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HIF (Health Insurance Fund)

HIF (Health Insurance Fund) (page 2 of 5)

3.1 from 98 reviews

Excellent Customer Service

I really love the customer service from this company. Short wait times and speak with representatives who communicate clearly and effectively. I have used the cover for hospital stays and have found claiming to be really straightforward.
My only issue is that the cost of my same level of cover has doubled in the 6 years I have been with them.

Insurance claim madeYes
1 comment
Hi L, Thank you for your review, that’s wonderful to hear! I really appreciate you taking the time to share such terrific feedback. If you ever have queries or need assistance with your HIF policy in the future, please don't hesitate to chat with me directly. You can email me any time on social@hif.com.au. In the meantime, I will share your message with the whole team here as they love to read positive reviews like this. :) Thanks and warm regards, Kelsey Donnelly (Digital Marketing Consultant)

I am very disappointed with this service I really need to visit a doctor and this company cannot ans

I only need more contact with people to get information and there no available phone or no one answer me in an emergency moment. The customer support is awfull, I will coment more information when I solve my problem

Insurance claim madeNo
1 comment
Hi Hector, I'm really sorry you've had this experience today! Our call waiting times are currently less than five minutes though, so I’m not sure why you had such a long delay. In the meantime, I’d like to ensure your query is resolved asap, so would you mind emailing your full name and member number to social@hif.com.au. I'll then be able to locate you in our system, and ask one of our consultants to call you immediately. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)

What am I actually covered for? - No one can tell me

Signed up for maternity cover and called asking for more details regarding maternity and costs ect.
So sick of this insurance company being evasive and not answering simple coverage questions. "What will my policy cover, what won't my policy cover (maternity related), how much will a stay cost me.."
Couldn't even give ball park estimates.
I did have BUPA insurance and claimed more than once for hospital visits with only minor issues.
HIF is a classic example of what is wrong with our health insurance system.
I have sent a few emails regarding my upcoming use of maternity and still the only response i get is "we can put an estimate together if you have item numbers and provider numbers." My Dr isn't interested in going through all the possible item numbers and said don't bother.

I also claimed for extras and that has also been difficult with more paper work and longer time frames than I am used to from previous insurers.

Insurance claim madeYes
1 comment
Hello Amie, Thank you for providing this feedback and please accept my sincerest apologies for your experience so far. We pride ourselves on delivering excellent customer service, so this is certainly not how we want our members to feel. If I may, I'd like to investigate your recent interactions further. Please can you email your HIF member number to social@hif.com.au, so I can review your membership in detail and escalate this to our Member Services Manager Manager for immediate review? In the meantime Amie, it’s important to note that medical providers can charge whatever they like for their services. Health insurers however, are only permitted to pay a benefit based on the Government’s Medicare Benefit Schedule (MBS) - this is a schedule of fees set by the government for standard medical services which determines the amounts that Medicare define to be a fair charge by a doctor or specialist. If your doctor charges within the MBS, Medicare will pay 75% of the doctor's fee up to the pre-defined limit, and HIF will cover the remaining 25%. In some circumstances though, doctors will charge above the MBS limit and in those cases the member must unfortunately cover the gap themselves. This is why we always strongly advise our members to obtain a list of charges from their doctor before undergoing any procedure. It simply ensures that you’re fully informed of any potential out-of-pocket expenses that may incur and the benefits payable by HIF in advance. At HIF, we also have a "gap cover" arrangement in place called “AccessGap”, which encourages medical providers to limit their fees so they do not exceed the amount that Medicare deems to be a reasonable charge for that service. Doctors in Australia can nominate to opt in or out of AccessGap though, which is another reason why we advise our members to ask their doctor or specialist to treat them under our AccessGap arrangement. In case it helps more information (including a list of key questions for your doctor) can be found here: https://www.hif.com.au/health-insurance/hospital-cover/accessgap-specialists.aspx Once again Amie, I’m really sorry that you feel disappointed with HIF, but hopefully we can get this resolved for you ASAP. Thanks and kind regards, Molly Kelly – Digital Marketing Team Leader

Terrible huge increase in Premium

It was reasonable on the first year, and thereafter, the premiums kept going up at ridiculous rates, from $2343 a few years ago and to $2963 now!! I wrote to enquire if there can be any discount from my annual premium. They told me to downgrade to another policy, which is suitable for young women with IVF, maternity & pregnancy benefits. I am a 64 years old man, not a young woman starting my family of babies. I am now looking around to switch back to my other fund.

Insurance claim madeNo
1 comment
Hello Fran, I’m really sorry you feel that way but we do appreciate your feedback, and hopefully I can help to provide more context around this year’s premium increase. As a not-for-profit, member-owned health fund, we don’t enjoy raising our premiums either; but I’m afraid it’s necessary to do so each year in order to address rising health related expenses such as increased doctor charges, advanced medical technologies, increases in member claims frequency, and more. In 2015/16 for example, 95 cents of every dollar we received in member premiums went straight back out in claims benefits, compared to the average across health funds of 86 cents. And this compares to 67c for property insurance and 62c for general insurance. Since 2010, we’ve also implemented the lowest total average premium increase over the past eight year period (more info on that is available here: www.hif.com.au/premiums2017). So although it may not feel like it right now, please rest assured that we are doing our very best to keep a tight lid on our members’ premiums as far as the healthcare sector will allow. Regarding your comment around maternity and pregnancy benefits, I completely understand why you’re thinking like that, but consider it this way - a 70 year old man has a higher risk of need expensive medical treatment in the near future compared to a younger woman who is more likely to require maternity services - so the premiums balance out based on needs. For example, the highest claim we paid last year was $140,000 for a member in the 70-80 year bracket. In comparison, maternity claims cost much less (on average ranging from $10,000 - $15,000). It's also important to remember that your private hospital insurance policy covers you for thousands of different treatments and procedures - essentially anything that has a Medicare item number attached, and isn't specifically listed as a restricted or excluded service on your policy. We do list services like maternity on our product comparison table as it’s simply a popular service, but there are many other items that aren’t listed initial but that members can claim on when their health requires it. For example, I'll never need to claim on a male-oriented procedure such as prostate cancer treatment, and I'm not a smoker either so that (hopefully) reduces my risk of needing lung cancer treatment one day - but my own policy covers those services anyway because they're also covered by Medicare. :) Fran, if there’s anything I can do to ease your concerns further, please don’t hesitate to email me any time on social@hif.com.au. I can also arrange another policy review for you if that would help to assess your current premium and associated benefits? I do hope you decide to stay with HIF anyway, and please remember that I’m always here to chat if you ever have questions or need assistance. Warm regards, Kelsey Donnelly (Digital Marketing Coordinator)

AVOID at all costs - because you'll be the one wearing the costs - sellers of JUNK insurance

AVOID these bandits. I would give -5 stars if it was possible.
When you hear of insurers being under fire for selling 'JUNK' insurance policies HIF is mostly likely one of these insurers. I was recently advised I needed to have a basic, minor, common surgery - i was gobsmacked to find the junk policy HIF had sold me did not even cover this basic surgery, the only person more surprised was my GP when I told her i would not get any coverage. She was shocked at how 'terrible' the policy was since most insurers at the most basic level provide coverage for this surgery.
Moral of the story: AVOID HIF! And unlike me - don't find yourself circa $7000 out of pocket because of these bandits.

It is timely that the Federal Government is reviewing the incidence of junk health insurance sellers - hopefully HIF is under close examination with their highly questionable practices and product offerings. Reforms are urgently needed in this sector, and HIF is a contributor to these massive problems.

Insurance claim madeNo
1 comment
Hello Andrew, Thank you for your review. I understand that you’re disappointed with the outcome of your recent claiming experience. Our GoldVital Hospital policy was created in response to significant demand from younger consumers who consider themselves fit and healthy, and just need basic private hospital insurance to ensure they’re covered in case an accident happens. Essentially, in order to pay a much lower premium, they were happy with a lower level of cover. HIF offers five Hospital Cover options (ranging from basic to top coverage) and we’re very keen to ensure all members are fully aware of what’s covered on the policy they choose. That’s why, when you purchased GoldVital Hospital Cover online, your policy was described as follows: “GoldVital Hospital is available to singles and couples who just wish to be covered for vital medical treatment for accidental injuries. GoldVital also covers the surgical removal of wisdom teeth, tonsils, adenoids and appendix, along with minor gynaecological procedures. Plus, GoldVital is excellent value if you want to save tax by avoiding the Medicare Levy Surcharge.” We also have a dedicated web page for this policy (and all other policies) which details all the inclusions, exclusions, restrictions and other conditions relating to GoldVital Hospital Cover. For your reference, that link is: http://www.hif.com.au/goldvital In addition, all HIF members are sent a ‘Standard Information Statement’ (SIS) at least once a year. These SIS documents are a federal government requirement for all health funds, and they clearly detail what is and isn’t covered on a member’s specific policy. I’ve just checked the last SIS document we posted to you in December 2016, and for your GoldVital Hospital policy it states, “This policy only provides full benefits for joint reconstructions and investigations, removal or tonsils, adenoids, appendix and wisdom teeth in a hospital, and same day (no overnight stay) minor gynaecological procedures. It also covers hospital treatment in the event of an accident.” As a not-for-profit health fund, our members’ health and happiness is always our number one priority. We also have one of the highest claims/benefit ratios in our industry; for example, in the 2016-17 financial year, we paid out 95 cents in claims benefits for every dollar received in member premiums (the industry average was 86 cents for that period). I’m afraid we just can’t pay benefits on a member’s medical procedure if their chosen policy doesn’t cover it. I hope this helps to provide more clarification on our claims assessment process, Andrew, but if you have more questions or feedback please don’t hesitate to email me on social@hif.com.au. In the meantime, I hope you have a speedy recovery and feel better very soon. Kind regards, Nikki Dale (HIF Digital Manager)

Overall very happy with HIF

My husband and I transferred to hif from one of the major health funds due to massive price increases every year. We find hif to be very competitively priced and we like that it is a member's own fund, not a for-profit fund. When I have called, I have found my calls to be answered quite quickly. Lodging an extras claim through the app takes a few weeks to be paid, but I don't find that to be a major issue. I love that I can claim through an app....previous health fund did not even have this capability! Had to post it in or go to a branch. Very happy and have already recommended hif to a friend who joined up.

Insurance claim madeYes
1 comment
Hello Di W, Thank you so much for this wonderful review. We’re very proud to be a not-for-profit health fund, so to hear feedback like this really does make our day. I’m also delighted to hear your comments regarding our mobile app and that you’re recommending friends to HIF too. I hope they mentioned your name at the time of joining, as you'll receive a bonus $70 eftpos gift card for each new member you send our way as a thank you. In the meantime, if you ever have a query regarding your HIF policy, please don't hesitate to email me direct. You can reach me any time on social@hif.com.au Warmest regards, Maureen Kelly (Digital Marketing Consultant).

Simple question on amount claimable, difficult process

I rang the office today and the wait time as usual was unacceptable. seems still a staffing problem ??
all i required was a verbal estimate of the amount i expect to receive back after a pathology procedure. verbally i gave hif the provider no-, item number, and the pathology dr;s account amount $. impossible to receive any indication of the refund amount ?. no i have to send into the hif the account and a hif claim form also the medicare form to have it assessed.!!! What if there is no rebate !! all this posting etc for nothing its a big thing for older people to do these things while it would have been so simple to say sorry there is no amount claimable, or yes you could expect about x amount $ refund on your policy and that item number you are claiming...
Lets get with it. Is It so hard to give people a indication of there refund amount>
getting very dis- satisfied.

Insurance claim madeNo
1 comment
Hello Mr Hartman, Thank you for your review, and once again please accept my sincerest apologies for your recent experience. As per our private conversation, I’m delighted that we were able to resolve this query for you last week. If I can ever be of assistance with your membership in the future please don’t hesitate to contact me directly anytime on social@hif.com.au and I’ll be happy to assist. Thanks again, Kelsey Donnelly (Digital Marketing Coordinator)

LONG wait times for claims

Spoke to HIF today 2/06/2017 and asked about my dental claim I lodged with smart claim on Monday a week ago. I was told it would take less then 5 business days. It's been longer then that, and was told HIF couldn't even find it in the system yet!!!! So I was told to lodge it again online. So i have lodged two claims for the same claim, to be told your so busy at the moment with claims.... this is always the case! Anytime I lodge I get the same excuse - we are just very busy at the moment.
I'm really disappointed and asked if it could process over the phone as it isn't my fault why I had to wait so long seeing as I normally use HICAPS but your system was DOWN on the day I used it so I had to pay the full amount which is alot of money. Now I'm waiting on my money back asap.

Really disappointed and am looking at changing health funds if this is going to be an ongoing occurrence.

March 14th 2018 Update: Seen the no pregnancy cover advertised on product review rang to join but not allowed!!

I am extremely disappointed and upset and feel HIF are advertising a product that not everyone is able to join!
I am a current member of HIF and am looking to leave now after many years due to the price increase - then discovered the new no pregnancy cover with MID extras and i thought bonus! we are a young family struggling to afford health insurance in general and i called up to join this new cover and was told we can't because we have children already?
I find this extremely discriminative - i have had a hysterecthemy and am no longer able to have children due to a medical issue and to be told i can't have this cover that includes no pregnancy is a insult and unfair.
I am looking at moving covers due to the fact you are unable to offer me this cover you are advertising everywhere yet you don't say that is was not available to me!
SHAME on you HIF!!!!

Insurance claim madeYes
1 comment
Hi there, Thank you for your review and for your email to social@hif.com.au. As discussed, I’m really sorry to hear about your recent claiming experience. The month of June is admittedly a busy period for us, however you’ll be happy to hear that we have recruited additional staff members to ensure we’re able to manage the backlog and return our claims processing time to our usual 3-5 working days. In the meantime, I’ve just sent a reply to your email this morning regarding your dental claim, which I hope will help to alleviate any concerns you may have. If I can be of any further assistance though, please do not hesitate to reply to me directly and I’ll ensure any other queries are resolved as soon as possible. Thanks and kind regards, Maureen Kelly (Digital Marketing Consultant)

Long wait on the phone

Called today to discuss my policy, waited 18 minutes to finally talk to someone. Just to be told it was a peak period, this is the second time this has happened. Perhaps you may need to review staffing levels in order to improve customer sercive delivery. Definitely should have looked ALL of the below reviews prior to signing up. Unacceptable customer service.

Insurance claim madeNo
2 comments
Hi Jess, I'm really sorry you've had this experience today! Our standard call waiting time is 3-5 minutes but I'm afraid we've been under the pump this week. You'll be pleased to hear that we've just hired more staff though, and we're doing our best to get waiting times back to normal as soon as possible. If you ever need to chat about your membership in the future though, please don't hesitate to email me on social@hif.com.au and I'll personally refer your query to the relevant department as a priority matter. Thanks and warm regards, Nikki Dale (HIF Digital Manager)Just some feedback for you. I called again today on hold for 17 minutes prior to talking to someone.

WAITING TO LONG ON THE PHONE

I transferred to HIF from HBF a few years ago but now I'm wondering why?
Today I rang HIF and I was put on hold for 14 minutes 47 seconds with a recorded message apologising for the delay. This is totally unacceptable and this never happened when I first joined. The service at that time was great, but waiting l4 minutes is just not on. The polite lady who eventually did answer also apologised and I said then HIF need to employ more staff to answer the phones. It better not happen again or I'm moving on once again.

Insurance claim madeNo
3 comments
Hello Dee, Thank you for your review, and please accept my sincerest apologies for a less than satisfactory experience with HIF on this occasion. This is certainly not how we want our members to feel, but please rest assured that our usual call waiting time is only 3-5 minutes and our team is working hard to return this to normal as quickly as possible. Dee, did you manage to resolve your query when you spoke to one of our consultants yesterday, or would you like me to schedule a call-back for you this afternoon? If there’s anything else I can help with too, please let me know and I’ll be happy to assist. In the meantime, please know that you’re always welcome to email me on social@hif.com.au if you ever have queries about your membership in the future. :) Kind regards, Kelsey Donnelly (Digital Marketing Coordinator)The consultant did answer my query very well. Thank you.That's excellent to hear Dee, thanks for letting me know. Kind regards, Kelsey.

They know how to take the money just not how to pay it.

I submitted my Claim over one month ago and have not been paid. The lady I spoke to said that was normal and nothing she could do and it would be another 2 weeks because of how busy they are. With the amount of money we pay and the premium increases every year, the service is along way from being satisfactory. Maybe we should be able to not pay our premiums until our claim has been paid. There is nothing you can do, than just wait until they are ready to pay you.

Insurance claim madeYes
2 comments
Hello and thanks for your review. I'm really sorry to hear you're still waiting for a claim to be processed and I'd love to resolve this for you quickly. In order for me to follow up the current status of your claim, please email your HIF member number to social@hif.com.au, then I can escalate your concerns immediately. Warm regards, Nikki Dale (HIF Digital Manager)I have been contacted by HIF and they have apologised and sorted this issue out immediately. The phone call from the HIF representative was a breath of fresh air and I was happy with his actions.

Always have problems with claim delays

I always find claiming through the app results in delays in the benefit being paid. Five plus days to process a claim and when I email about it I get a response about an old claim.

It happens every time and it's extremely disappointing because rebate is great but this is frustrating. You really need to look at your turn around time and response to queries.

Insurance claim madeYes
2 comments
Hi Monica, Thanks for getting in touch today and please accept my sincerest apologies for the delays you’ve encountered recently. I’ve just investigated this for you and it appears that our Benefit Services Team are experiencing a large volume of claims at the moment which has unfortunately caused a bit of a backlog. Please rest assured that they’re working hard to return claim processing times to our usual 2-3 working days though, and in the meantime please feel free to forward your latest confirmation email to me on social@hif.com.au and I’ll personally ensure your claim is processed as a matter of priority. Warmest regards, Kelsey Donnelly (Digital Marketing Coordinator)thanks for the response and I have sent you my claim. This backlog happens quite often though. So I think a system review is required especially since premiums go up each year yet rebates don't.

fantastic rebates on optical

I just took the family for an annual eye check. I was amazed when told by spec savers that HIF had paid the lot and that I didn't have any OP expenses! that's a pair of reading glasses each and a pair of stylish sunglasses!! HIF you rock! thank you so much !!!! I will definitely recommend you to my f&f.

Insurance claim madeYes
1 comment
Hi Channa, Thank you for taking the time to share this wonderful feedback, it’s fantastic to hear you’ve had such a positive claiming experience with HIF. I will share your review with our Member Experience Manager and our Claims Team as I’m sure they will be thrilled to read this too. In the meantime, if you ever have membership queries or need assistance in the future, please don't hesitate to email me direct. You can reach me any time on social@hif.com.au Warmest regards, Kelsey Donnelly (Digital Marketing Consultant).

Not happy about service!!! was kept waiting on the phone for over 30mins before I got a response.(I

1.We have found the policy ok for us at this stage in our life and also quite easy to set it all up. Customer support however needs to be looked at.

Insurance claim madeNo
1 comment
Hi there, Thank you for taking the time to post this feedback, I'm pleased to hear your joining experience was a positive one, however it’s disappointing to read your comments regarding our telephone lines. Please rest assured our usual call waiting time is 3-5 minutes, so I do apologise for the longer than usual wait on this occasion. If there’s anything I can assist with in the future regarding your membership, please feel free to contact me directly on social@hif.com.au and I’ll be happy to direct your query to the relevant department. Warmest regards, Kelsey Donnelly HIF – Digital Marketing Consultant.

Unwilling to cooperate

Having been alerted by the comments that follow, HIF customer support rectified their error within hours. This is pleasing and I have changed the star rating accordingly. Just a pity the first point of contact did not yield the same result:

I have been left extremely frustrated by HIF's lackadaisical approach to my predicament. I am signed up to HIF's 'Super' options and recently paid for two months cover up front to take advantage of paying the lower rate before their premium increased. Today, with a rare day off scheduled tomorrow, I decided to book an appointment with the dentist. I then went into HIF's member area online to discover that as far as HIF are concerned, my membership is due for renewal today. This means it will be overdue tomorrow, the day of my scheduled visit. This means my HICAPS claim will not be honoured. Obviously flawed as I have paid upfront for another two months down the line. Having double checked my bank transactions, this was confirmed. I then contacted HIF only to be told to send them an email notifying them of the issue and that it would likely be looked at within a few days. In spite of explaining that it was a matter of urgency given my appointment tomorrow, they could not look into the matter right away. Why? It is their fault and it should be a fairly straightforward procedure. One would imagine they would accept that the onus would be on them to investigate the matter immediately. I am a father working 50 to 60 hour weeks. Days off are rare and the opportunity for dentist appointments rare. I will now have to cancel my appointment and waste very precious time off proving to HIF that I have indeed paid them for the forthcoming two months. Not happy HIF. Just the sort of incident that makes people start shopping around for insurance funds that treat their customers with a little more respect.

Insurance claim madeNo
1 comment
Hello again Jason, Thank you for taking the time to adjust your review, we really do appreciate it. I’m delighted to hear that we were able to resolve your query so quickly and I hope your visit to the dentist went well today. As I mentioned in my reply to your Facebook comment, please feel free to contact me directly on social@hif.com.au if I can ever be of assistance in the future regarding your membership – I’m always here to help. Warmest regards, Molly Teague (HIF Digital Consultant)

Best value my circumstances

I rarely write reviews about things but felt the need to write a positive one about HIF. After being fed up with the lack of value I was getting from BUPA and the increasing restrictions of which health providers I could see, I contacted a third party health insurance reviewer and whilst reluctant to go through the process, I am actually glad the operator found HIF for me.

I have had no issues with HIF since signing up, all my waiting periods were matched and I have received more value from HIF than I would have ever done with my previous fund. There are rarely any 'preferred' providers which allows me to choose which health professionals I would like to see. I have only ever once had to call customer support and whilst there was a long wait via telephone (I rang late on a Friday afternoon!), I eventually ended up emailing their team and got a prompt response.

My disclaimer is that for the specific extras I use and because I do not need extensive hospital cover, I have only good things to say about HIF. Their claiming system is extremely easy and rebates get deposited electronically within a few days.

Admittedly the increase in premiums for the upcoming year were a bit steep but I have chosen to prepay for the next few months which saves me some money. Whilst still happy with HIF, I do research regularly as to what other health funds are offering and I am yet to find a better policy for my life circumstances at this point in time.

Insurance claim madeNo
1 comment
Hello Fmyt, Thank you so much for taking the time to leave such a wonderful review, especially as you rarely write them. As a not for profit health fund, we pride ourselves on providing a great experience to all members, so to hear such terrific feedback has really made our day. With regards to ‘preferred’ providers, we want members, like you, to have total freedom of choice when it comes to the providers you choose, so as long as your providers are legally qualified to practise in Australia, please rest assured they'll be automatically covered by HIF. 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 In terms of our premium increase for 2017, we don’t enjoy raising our premiums either. However, I’m afraid it was necessary to do so this year in order to address rising health related expenses such as increased doctor charges, advanced medical technologies, increases in member claims frequency, and more. As a new member though, you may be interested to know that since 2010, we’ve implemented the lowest total average premium increase over the past eight year period. So although this year’s increase was higher than usual, we always do our very best to keep a tight lid on our members’ premiums. In case it helps more useful information and FAQs about this year’s premium increase can also be found here: www.hif.com.au/premiums2017 Once again, Fymt, thank you very much for your kind words and if I can ever be of assistance in the future regarding your membership, please don't hesitate to email me direct. You can reach me any time on social@hif.com.au Warmest regards, Molly Teague (HIF Digital Consultant)

Excellent Customer Service.

Excellent value, easy to set up, unbeatable Customer Support. Would highly recommend HIF. Was recommended to us by a third party Health Insurance reviewer and moved across after almost 15 yrs with another provider. Claim submitted and paid seamlessly. Customer service second to none (after a considerable wait but first thing consultant did was apologise for the wait). Overall, extremely professional.

Insurance claim madeYes
1 comment
Hello Ms TB, Thank you for your wonderful review, I’m delighted to welcome you to HIF. We pride ourselves on providing excellent customer service, so to hear feedback like this really does make our day. I am sorry to hear that you had a considerable wait recently though; as April 1 is fast approaching our phones lines are busier than ever with members wishing to pre-pay their premiums. Please rest assured though that we are working hard to ensure our call queue times return to normal. In the meantime, if I can be of any further assistance regarding your membership, please do not hesitate to contact me directly on social@hif.com.au - I’m always happy to help. Best wishes, Kelsey Donnelly (HIF Digital Marketing Consultant)

Customer service unreachable

30 minutes waiting over the phone with annoying ads and then it dropped. No "leave your number and we'll call you back" service. Email not replied within 24 hours. Apparently they've got now loads of clients and became unreachable :(

Insurance claim madeNo
3 comments
Hello Dmitry, Thank you for getting in touch and please accept my sincerest apologies for any disappointment caused by our phone lines today. We’re admittedly encountering a significant increase in calls (and emails) in the lead up to April 1; however please rest assured that we are reachable and are working tirelessly to ensure our standard call (and email) wait times are returned to normal. In the meantime, I’d like to ensure your query is resolved asap, so would you mind emailing your full name and member number to social@hif.com.au. I'll then be able to locate you in our system, and ask one of our consultants to call you immediately. Thanks and warmest regards, Molly Teague (HIF Digital Marketing Consultant)The simple option of calling back would help a lot saving your clients time, if you only cared a bit more.I’m sorry we let you down Dmitry. One of HIF’s core values is “Care” and we strive to provide great service at all times so I’m disappointed that you’ve had this experience on this occasion. Unfortunately March is a very difficult time for all health funds as the Federal Government only allows us to increase our premiums on April 1 each year, and we can only notify our members once the Minister for Health has made their annual public announcement. This leaves a relatively short space of time between members being advised of their new premiums and the date the new premiums will apply, which is why all health funds encounter large volumes of calls and emails in these final weeks of March. And given the complexity of private health insurance, it’s not easy to sufficiently train additional staff to answer queries for just a few weeks each year. Ideally it would be great if we had the flexibility to stagger our premium increases as general insurers do, by issuing renewals on policy anniversary dates and therefore ensuring member enquiries remain steady through the year. Sadly, health funds don’t have this option. This challenge aside, we are focused on efficiently serving all our members via phone, email and social media. We’re also constantly exploring ways to better serve our members in this very busy March period, as we do understand the frustration our members feel when they have wait an extended amount of time to speak to a consultant. If you’d like to chat to our Member Service Manager about your recent experience, Dmitry, please let me know and I’ll ask them to get in touch with you. In the meantime, please remember that you’re always welcome to email me direct on social@hif.com.au if you ever need assistance with your membership in the future. :) Kind regards, Molly

Massive premium increase

I've been a member with HIF for a few years now. This is the first year where there has been such a massive increase in premiums. My premium has gone up by 17% for combined cover! I understand that costs have gone up but the price increases are getting ridiculous. The excuse that price increases were limited years ago doesn't hold if you have to massively increase your prices in the following years. Better financial management would have seen these prices spread out over time. We're still also waiting for HIF to remove pregnancy cover from their premium products which they indicated years ago they would do to bring down the costs for those who have no intention of having children. This would be one way to reduce pricing for members.

Insurance claim madeNo
3 comments
Hello Chris, Thanks for your review. I completely understand how you’re feeling about your large premium increase and I apologise for any concern or dissatisfaction caused by this. Being a not-for-profit, we aim to keep our premium increases to a minimum as we don’t have to pay dividends to shareholders and only exist for the benefit of our members. In the last financial year though, for every dollar we received in premiums, we paid out 95 cents in benefits compared to an industry average of 86 cents and a general insurance average of 62 cents. So you can see, there is not a lot of margin in our pricing this year. Significantly though, with the rising costs in health care and the different costs between states, we identified some areas where the hospital claims we’d paid exceeded the premiums we’d collected in the same period, so this needed to be adjusted. I understand that you believe those adjustments should have started earlier, and our premiums should have been higher sooner, but we’ve worked hard to keep the premiums low for as long as possible; it’s simply something we have to balance. Our priority is always our members and we have to balance best value-for-money against premiums and benefits paid, and this year it was unfortunately necessary to implement a (one-off) higher increase in some areas to restore that balance. Even with this year’s increase though, we believe that our prices will still be very competitive in the market, as historically, our premiums have been significantly lower than those of comparable products with other funds, especially on the Eastern Seaboard. Chris, I do understand that affordability is critical though, especially at this time of year, and it’s not just about pricing competitiveness. Can I get one of our consultants to contact you to see if there is a cover to better suit your circumstances? Just email my team on social@hif.com.au if so and we can organise that for you at a time that suits. In terms of excluding maternity, we have been modelling products but so far we’ve found that the difference in costs would actually be very minimal, which I don’t believe would be your expectation. One factor in this is that health insurance is ‘community rated’ which means we can’t charge more for higher risks. The principal of community rating prevents private health funds from discriminating between people, and underpinning community rating is ‘risk equalisation’ which spreads the costs of older policyholders and the most expensive claims across all health insurers. Essentially, for every adult insured in each risk equalisation jurisdiction, all health funds contribute the same amount to the risk equalisation pool, no matter what level of cover they are on, what they are covered for or how much premiums they are paying. More information on that is available on our knowledge base here if it helps: http://www.hif.com.au/help/government-legislation/what-is-community-rating-and-risk-equalisation.aspx The other key factor to consider with private hospital insurance is that most people are covered for things that they will never use (like car insurance, the best possible outcome of having hospital insurance is to hopefully never use it). Your private hospital insurance policy covers you for thousands of different treatments and procedures – essentially anything that has a Medicare item number attached and isn’t specifically listed as excluded or restricted services on your policy. We do list services like maternity in our hospital cover comparison table as it’s simply a commonly used service, but there are many other items that members can claim on when their health requires it. For example, I'll never need to claim on a male-specific procedure such as prostate cancer treatment, and I'm not a smoker either so that (hopefully) reduces my risk of needing lung cancer treatment one day - but my policy covers those services anyway as they're also covered by Medicare. I’m also covered for maternity yet my child bearing years are well and truly behind me. That said, we’re still reviewing the possibility of creating a hospital insurance policy that doesn’t include maternity because, like you, many people are asking for it nowadays. I hope that I've helped to provide more context now, Chris, but please don’t hesitate to get in touch if you would like to discuss this further in person. Kind regards, Anne Humphrey (Business Development Manager)As a follow up to my review, I have just been on the phone with HIF for 10 minutes waiting in a queue and only moved three spots. I want to change my policy but HIF make this a painful experience. It can take days to process. There is also no option to change policy in the online member centre or change payment frequency. If HIF know there will be a lot of calls at this time of the year, either put on more call centre staff or allow customers to make changes online. I am now considering cancelling my policy after this experience.Hi Chris, Thank you for taking the time to reply. I’m really sorry to hear that you’ve experienced a longer than usual wait time with our phone lines today, I completely understand how frustrating that can be. As April 1 is fast approaching we’re experiencing a significant volume of calls and emails with members, like you, wishing to review their policies or pre-pay their premiums. Please rest assured we are working hard to respond to all queries and calls as soon as possible. Regrettably though Chris, this is the busiest period of the year for all Australian health funds. The reason being the Federal Government only allows health insurers to increase their premiums on April 1 each year, so unlike general insurers who can stagger their increases throughout the year (and therefore spread the volume of calls) – we are unable to do so. In addition to this, the Government only allows health funds to notify their members once the Minister for Health has publicly announced this, which leaves a relatively short period of time to notify members of their new premiums and the date the new rates take effect. Considering that approximately 50% of the population has health insurance, the large volumes of calls and emails is unavoidable and makes it difficult for all health funds to respond quickly in this one intense period of the year. As health insurance is a complex industry too Chris, it’s unfortunately not easy to recruit and sufficiently train additional employees to answer queries for just a few weeks of the year. In terms of changing your level of cover online, I completely agree that this functionality should be available and it is something that we are working towards. In the meantime, please note that you do have the ability to update your payment frequency in our Online Member Centre. Simply visit www.hif.com.au/members, log-in and click on the “My Payment & Rebate Details” section. We would hate to lose you as a member, Chris, so please do let me know if you have been able to make the necessary changes to your policy. If not, please feel free to email your HIF membership number and the policy changes you’d like to make directly to my team on social@hif.com.au . Kind regards, Anne

HIF 2017 premium increase of 22.5% in April

A warning note to everyone on HIF 2017 premium increases. They are going up by a whopping 22.5%!!! I joined earlier this week having not been informed by HIF of their intension to increase their premiums by such an amount. Today I found out the truth and immediately cancelled my policy.
How has the Federal Govt allowed HIF to increase their premiums by so much?

Insurance claim madeNo
3 comments
Hello Beachgrob. Thanks for your review, and sincere apologies for any concern or confusion caused by our upcoming premium increase. An increase of 22.5% doesn’t sound quite right though, so I'd like to investigate this further if I may? In order to do so, please send your application reference number to me on social@hif.com.au and I’ll review this immediately for you. In the meantime, it’s important to note that as a not-for-profit, member-owned health fund, we don’t enjoy raising our premiums either; but I’m afraid it’s necessary to do so each year in order to address rising health related expenses such as increased doctor charges, advanced medical technologies and an increase in member claims. As an insurer, it’s crucial that we can always pay our members’ claims and that means the premiums have to be sufficient. For example, in 2015/16, for every dollar we received in premiums, 95 cents went straight back out the door in claims benefits. That's why HIF has one of the best premiums-to-claims ratios in the industry, compared to an average of 86 cents across other health funds; and in some states on the East Coast, we’ve actually been paying out more in hospital claims than we’ve been receiving in hospital insurance premiums. In fact, our latest annual report (available on hif.com.au) illustrates that in those particular states, our premiums are currently up to 30% lower than those of comparable products with other funds; so while this year's premium increase may be higher than previous years, it’s important to remember that this is coming off a much smaller base in dollar terms. That’s why, if you compare HIF against other health funds, I'm confidant that your post-April premium would still have been very competitive in the market. It's also important to remember that the Federal Government has also eroded your health insurance rebate again this year, resulting in a further reduction of the discount you'd receive off the price of your HIF policy (and therefore inflating your newly quoted premium above the amount that we initially increased it by). More information on that is available on our website here, along with other useful information and FAQs about this year’s premium increase: www.hif.com.au/premiums2017 With regards to our communications though, please can you tell me if you received any assistance from our Sales Team when joining, or did you apply online? The reason I ask is because a message about this year's premium increase is clearly highlighted on both our online joining form and the subsequent confirmation email, as it's important to us that our members are fully informed. If you joined HIF over the phone though, perhaps the increase wasn't properly communicated to you by the sales consultant, so I'd also like to investigate that for training purposes. I’m really sorry to hear that we’ve lost you as a member; however I sincerely hope that you'll reconsider your decision after reading my response. Should you still wish to leave HIF though, I’ll personally do all I can do to make the transition as smooth as possible for you. Kind regards, Kelsey (HIF Digital Marketing Consultant)How surprising that an insurance company would suggest that the client got it wrong and not them! And thanks for the apology but it is very difficult to see where you have actually done anything to apologise for as it was me that got it wrong! But maybe others might just think differently? On the 8/3/2017 at 2.18 pm (just after I signed up online) I received an email from HIF welcoming me to HIF and containing the statement "GoldStar Hospital (Excess 500/1000) - Couples Policy $2,750.65 per year". On 9/3/2017 you debited my credit card for this amount being for the period 13/3/2017 to 12/3/2018. On 9/3/2017 at 11.27 I received another email from HIF with an attached letter from Lauren Davidson containing the flowing statements; "Ongoing Standard Payment: $3,368.15 Frequency: Yearly" and "All you have to do to ensure seamless cover is to make a payment of $3368.15 which is due on 12/03/2018 for the period 13/03/2018 to 12/03/2019." Yes, I did pay before the 1st April and I did pay for the full year. So the increase that I will need to pay in 12 months time is $617.50 which when I went to school (all those years ago) equates to an increase of 22.449%! Of course you may have a different way of calculating the increase which will make it closer to the number you want the public to think you are increasing the premiums. On Receiving your 2nd email I immediately rang your contact number 1300 13 40 60 and expressed my deep concern at the increase. The lady put me on hold for a few minutes, when she returned she did NOT dispute the increase. I immediately cancelled my policy. What part of this information "doesn't sound quite right" to you??? It all came from you! Regarding your other comments ...... Yes, the Govts contribution has decreased. That will be about 1%. Or let's make it 1.5% so the increase is 21%. Oh well that makes all the difference! Yes I did communicate with your sales team - a total of 22 emails went back and forth over a week so that I could clarify some points. I even pointed out to your staff that Canstar had made a mistake on their website about your cover - I was actually thanked for that information. And yes I did get a quote from the sales team. And yes I did speak on the phone to one of your sales team just before I joined HIF online. None of the emails or the phone conversation indicated that the premium for my second year of membership would increase by 22.5%. Regarding your online system, I regret to inform you but there is nothing indicting what the actual new amount will be after 1st April. All you say is to 'get in touch'. As I had received a quote via email, anything out of the ordinary should have been reported to me then. If you think your system does indicate what my premium will be after 1st April I would love you to post a screen shot. This is a very serious deficiency in your online system as many of the other insurer's site that I visited (Medibank, Frank) clearly indicated, well before signing up, what the policy would cost after 1st April. No, the increase was not told to me in the "subsequent confirmation email". That email only indicated I would be charged $2750.65 for the coming year. It was not until I received the second email, 21 hours later, that I learnt that my premium would increase by 22.5% in the second year. I am happy to acknowledge ANY mistake I have made. I certainly hope you are prepared to own up to yours and tell the public about it. Of course, if you are increasing your premium by 22.5% or had intended to do so prior to me making this post, Maybe you should also come clean about that! I won't hold my breath waiting!!Hello again, Thank you for your response and for the information you’ve provided. I really appreciate you taking the time to write such a detailed account and I hope you’ll accept my sincerest apologies for making you feel like I was suggesting you were wrong in any way; that certainly wasn’t my intention. On the contrary, I actually thought that perhaps there’d been an oversight on our part as our average annual increase this year was 7.99%. That’s why I wanted to investigate this for you as soon as possible. I’ve now reviewed your membership and I completely understand why you’ve experienced bill shock; affordability is of natural concern to all health fund members at this time of year (myself included). And you’re absolutely correct that the premium for your chosen policy in NSW would have increased by 22.5% after April 1. The issue for HIF, however, can be seen in the ‘Underwriting Result’ data on page 12 of our annual report. The results detailed there were largely driven by our current pricing in NSW, VIC and QLD, where (as I mentioned in my previous response) our premiums are up to 30% lower than those of comparable products. That’s why a significant adjustment was required this year in order to ensure that the premiums received in the next 12 months are sufficient to cover our members’ claims, particularly in those states where the cost of healthcare is so much higher. As you joined us before April 1 and paid annually though, you were able to lock in the current premium until this time next year. That means that the increase you mentioned would have been applied to your policy at that point based on the April 2017 rate – so if you chose to stay with HIF after all, you could pre-pay for another 12 months at that rate next year, therefore ensuring you’re always ahead by avoiding the April 2018 increase (and so on). We do intend to have a much lower premium increase next year but as I mentioned above, this year’s increase was necessary in order to make that critical financial adjustment, ensuring that we remain a viable business for our members. I hope that our previous track record will reiterate that we only ever implement premium increases to the level that our financial reserves require though. For example, in both 2014 and 2015, HIF had the lowest average annual increase of all 22 publicly accessible health funds, and we’ll strive to achieve that result again for our members next year. For this year though, a larger increase was regrettable but essential. Regarding the premium increase information we provide on our online quote engine and sales confirmation emails, I apologise if my previous response wasn’t clear. You’re correct that the messages there don’t provide individual post-April prices, I simply meant that there is a standard notification which states, “Please note: the rate quoted here will increase on 1 April 2017. If you would like to make a saving by locking in the current 2016-17 rate for the next 12 months, please opt to pay for a year upfront and set your policy commencement date as 31 March 2017 (this can be done when you reach the Payment Details page). For more information, please visit hif.com.au/premiums2017. Alternatively, call us on 1300 13 40 60 to confirm your post-1 April premium.” As you mentioned, our current online system isn’t configured to display both pre and post-April premiums, but this is something we’re working on at the moment so that we can ensure that functionality is available next year. As such, I really appreciate your feedback on that issue and will forward your comments to that project team shortly. In the meantime, if there’s anything else I can do for you today, please don’t hesitate to ask. Warm regards, Kelsey

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Questions & Answers

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)

Has anyone had weight lose surgery with HIF any issues with claiming ?? I have Gold Hosp for nearly 12 mths !! These are some numbers and types of surgery I was thinking about { Below info from a clinic } Adjustable Gastric Banding: 31569 (previously 30511) Sleeve Gastrectomy: 31575 (previously 30518) Gastric Bypass: 31572 (previously 30512) also there is a new one called Laparoscopic gastric greater curve plication, .{ at the moment this one is not covered by private health cover but can Hosp and other services be claimed}??? Thanks any info will be helpful .
1 answer
Hi there, Thanks for getting in touch. With regards to weight loss surgery, this is certainly included on your Gold 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. 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. As you've provided those details above, please feel free to email me your HIF Membership number 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 get in touch. Kind regards, Kelsey Donnelly (Digital Marketing Consultant)

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