
Dental - General Limited* ✓ ✓ ✓ ✓
Dental - Major ✗ ✓ ✓ ✓
Diabetes Education ✗ ✗ ✓ ✓
Dietetics ✓ ✓ ✓ ✓
First Aid Courses ✗ ✗ ✗ ✓
Healthy Lifestyle ✓ ✓ ✓ ✓
Hearing Aids ✗ ✗ ✓ ✓
Nebuliser/Humidifier ✗ ✗ ✓ ✓
Occupational Therapy ✗ ✗ ✓ ✓
Orthoptics (Eye Therapy) ✗ ✗ ✓ ✓
Orthotic Appliances ✗ ✗ ✓ ✓
Optical (glasses and contact lenses) ✓ ✓ ✓ ✓
Osteopathy ✓ ✓ ✓ ✓ Peak-flow Meter ✗ ✗ ✓ ✓ Pharmacy Drugs ✓ ✓ ✓ ✓ Physiotherapy ✓ ✓ ✓ ✓ Podiatry Consultations ✓ ✓ ✓ ✓ Psychological Consultations ✗ ✗ ✓ ✓ Speech Therapy ✗ ✗ ✓ ✓
And there’s more to smile about: smartteeth Dental
Whichever ancillary cover you choose, you’re covered by SmartTeeth, our unique big-benefits dental program that means you can receive up to 100% of your dental provider’s fee. Find out more about SmartTeeth on page 8.
Please note:
• Some waiting periods may apply. See page 23 for full details.
• *For inclusions, benefits and annual limits, please refer to the separate PDS (Product Disclosure Statement).
• For items or services not listed in the above table, please contact us or refer to the separate PDS (Product Disclosure Statement) for coverage details. • Legal dependants of members will be covered until they turn 21 years of age, or 25 if they are in full-time study.
7
Urgent ambulance cover
If you take out one of our popular ancillary options, you’ll be automatically covered for urgent ambulance services (and a small $50 co-payment will apply for non-urgent ambulance). It makes financial sense too, especially when you consider the price of urgent ambulance transport costs over $800. In comparison, we think our ancillary options covers are great value. For example, the annual cost for a single Saver Options policy is hundreds of dollars less than the average cost of ambulance assistance and means you’ll be covered for 10 other commonly used services too (including general dental, optical, physio, chiro and pharmacy).
Understanding ambulance cover
arrangements across Australia
Firstly it is important to understand that in the unfortunate event you require emergency ambulance transport, Medicare won’t cover the cost. However, some state governments subsidise ambulance services, and some pensioners and low income earners may also be entitled to free ambulance assistance. For more information and to view the ambulance arrangements in your state or territory, visit hif.com.auHIF Ambulance cover explained
The great news about our ambulance cover is that it doesn’t matter which level of ancillary cover you choose, the benefits for ambulance are exactly the same (and no limits apply either.) So if you do happen to need an ambulance in the future, you can rest assured that you’ll be covered for 100% in most circumstances. The only time you’ll be required to contribute is if the call out is considered “non-urgent” (or “non-emergency”) in which case a $50 co-payment will apply.Benefits paid:
• Emergency call-outs and transportation: 100% covered by HIF.
• Non-emergency call-outs and transportation: a $50 co-payment will apply.
Please note:
• Benefits are paid on charges raised for approved ambulance services. • A patient co-payment of $50 per service applies to non-emergency
call-outs and transportation.
• Benefits are not payable for inter-hospital transportation except for inter-hospital transfers relating to an emergency or new illness where approved on a case by case basis by HIF.
• Benefits are not payable for transportation from a hospital to your home, nursing home or other hospital, or for transportation for ongoing medical treatment.
• For more information, please refer to the separate Product Disclosure Statement (PDS) or visit hif.com.au/PDS
8
SmartTeeth is a unique benefits
program that sets our private dental
insurance cover apart. It’s brilliant.
And we can say that in all modesty
because it was our members’ idea.
They asked us for dental cover that rewards proactive dental care and provides higher rebates for the most popular services. So that’s what SmartTeeth provides – up to 100% rebate for the most popular dental services, like: • Examinations
• Remineralisation
• Plaque and calculus removal • Dentist-fitted sports mouthguards
And it doesn’t cost you a thing
As a standard part of our ancillary health insurance cover, SmartTeeth provides added value, but at no added cost.smile, dental benefits are better with smartteeth
Choose your own dentist.
Unlike some health funds, we don’t have ‘contracted dentists’. With HIF, you’re free to choose any dentist you want. In fact, the Australian Dental Association of Western Australia (ADAWA) has publicly commended our stance on protecting your right to choose. That makes us the only health insurance fund in Australia with an ADAWA commendation. Dental Item Description Dentist Fee Percentage of Fee Maximum Payable Rebate paid to Mary 011 Oral examination (first visit) $55.00 100% $51.65 $51.65 114 Removal of calculus (first visit)
$95.00 100% $95.65 $95.00
012 Oral examination (second visit)
$55.00 80% $36.90* $36.90
* Figure represents 80% of the maximum rebate which is the maximum amount payable for subsequent visits.
smartteeth: An example
Mary is covered under Super Options and she visits her family dentist who completes Mary’s first oral examination and her first plaque removal in the calendar year.
As recommended by her dentist, Mary has a second (6 monthly) examination later that year. The following table is an example of the dentist’s fee and the rebates Mary will attract.
9
Brush up on your dental care.
Check out our free online dental information resource – our Healthy Advice Blog by Dr Emma. Focusing solely on dental health matters, it’s written by a professional dentist who answers questions from our members. Visit hif.com.au/members-centre
10
How will my smartteeth dental
rebate be calculated?
We will pay a percentage of the dentist’s fee, up to a set maximum benefit for each item of service^. For example, with our Premium Options ancillary cover you get:
1 Top 24 general dental services: 80% to 100% of the fee, up to a set maximum benefit per item.
2 All other general dental services: 70% of the fee, up to a set maximum benefit per item*.
3 All other (i.e. major) dental services: 60% of the fee, up to a set maximum benefit per item*.
^ Benefits may be limited where potential rebates exceed dental service sub limits or annual limit.
* Contact us on 1300 13 40 60 for details of these services.
Item Number
Description Percentage of
fee (first visit item) Percentage of fee (further visits/items) 011 or 012 Oral examination 100% 80% 111 or 114 or 115
Removal of plaque, stain or calculus 100% 80%
121 Topical application of remineralising agent 100% 80%
151 or 153 Provision of a mouthguard 100% 80%
Please note: These benefits are payable on all our ancillary products. The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or annual dental limit. See the example on page 8 for more information.
11 Item Number Description Premium Options Super Options Special Options Saver Options 013 Emergency oral examination 80% 70% 65% 65% 014 Consultation 80% 70% 65% 65% 022 Intraoral periapical or bitewing radiograph 80% 70% 65% 65% 118 Bleaching, external - per tooth 80% 70% 65% 65%
161 Fissure sealing - per tooth 80% 70% 65% 65%
311 Removal of permanent tooth
80% 70% 65% 65%
512 Metallic restoration - two surfaces - direct
80% 70% 65% 65%
513 Metallic restoration - three surfaces - direct
80% 70% 65% 65%
521 Adhesive restoration - one surface - anterior
80% 70% 65% 65%
522 Adhesive restoration - two surfaces - anterior
80% 70% 65% 65%
523 Adhesive restoration - three surfaces - anterior
80% 70% 65% 65%
531 Adhesive restoration - one surface - posterior
80% 70% 65% 65%
532 Adhesive restoration - two surfaces - posterior
80% 70% 65% 65%
533 Adhesive restoration - three surfaces - posterior
80% 70% 65% 65%
575 Pin retention - per pin 80% 70% 65% 65%
577 Cusp capping - per cusp 80% 70% 65% 65%
Please note: The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or overall annual limit.
our top 24 smartteeth dental services (continued)
12
prIvAte HospItAl cover optIons
Quality private hospital cover that is affordable for all Australians.
We know that choosing private hospital insurance cover can be confusing. Which fund should you choose? What level of cover? Will hospital cover cut your tax bill? How easy is it to switch health funds? But relax. It’s really not that complicated or expensive. Read on to see if private hospital cover is for you and, if so, which option suits your needs.
13
Nobody likes the idea of going into
hospital. But if you or a member of
your family has to, it’s good to know
you’re able to:
• choose your preferred public or private hospital; • choose the doctor or specialist you want; • choose a private room, rather than a shared one; • focus on getting better, safe in the knowledge
you’re covered for things like accommodation, in-patient services and theatre room fees. Simply choose the level of cover that suits your requirements – there’s an option for everyone.
Recently arrived in Australia from overseas?
If you have – welcome! HIF has a range of products to suit the circumstances of all temporary or new residents of Australia. The products listed in this brochure are designed for permanent Australian residents only and cannot be used for private treatment by temporary residents; so if you’re not a permanent resident of Australia and you are unsure of your options, visit hif.com.au to find out more
about Overseas Visitors Health Cover or call us on 1300 13 40 60.
Which hospital option is right for you?
GoldStarter Goldstarter is our entry-level hospital cover option and is a smart choice if you’re younger and less likely to require things like maternity services or cardio thoracic (heart/chest) procedures. It covers all the essentials and is great value for money too, especially if you can make a tax saving (visit hif.com.au for more details on the Medicare Levy Surcharge).
GoldSaver Goldsaver is our intermediate hospital cover and is a step up from GoldStarter. It’s great for young couples and families who are likely to need things like maternity cover (including up to three days in a private room) but are less likely to require cardio thoracic (heart /chest) procedures or joint replacement surgery.
Gold Gold is our award-winning shared-room hospital cover option. With Gold hospital, you’re fully covered for theatre and ward fees. It’s especially great if you’re planning on having a baby, because our maternity cover includes up to five days in a private room at no extra cost.
GoldStar Goldstar is our premium hospital cover option, with all the bells and whistles. You’re fully covered for everything, including a private hospital room, theatre fees and ward fees. No worries. Just total peace of mind for you and your family.
Please note:
• Some waiting periods may apply. See page 22 for full details.
• Cardio thoracic surgery/monitoring includes services like heart bypass procedures, angiograms, coronary care, lung surgery and medical treatments for upper respiratory conditions (like bronchitis or asthma). Please contact us prior to admission to confirm payable benefits.
14
What does our hospital cover include?
For in-hospital procedures for covered services
✓
= Covered ✗
= Not coveredGoldStarter GoldSaver Gold GoldStar
Shared room ✓ ✓ ✓ ✓
Private room ✗ ✗ ✗ ✓
Private room
(maternity only) ✗ (3 days)✓
✓ (5 days) ✓ (unlimited) Maternity services ✗ ✓ ✓ ✓ Choice of excess ✗ ✗ ✓ ✓ Intensive care ✓ ✓ ✓ ✓ Theatre fees ✓ ✓ ✓ ✓ Same-day accommodation ✓ ✓ ✓ ✓ Same-day theatre ✓ ✓ ✓ ✓ AccessGap ✓ ✓ ✓ ✓ Restrictions Exclusions
GoldStar Surgery by Podiatrists Cosmetic services
Services not covered by Medicare
Gold Surgery by Podiatrists Cosmetic services
Services not covered by Medicare
GoldSaver Surgery by Podiatrists Psychiatric
Cardio Thoracic (heart/chest) conditions, procedures or monitoring Eye Surgery
Joint Replacement
Assisted Reproductive Technology
Cosmetic services
Services not covered by Medicare Gastric banding and obesity surgery
GoldStarter Surgery by Podiatrists Psychiatric Palliative Care Rehabilitation
Cosmetic services
Services not covered by Medicare Gastric banding and obesity surgery Obstetrics (Maternity)
Cardio Thoracic (heart/chest) conditions, procedures or monitoring Joint Replacement
Eye surgery
Assisted Reproductive Technology
Please note:
• Some waiting periods may apply. See page 22 for full details.
• Cardio or thoracic surgery/monitoring includes services like heart bypass procedures, angiograms, coronary care, lung surgery and medical treatments for upper respiratory conditions (like bronchitis or asthma). Please contact us prior to admission to confirm payable benefits.
• Where a service is deemed by Medicare to be cosmetic or does not attract a Medicare rebate, all charges raised during your hospital stay will not be eligible for payment. • A restricted service means a basic public hospital rate will be paid for accommodation and all other charges raised during the stay and out-of-pocket expenses
will be paid by the member.
• An excluded service means all charges raised during the stay will be paid by the member. • Please refer to the separate Product Disclosure Statement (PDS) for more details. hif.com.au/pds
15
Whether it’s your first baby or your
fifth, a new addition to the family is
always a magical time. So when it
comes to maternity services, our
affordable hospital cover options
will give you the peace of mind
you deserve.
For example...
• You can choose your own private hospital • You can choose your own obstetrician • Your labour ward fees will be fully covered • Your baby will be fully covered on your HIF policy
from the moment they’re born.
We offer three great hospital products that cover maternity services - GoldSaver, Gold and GoldStar.
Conditions may apply - please see our Product Disclosure Statement for more information or restrictions and exclusions. hif.com.au/pds
What about maternity waiting
periods?
We know from experience that being pregnant can often result in swollen ankles (not to mention some rather interesting food cravings), but the bundle of joy that arrives nine months later will definitely make the wait worthwhile.
And speaking of waiting, the waiting period for all obstetric related services is 12 months. That means you’ll need to have held maternity cover for 12 months prior to your estimated due date - so remember to take out hospital cover as early as possible. That way, you’ll have already served your hospital waiting periods long before your new bub arrives.
16
Affordable health cover is just a click away.
To get an instant quote, join at a time that suits you or simply learn more about HIF and our popular range of health cover options, visit hif.com.au
17
Maybe you’ve already chosen the
hospital cover, ancillary cover or
combination you want. Perhaps
you’re not quite sure and need a bit
of advice. Either way, we’re here to
help you, so get in touch.
• Online.Visit hif.com.au to use our online product selector (it’s easy). You can also get an instant quote and join online.
• By phone. Call us on 1300 13 40 60 and speak to one of our friendly sales consultants. They understand our cover options inside out, so they can help you make a decision and join over the phone. Our call centre is open from 8.00am until 5.00pm (WST), Monday to Friday.
• By email. Email us at sales@hif.com.au. A member of our team will contact you with all the information and assistance you need to make the right decision and join.
you spread the word, we’ll share
the love
We don’t waste money on lots of advertising, like some health funds. That’s one of the reasons we have some of Australia’s lowest premiums and best benefits. Besides, our satisfied members spread the word for us. And when they do, we like to say ‘thank you’ via our Member Rewards Program* – you get a $70 gift voucher every time a new member joins us as a result of your recommendation and mentions your name on their application form. *Terms and conditions apply, please visit hif.com.au for more information.
Don’t throw me away
It’s important that you read and keep this brochure and the accompanying PDS. We’ll be testing you to make sure you’ve digested all the information... OK, so we won’t be testing you, but you really should keep hold of all the information you receive about membership, benefits and conditions.
In fact, we’re continually improving our benefits, so it’s worth downloading the latest version of this brochure and the PDS from time to time. It’s the best way to ensure you get the most out of your cover when you need to claim. Visit hif.com.au for the most up-to-date publications.
Get a quote and join today
Please note:
• Your cooling-off period: Once you’ve applied for HIF membership, you have 30 days to read your policy. If, during this time, you decide that you don’t wish to take up the cover, you may cancel the policy and we will give you a full refund, provided you have not made a claim.
• Your fund membership will commence on the date your completed application form is lodged with HIF, or a date after the date of lodgement which you have nominated. (The date of lodgement is the date we receive your application.)
18
If you’re ready to say goodbye to
your old health insurer and hello to
better cover, service and premiums
with us, it’s easy. Just let us know
you’re switching when you apply
for HIF cover and we’ll arrange a
seamless transfer, pronto.
one form, one signature
All you have to do is fill in and sign our Switching Funds form. That’s it. We’re then authorised to arrange everything on your behalf. No additional paperwork. No hassles. No unnecessary delays.
Waiting periods? What waiting
periods?
When you become an HIF member, we’ll even take your previous membership into account. For example, if you have been with your current fund for 10 years on an equivalent level of cover, we will bring your loyalty across to HIF and you can immediately claim a higher benefit amount.
And you won’t have to serve new waiting periods. In fact, even if you’re switching to a higher level of ancillary cover, we will waive all two month waiting periods, so you can claim straight away on popular ancillary services like dental, optical, chiro and physio. Call us on 1300 13 40 60 or email our team at
sales@hif.com.au to find out more about switching.
We know first-hand just how confusing private health insurance can be. But that’s why we’re here – to make everything as simple (and affordable) as possible. So, if you can’t find the answer to your questions in this brochure, don’t fret. The full need-to-know details of all our hospital and ancillary cover options, plus FAQs and a glossary, can be found in our Product Disclosure Statement booklet or on our website – hif.com.au/pds
switching health funds? We’ll take care of it.
confused about health insurance? Don’t be.
Please note:• To ensure that all your existing benefits and previously served waiting periods are recognised, you must switch within two months of leaving your previous health fund. • While we’ll take care of all the paperwork associated with switching, you are required to contact your previous fund directly to cancel any direct debits that may
19
We’re all about choice and making
life easy at HIF. Choose the cover
that suits you. Choose your hospital,
your doctor, your specialist, your
dental provider… And we also
offer a choice of ways to pay your
premiums and make a claim, all
designed to make life simple.
So choose away.
Ways to pay
• Direct debit. Flexible. Automatic. Convenient. No wonder it’s our most popular payment option. • Manually. We send you an account when
your premium is due and you can pay however you like:
• Phone – call 1300 13 40 60 for over-the-phone credit card payments (we accept Mastercard, Visa, Diners Club and AMEX) • BPAY – through your bank’s phone or
internet banking system
• Billpay – via your phone or the internet • In person – at any Australia Post branch • By mail – post your cheque or money order
and the lower half of your invoice to: HIF, GPO Box 2221, Perth WA 6847.
Discounts and special offers
Premiums are discounted for members who pay in advance via direct debit or manual invoice: 2% for half-yearly and 4% for yearly. We also operate other special offers throughout the year. Visit hif.com.au
to see what’s new.
Ways to claim
• Electronic Claiming. Healthcare providers with electronic claiming technology (HICAPS or iSoft) can settle your account with you on the spot. All you need to do is swipe your HIF membership card and pay the difference (if any).
• SmartClaim for mobile. If you have an Apple or Android mobile device, you can submit paid ancillary accounts of $700 or less by using your mobile’s in-built camera to photograph receipts and invoices. Download HIF SmartClaim now from the Apple App Store or the Android Market or see page 20 for more details.
• Fast-Track Claiming. For paid ancillary accounts of $700 or less, try our quick and easy Fast-Track option. Simply scan your completed HIF claim form and associated receipts and invoices, and email a copy to claims@hif.com.au. Alternatively, fax a copy to (08) 9328 1685. Visit hif.com.au or read our Product Disclosure Statement to find out more about our claiming options.
Please note:
• All providers must be registered with HIF for claim benefits to be paid. • Benefits will not be paid for any hospital or ancillary costs incurred outside
Australia or which are not provided as part of a recognised consultation process. • Conditions apply for SmartClaim and Fast-Track claims. Please visit hif.com.au
or call us on 1300 13 40 60 for more details.
• Upon joining HIF, member cover, benefits and services are subject to our Business Rules. For a copy of the rules, contact us or visit hif.com.au.
20
Welcome to
SmartClaim
, our free
and easy-to-use mobile app that
makes it simple to submit ancillary
claims when you’re out and about.
tap. snap. claim. easy.
With SmartClaim, you can make a claim wherever you are, whenever you like. It puts HIF in your pocket and the process is as simple as:
• Tap in your details
Type your personal information and claim details directly into SmartClaim.
• Snap your receipts
Use your phone’s camera to take a photo of your invoices and SmartClaim will cleverly bundle them up for you, ready to submit with your claim details.
• Submit your claim
Hit the submit button within the app to send the claim through to us.
We’ll then take care of the rest, reimbursing your money asap.
It’s Free, fast and green
While swiping your membership card is still the quickest way to claim, there may be instances where the eClaiming option is unavailable; and when that happens, SmartClaim will take the pain out of the manual process. It’s fast, free and reduces paper waste too.
Conditions of use:
SmartClaim puts the power to claim in the palm of your hand. However, please bear in mind that:
• A maximum of four items can be lodged per SmartClaim • A maximum of $700 (total service fee value) can be claimed per day • The ‘Date of Service’ must be no more than two years prior to the date you claim • You must retain all original invoices/receipts for two years from the date you claim • HIF reserves the right to randomly select claims for auditing purposes.
Who can use smartclaim?
SmartClaim is available to HIF members who currently hold ancillary cover and own an Android mobile device or Apple mobile device (with iOS4+) that includes an integrated camera. Open iTunes or the Android Market on your mobile device now to download the SmartClaim app for free and try it for yourself.
21
Pick your own healthcare provider...
Unlike some health insurance funds in Australia, we believe in your right to choose your own healthcare providers. So while some health funds might restrict you to their contracted provider lists, we say you’re free to seek treatment wherever you like, anywhere in Australia. With our very affordable hospital and ancillary cover options, the choice is yours. To find out more, visit
22
Whether we’re answering your call,
or helping you switch from another
health fund, we don’t like to keep
you waiting. Unfortunately though,
waiting periods are a universal
necessity for all health funds.
Waiting periods protect us and our members against people who simply join our health fund to claim large amounts and then leave. That said, we try to keep waiting periods to a minimum. That’s why, if you join us from another health fund, we’ll take your previous membership into account so that, wherever possible, you don’t have to re-serve waiting periods.
Hospital waiting periods
How long do you have to wait before making a claim?
GoldStarter GoldSaver Gold GoldStar General hospitalisation 2 months 2 months 2 months 2 months All obstetric-related
services
Not covered 12 months 12 months 12 months All treatment related
to a pre-existing ailment or condition, but not including pre-existing conditions for psychiatric care, rehabilitation or palliative care
23
Ancillary waiting periods
Type of Service Saver Special Super Premium Waiting Period
Ambulance (urgent) ✓ ✓ ✓ ✓ 2 months
Auxiliary Home Nursing ✗ ✗ ✓ ✓ 2 months
Asthmatic Spacers ✗ ✗ ✓ ✓ 2 months
Chiropractic ✓ ✓ ✓ ✓ 2 months
Complementary Therapies ✓ ✓ ✓ ✓ 2 months
Dental - General Unlimited ✓ ✓ ✓ ✓ 2 months
Diabetes Education ✗ ✗ ✓ ✓ 2 months
Dietetics ✓ ✓ ✓ ✓ 2 months
First Aid Courses ✗ ✗ ✗ ✓ 2 months
Healthy Lifestyle ✗ ✓ ✓ ✓ 2 months
Occupational Therapy ✗ ✗ ✓ ✓ 2 months
Optical ✓ ✓ ✓ ✓ 2 months
Orthoptics (Eye Therapy) ✗ ✗ ✓ ✓ 2 months
Osteopathy ✓ ✓ ✓ ✓ 2 months
Peak-flow Meter ✗ ✗ ✓ ✓ 2 months
Pharmacy Drugs ✓ ✓ ✓ ✓ 2 months
Physiotherapy ✓ ✓ ✓ ✓ 2 months
Podiatry Consultations ✓ ✓ ✓ ✓ 2 months
Speech Therapy ✗ ✗ ✓ ✓ 2 months
Dental - General Limited ✓ ✓ ✓ ✓ Up to
12 months
Blood Glucose / Pressure Monitor ✗ ✗ ✓ ✓ 12 months
Dental - Major ✗ ✓ ✓ ✓ 12 months
Nebuliser / Humidifier ✗ ✗ ✓ ✓ 12 months
Orthotic Appliances ✗ ✗ ✓ ✓ 12 months
Psychological Consultations ✗ ✗ ✓ ✓ 12 months
Assisted Reproduction Drugs ✗ ✗ ✓ ✓ 36 months
Hearing Aids ✗ ✗ ✓ ✓ 36 months
From time to time we promote special offers for new members. Visit hif.com.au for more information and to view our current offers.
need some help?
Visit hif.com.au
Call 1300 13 40 60
Email info@hif.com.au
The information in this brochure is correct as at 1 September 2012. Minor changes may occur after that date. If major changes occur, a separate insertion will be included in the brochure or the brochure will be reprinted. HIF members are encouraged to regularly download the latest copy of this brochure from
hif.com.au, or contact us and we will send one to you.
Health Insurance Fund of Australia Ltd (HIF) ACN 128 302 161 An Australian public company limited by guarantee.
A registered private health insurer.
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