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HIF (Health Insurance Fund)

HIF (Health Insurance Fund) Questions & Answers

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47 questions from our users

I am a member (Gold) No : 158127 . I have two inplants done and paid for. I now have to have the two teeth done, am I covered at all for the teeth. Please let me know by my email. Greetings Hester Tosen
1 answer
Hi Hester, Thanks for getting in touch. As requested, I forwarded your enquiry to our member experience team and a consultant will be in touch shortly to assist you. Warm regards, Lisa Chaperon (Digital Marketing Consultant)

As a provider what health fund provider number do I need for my patients to get a receipt
2 answers
Hi Sue, Thanks so much for getting in touch! I can certainly help you with this, but we do need a little more information first though. Would you mind emailing me directly on social@hif.com.au and I’ll ensure our Claims Manager gets in contact with you as soon as possible. Thanks Sue, and I’ll look forward to hearing from you soon. Kind regards Carly Stewart (Digital Marketing Consultant)Thank you Carly, I called the HIF yesterday and was told that I could use my Medicare provider number. So looks like it’s all done already and my client has his invoice and receipt. Sue

Hi To cover GP and pathology cost what cover I should take for my Mum? She is on visitor visa 600 in WA. How many percent HIF cover for GP and blood testes? Thanks
1 answer
Hi Deep, Thanks for getting in touch and its wonderful to hear you’re considering HIF for your Mum. For the services you’ve mentioned above, you’d need to purchase our Visitor Value Policy. This is our intermediate hospital and medical insurance option and would cover your Mum for a shared room in a public or contracted private hospital, plus some out of-hospital medical expenses such as x-rays, GP visits and outpatient pathology. In terms of the benefits payable, HIF will pay 100% of the Government’s Medicare Benefit Schedule (MBS) amount for each medical item number. So, any out-of-pocket expenses would then depend on how much the doctor or specialist would charge you for their services. It is important to note though Deep, that we can only offer overseas visitor cover to people aged 64 and under. If your Mum is over this age, then unfortunately we wouldn’t be able to cover her – sorry about that. In case it helps, you can find a complete breakdown of the inclusions, exclusions and the applicable waiting period for each service on our Non-Working Visa Comparison Table here: www.hif.com.au/health-insurance/visitor-cover/non-working-visa Alternatively, if it would help I’d be more than happy to put you in touch with one of our product experts? They’ll be able to provide you with some costs, plus answer any other questions you may have. If that sounds ok, please email me directly on social@hif.com.au with your contact details and a convenient time to talk and I’ll schedule this in for you. Many thanks, Carly Stewart (Digital Marketing Consultant)

Do you cover buying Sleep apena machine , if yes under which health insurance cover?
1 answer
Hi Micheal, thanks for getting in touch. We certainly do pay a benefit towards Sleep Apnea Machines (CPAP Machine). This service is included on our top two Extras Covers, Super and Premium Options, within the External Prosthesis / Medical Appliance category. It’s important to note though, a 3 year waiting period would apply before you can claim for the machine, unless you’ve held cover for this service with another health fund previously. Here's a quick overview of what can be claimed: With regards to the annual limit: You can claim one machine every 5 years from the previous supply (per person) and the benefit will be deducted from the Prosthesis annual limit of $1,500. The benefits payable are: • $300 for members who've held Super or Premium Options for 3-5 years. • $600 for members who've held Super or Premium Options for 5+ years. • Please note that a benefit is only payable towards the CPAP machine itself (accessories like the mask and nose piece cannot be claimed from HIF). • Waiting period: 3 years In order to claim for the device, it must follow admission to hospital for sleep apnea and/or a letter recommendation from your treating practitioner must be provided in support of the claim. If it would help Micheal, I’d be happy to arrange a quick call with one of our product experts to discuss this in more detail and provide you with a quote. If that sounds ok, please email your contact details and a convenient time to talk and I’ll schedule that in for you. Alternatively, you can get a quote online using our interactive product selector here: www.hif.com.au I hope that helps, but please do let me know if there’s anything else I can assist with. Kind regards, Kelsey Donnelly (Digital Marketing Consultant)

Please explain WHY my contribution has increased by 17.32% from 2017 to 2018?
1 answer
Hello Jude, Thank you for getting in touch. So that I can investigate this for you, please can you email your member number to me on social@hif.com.au? Warm regards, Nikki.

Does HIF allow claim for an ultrasound? Recently had a pelvic ultrasound and they said medicare has been claimed so wondering if the balance or some of is claimable? Regards Tammy
1 answer
Hi Tammy, Thanks for getting in touch. May I ask if you hold Hospital cover with HIF? The reason being that a benefit may apply if you were treated as an inpatient (e.g. you were admitted into an approved hospital or day facility, allocated a bed and then discharged following the treatment). If you were treated as an outpatient however, the Medicare benefit you’ve received would only apply. I hope that helps Tammy, but if you have any further questions please do not hesitate to email me direct on social@hif.com.au. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)

Hello I am considering Laser eye surgery. I noticed a previous query a year ago in regards to laser surgery, where you said it was not covered but you would submit the query for consideration. I am aware that many of the other health funds cover some to all of the costs. Does HIF now offer some sort of rebate? Regards Diane
1 answer
Hello Diane, Thanks for your question. We did review the inclusion of laser eye treatment on our policies, however to do so would have required an increase in member premiums. As a member-owned health fund (and given the current economic climate) a decision was made not to progress this any further. I hope that helps to answer your question, but if you’d like to discuss this further please don’t hesitate to get in touch. You can email me direct on social@hif.com.au. Thanks, Molly Kelly (Digital Marketing Team Leader)

We are having to take our son to a private Gastroenterologist - the GAP is in excess of $200 - are we able to claim this through our HIF Extras cover?
1 answer
Hi there, Thanks for getting in touch. Unfortunately this isn’t claimable under your ‘HIF Extras Cover’ as Gastroenterology is considered a medical service. May I ask if you hold Hospital cover with HIF? The reason being that a benefit may apply if your son was admitted to hospital as an inpatient (e.g. he is admitted into an approved hospital or day facility, allocated a bed and then discharged following the treatment) and the relevant waiting periods have been served. If your son was treated as an outpatient however; a Medicare rebate would only apply. I hope that helps Sandd, but if you have any further questions please do not hesitate to email me direct on social@hif.com.au. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)

Hi - i am on hif extras Super. Can i claim for item number 942 - intravenous sedation? Thanks
1 answer
Hi Jesse, Thank you for your question. With regards to item number 942 (Intravenous Sedation), unfortunately we don’t pay benefits towards this on any of our levels of cover – sorry about that. If you have any other dental item numbers you would like me to check for you, please feel free to send them directly to me on social@hif.com.au and I’ll ensure a dental benefit estimate is generated for you. I hope this helps, but if there’s anything else I can assist with, please do not hesitate to ask. Kind regards, Kelsey Donnelly (Digital Marketing Consultant)

Hi. I have Goldstar Hospital Cover with Super Extras. I am considering having Weightloss surgery - Laparoscopic Sleeve Gastrectomy - and wondered if I am covered. Please also advise what hospital excess I would be up for - it says $500/$1,000 on my card. Thank you. Catherine
1 answer
Hi Catherine, Thank you for getting in touch. With regards to weight loss surgery, this is certainly included on your GoldStar Hospital cover, providing it’s deemed medically necessary by Medicare and that you’ve served your 12 month waiting period with HIF on this level of cover. In terms of your excess, this simply means that you’ve nominated a $500 excess on your policy, per person, per year. So this means you will be required to pay a $500 excess upon admission for your surgery. It’s also important to note that the excess only applies to overnight stays in hospital, so if you’re having day surgery the $500 excess wouldn't apply. As some out-of-pocket expenses may be incurred though, we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. Your doctor should be able to provide you with this information so once you have this, please feel free to send it directly to me on social@hif.com.au and I’ll ensure a medical benefit estimate is generated for you. I hope this helps to answer your question Catherine, but if there’s anything else I can assist with, please do not hesitate to get in touch. Kind regards, Kelsey Donnelly (Digital Marketing Consultant)

Hi - I am currently a GoldSaver member, and wanted to inquire how obstrecian fees under pregnancy? I got the rebate back from medicare? Do HIF cover the gap? How can I check? My doctor is Dr. Nader Bakhit in Liverpool. Please advise if the treatment costs are covered by HIF?
1 answer
Hi Elaine, Thanks for getting in touch and congratulations on your pregnancy. To answer your question, yes - your HIF GoldSaver Hospital policy absolutely covers you for any inpatient obstetrician and labour fees (once you’re admitted to hospital). So when the time comes for you to be admitted to hospital to give birth, we’ll be there to help you with the medical bills. Depending on the hospital and specialists you choose though, some out-of-pocket expenses may apply so we always advise our members to provide HIF with an itemised medical estimate prior to admission. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. Your obstetrician will be able to provide you with that estimate, so once you have a copy please feel free to send it directly to me on social@hif.com.au and I’ll ensure a benefit estimate is generated for you as a matter of priority. Please note that private hospital insurance only pays benefits on inpatient services though; so for any associated outpatient services such as planning fees, scans or consultations, you can only claim a rebate from Medicare. Does that help to answer your question Elaine? If you need any further clarification though, please don’t hesitate to contact me and I can arrange for a consultant to give you a call to explain this in more detail. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)

I was wondering if HIF covers the removal of a lapband? I have Gold Cover. And what if I wanted to have weight loss surgery in the future, what types of surgery does Gold cover? Thank you.
3 answers
Hi Monica, Thank you for your question. With regards to the removal of a lapband and weight loss surgery, you’ll be happy to hear that this is included on your Gold Hospital cover (providing it’s deemed medically necessary by Medicare). It’s important to note however that a 12 month waiting period applies, so if you’ve been with HIF for 12 months on this level of cover, we will certainly pay a benefit. You may incur some out-of-pocket expenses though Monica, which is we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to any hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets expenses are kept to a minimum. Your doctor or specialist will be able to provide you with this information so as soon as you receive this, please feel free to send it directly to me on social@hif.com.au and I’ll ensure a medical benefit estimate is generated for you. I hope this helps, but if there’s anything else I can assist with, please do not hesitate to ask. Kind regards, Kelsey Donnelly (Digital Marketing Consultant)Thank you very much Kelsey, that is very useful to know :) MonicaHi Monica, I would not recommend HIF at all. I joined in October 2016, after discovering my health insurance was not being paid by my ex. My teenage daughter was scheduled to have gastrointestinal sleeving done. I had to reschedule it all and advised very clearly upon joining HIF of this operation and if she would have to wait. The answer was no. In Feb 2017, she was booked in, I'd paid $7000 cash in gap fees and got a call late on the Friday afternoon before the operation Monday morning that HIF weren't covering the costs. I had the weekend to come up with $14000.00 cash!!! NOT one person helped. The operation went ahead thanks to my family and I'm currently struggling to pay them back. This operation has saved her life. Was not for cosmetic reasons. I'm a single parent and upon joining was advised I had to join top hospital and extras for the operation and I did that. Nearly $180.00 a fortnight premium. It has apparently been sent to the MAC for review but still haven't heard back. It was sent to them because when the Team Leader listened to my initial phone call, clearly confirmation was given that the operation would be covered.

How much is the cost for health insurance for a healthy full time working single male aged 42 with high earnings salary?
1 answer
Hello Karen, Thanks for getting in touch, I’m delighted to hear you’re considering HIF. We have five great-value Hospital products and Extras products to choose from. The prices differ based a number of variables including your location, rebate eligibility and the type of cover you would like, e.g. Hospital, Extras or a combination of both. With this in mind, I can arrange for one of our product experts to give you a quick call to discuss some cover options? That way, they’ll be able to assess your circumstances in more detail and provide a comprehensive price and benefit comparison, (obligation free of course!). Alternatively, you can get an online quote via our interactive product selector which you can access on our homepage here - www.hif.com.au I hope that helps Karen, but if you have more questions please don't hesitate to ask. You can email me directly anytime on social@hif.com.au. Kind regards, Kelsey (HIF Digital Marketing Consultant).

I have been a member for over 20+ years and have top cover and would like to know what my benefits would be regarding dental as I will be requiring extensive work next year. On my medical records it outlines I have some osteonecrosis and because of this I will require some teeth taken out and porcelain veneers. I would appreciate knowing whether I am covered for this? Thank you
1 answer
Hi Naze, Thank you for your question. I can certainly confirm that for you, but I do need a little more information first though. Would you mind emailing me directly on social@hif.com.au with your HIF membership number, the applicable dental item numbers and your dentist’s charge per item number, that way I can complete a dental estimate for you and advise of any out-of-pocket expenses payable. Thanks Naze, and I’ll look forward to hearing from you soon. Kind regards, Kelsey (HIF Digital Marketing Consultant).

Hi, I'm going to attend a sleep school for my baby with a GP's refferal, which involves admission to a hospital (mum and baby). Baby and I have the most basic hospital cover (member#117868). How much does this plan cover the cost of sleep school? Thanks.
3 answers
Hi AYS, Thanks for your enquiry. Sleep school may be claimable on your policy provided we have a contract in place with your chosen hospital and your baby is admitted to hospital as an inpatient (e.g. he is admitted into an approved hospital or day facility, allocated a bed and then discharged following the treatment). As some out-of-pocket expenses may be incurred though, we always advise our members to provide HIF with an itemised medical estimate prior to being admitted to hospital. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. Your doctor at the sleep school will be able to provide you with that estimate so once you have a copy, please feel free to send it directly to me on social@hif.com.au and I’ll ensure a medical benefit estimate is generated for you as a matter of priority. In the meantime, it’s important to note that your Hospital Cover does have an excess of $200 per person per year, so you will need to pay that for both yourself and your baby on this occasion as you’ll be admitted to hospital together. I hope that helps, AYS, but if you have any further questions please do not hesitate to ask. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)Hi AYS, I am considering sending my wife and non sleeping bub to sleep school as you have. Your situation seems exactly the same as mine. How did you go? Did HIF cover anything? I also have basic hospital cover. Did it work? Regards, DanielHi Daniel, Yes they covered all for my bub except for the excess of $200 I had with my policy. They didn't cover my expense because my bub was the patient and I was the boarder, which I think is reasonable. So I only paid for my bed. All in all I was happy with their cover.

Does my membership (5213) cover me for laser eye surgery
1 answer
Hello Peter, Great question! None of our policies cover laser eye surgery at the moment, but I'll pass your query on to our internal Product Review Committee for further consideration. If you ever have questions about your membership in the future, Peter, please don't hesitate to contact me direct. You can email me on social@hif.com.au and I'll be happy to assist with any queries or action requests. :) Thanks and kind regards, Maureen Teague (HIF Digital Consultant)

I have some codes from my dentist so that I may obtain how much I would get back from HIF on my claim should I go ahead with the procedure Code 661 Code 672 code 688 Do you have a preferred Dentist in WA? that would give me maximum rebate?
2 answers
Hi Sharon, Thanks for getting in touch. I can certainly provide you with a dental benefit estimate but I'll need a little more information first, so please email me on social@hif.com.au and we can go from there. If you’re already an HIF member, please also include your member number in the email so that I can review your current policy. In terms of preferred dentists, we don’t actually have ‘participating provider’ lists like some other funds promote. Instead we want our members to have total freedom of choice when it comes to the providers they use (while still receiving great rebates), so as long as the dentist you choose is legally qualified to practise in Australia, they'll automatically be covered by HIF. The same goes for other Extras service providers like physios, chiros, opticians and so on. More details on that are available here in case it's useful: http://www.hif.com.au/health-insurance/information/pick-your-own-provider.aspx. Thanks Sharon, and I’ll look forward to hearing from you soon. Warm regards, Kelsey Donnelly (HIF Digital Marketing Consultant)Hi Kelsey apologise I forgot to put my membership number that always helps! My number is 17874 Thank you Sharon Hillier

Hi there, I'm on intermediate working health cover with extra saver. I would like to undergo some routine health check. Do you have a list of doctors that work with Hif, or do you have any routine check up included yearly in the cover? Thank you
1 answer
Hi Michela, Thanks for getting in touch and please accept my sincere apologies for the late response, it appears that we didn’t get a notification for your message. Regarding routine health checks, a yearly check-up isn’t a listed inclusion on our Overseas Visitors Hospital & Medical policies, but your Intermediate Working Visa Cover does include a $500 annual limit which you can access to claim on outpatient services each year. This means that you can make an appointment with any GP you choose, and they will be able to perform a routine health check for you (which you can then claim on your HIF health insurance policy). Your Saver Options Extras Cover also gives you total freedom to choose your own healthcare providers, so you can use any dentist, optician, physiotherapist, chiropractor, osteopath or other type of provider that’s covered by your HIF policy. Our only requirement for the providers you choose is that they must be legally qualified to practise in Australia. More information on this can be found here: http://www.hif.com.au/health-insurance/information/pick-your-own-provider.aspx I hope this helps Michela, but if you have any further questions please don’t hesitate to ask. You can also email any future queries to me direct on social@hif.com.au and I’ll be happy to assist. Kind regards, Nikki Dale (HIF Digital Manager)

Hi! I would like to ask if the Mandibular advancement splint, a sleep apnea treatment, will be covered by hif?
1 answer
Hi Grace, Thanks for your question. Regarding the Mandibular Advancement Splint, I just need a little more information from you please. Do you mind sending a quick email to me on social@hif.com.au and confirm if a dentist will be providing this service and what the applicable item number is? I’ll then be able to provide some clarification on that. If you’re planning to undergo any hospital, medical or major dental treatment, we always recommend that you contact us in advance with an itemised estimate from the doctor, specialist or dentist. That way, we'll be able to confirm all the benefits you can claim and help you to ensure any out-of-pocket expenses are kept to a minimum. In fact, you can request a benefit estimate for any Hospital or Extras service you like, and we'll be happy to advise you of the rebates payable. :) Did you also know that we pay benefits on sleep studies providing you are admitted to a sleep clinic as an inpatient? If you'd also like more information on that, please let me know. I hope that all makes sense Grace, but if you have any other questions please don't hesitate to ask. Kind regards, Nikki Dale (Digital Manager)

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