Overseas visitor health cover

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Overseas visitor
health cover
New to Australia? We’re here for you.
Contents
4
Who is overseas visitor cover for?
4
The benefits of HBF overseas visitor cover
5
Choose wisely
6
Choices to suit every body
8
Compare levels of cover
11 Your benefits at a glance
11 Accommodation benefits
12 Theatre benefits
12 Pharmacy benefits
12 Prostheses benefits
12 Medical benefits
13 Crutches and wheelchairs
13Rehabilitation
13Repatriation
13Ambulance
14 How to claim
We’re here for
overseas visitors
HBF is Western Australia’s
oldest and largest
health insurance fund.
For over 70 years, we’ve been providing
Australians with access to the best in
healthcare. If you are new to the country –
or thinking about moving here – we will treat
you as an Australian too.
Call us on 133 423 or visit a branch and we’ll
help you understand everything you need to
know about Australia’s healthcare system.
14 How soon can you claim?
15 Would you benefit from additional cover?
16 How to join HBF
16 Ways to pay
17 Exclusions on benefits
17Glossary
18 Will I be covered outside of Australia?
18 Will I be exempt from the Medicare Levy Surcharge (MLS)?
19 Your rights and obligations
21 Your privacy
3
Who is overseas visitor cover for?
Choose wisely
Most overseas visitors are not covered under the Australian Government’s Medicare program.
HBF overseas visitor cover provides health insurance for anyone living or staying in Australia for
an extended period.
To help you choose the right health insurance, here are a few reasons why HBF is different
to other health funds.
If you’re a visitor from a country Australia doesn’t have a reciprocal healthcare agreement with,
you won’t be eligible for health cover under Medicare Australia. This means you’ll have to pay
for any medical treatment you may need while in Australia – from a simple doctor’s visit to
major surgery.
To find out if you’re eligible for treatment as a public patient under Medicare Australia please
go to medicareaustralia.gov.au or call 132 011.
Even if you are eligible for Medicare, if you don’t have private health cover you’ll still need to
pay for:
• Treatment in a private hospital
• Treatment as a private patient in a public hospital
The benefits of HBF overseas visitor cover
HBF overseas visitor cover pays benefits for in-hospital and outpatient medical treatment
(on some levels of cover). So, without the worry of huge medical bills, you can concentrate
on getting better sooner.
We’re not for profit; we’re for
your health
As a not for profit business, we don’t have
shareholders to pay so we can focus on giving
as much back as possible to our members.
WA’s largest and most trusted
health insurer
We’ve been looking after the health
of Australians for over 70 years. Today
we’re the largest health fund in WA,
with over 900,000 members.
More satisfied members
HBF has over half a million members who
have been with us for more than ten years.
And we have fewer complaints made to the
Private Health Insurance Ombudsman than
any other fund, relative to our market share.
A personal visit in hospital
Our hospital liaison officers visit most
HBF members staying overnight in WA
Member Plus private hospitals. They can
explain your hospital cover and answer any
other queries you may have. So you have help
when you need it most.
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Partners in health and happiness
We’re here to help you live the happiest,
healthiest life possible. So as an HBF
member you have access to:
• Free fitness training sessions
Our free group training sessions are
held throughout the year in the Perth
metropolitan area and major regional
centres. Find out more at hbffitness.com.au.
• Discounted entry to HBF Run for a Reason,
presented by The West Australian
HBF members receive an exclusive
20% discount on the entry fee to our annual
fun run through the streets of Perth.
• Home, car and travel insurance discounts
Choose HBF for your general insurance
needs and enjoy great member discounts.
• Mobile personal health record
Pocket Health is an app that makes it easy
to keep track of your health info. Download
it from the App Store or Google Play or find
out more at hbf.com.au/pockethealth.
• Discounts on healthy community events
Receive discounted entry to triathlons
and running events. Find out more at
hbffitness.com.au.
• Friendlies benefits
HBF have partnered with Friendlies to
help keep you well with a range of health
services and 15% off everyday purchases
- with a few exceptions like already
discounted products and restricted
pharmaceuticals, health services and
products. Just show your HBF card at
any Friendlies pharmacy. For a full list of
services, visit friendliespharmacies.com.au.
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Choices to suit every body
We have four types of cover for overseas visitors.
Whichever you choose, you’ll benefit from:
• The choice of your own doctor when you’re in a private or public hospital as a private patient
• Unlimited urgent ambulance transport
• The option to avoid public hospital waiting lists by being treated in a private hospital, which
means you get the best available treatment as soon as possible
1. C
omprehensive Overseas
Visitors cover
2. Working Visa Hospital
and Medical cover
3. Working Visa Hospital cover
4. Standard Overseas Visitors cover
Around $57.451 per week
Around $38.802 per week
Around $24.003 per week
Around $24.554 per week
Comprehensive Overseas Visitors cover
gives you cover for a private hospital room
and comprehensive hospital cover for over
5000 medical procedures, including removing
tonsils and wisdom teeth, knee and shoulder
reconstructions, cancer treatment, maternity
and birth-related services, cataract and
eye lens procedures, heart treatment, joint
replacement surgery and psychiatric care.
Working Visa Hospital and Medical
cover provides cover for a private hospital
room and comprehensive cover for over 5000
medical procedures, including removing
tonsils and wisdom teeth, knee and shoulder
reconstructions, cancer treatment, maternity
and birth-related services, cataract and
eye lens procedures, heart treatment, joint
replacement surgery and psychiatric care.
Working Visa Hospital cover provides
comprehensive hospital cover for over 5000
medical procedures, including removing
tonsils and wisdom teeth, knee and shoulder
reconstructions, cancer treatment, maternity
and birth-related services, cataract and
eye lens procedures, heart treatment, joint
replacement surgery and psychiatric care.
This is the ideal cover if you’re a single, couple
or family visiting Australia and would like to
keep your premiums as low as possible by only
paying for services you’re most likely to need.
You’re also covered for out-of-hospital
medical treatment, such as a visit to a doctor
known as a GP, or general practitioner.
You’re also covered for out-of-hospital
medical treatment, such as a visit to
a doctor.
In the event of a substantial life altering
illness or injury or terminal illness, you’ll be
covered for benefits towards your transport
back to your home country.
Note: waiting periods apply before you can claim.
Please see page 14 for details.
Note: waiting periods apply before you can claim. Please
see page 14 for details.
This cover complies with the Department
of Immigration and Border Protection’s
minimum requirements for health insurance
under condition 8501, including visa
subclass 457.
For holders of working visas only, this
cover complies with the Department of
Immigration and Border Protection’s
minimum requirements for health insurance
under condition 8501, including visa subclass
457. Refer to page 9 for a full list of visa
types which are eligible for this cover.
Price based on WA rates for a single policy paid annually by direct debit and equates to $2,985.60 per year including GST.
Price based on WA rates for a single policy paid annually by direct debit and equates to $2,016.00 per year including GST.
Working Visa Hospital has a $300 excess,
which helps keep the premiums as low as
possible. You’ll only pay the excess if you stay
in hospital overnight and only once per adult
member per calendar year.
Note: waiting periods apply before you can claim. Please
see page 14 for more details.
For holders of working visas only, this cover
meets the Department of Immigration and
Border Protection’s minimum requirements
for health cover under condition 8501,
including visa subclass 457. Refer to page 9
for a full list of visa types which are eligible
for this cover.
To save you money, you won’t be covered
for maternity, joint replacement, cataract and
eye lens procedures, assisted reproductive
services and heart treatment and have limited
cover for psychiatric care.
Note: waiting periods apply before you can claim. Please
see page 14 for details.
Standard Overseas Visitors cover is suitable
for visa holders who don’t need to meet
the Department of Immigration and Border
Protection’s minimum requirements for
health cover under condition 8501, including
visitors from countries with reciprocal
healthcare agreements.
Price based on WA rates for a single policy paid annually by direct debit and equates to $1,248.00per year including GST.
Price based on WA rates for a single policy paid annually by direct debit and equates to $1,274.40 per year including GST.
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2
4
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Standard Overseas Visitors cover gives
you cover for a shared hospital room and
comprehensive hospital cover for over 5000
medical procedures, such as removal of
tonsils and wisdom teeth, knee and shoulder
reconstructions and cancer treatment. You’re
also covered for out-of-hospital medical
treatment, such as a visit to a doctor.
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Compare levels of cover
To help you choose the right cover, the
table below shows you how the different
levels compare.
Benefits
Comprehensive
Working
Overseas
Visa Hospital
Visitors
& Medical
Working
Visa
Hospital
Visa requirements
Standard
Overseas
Visitors
Full cover for single room accommodation in a
public or private hospital
Full cover for shared room accommodation in a
public or
private hospital
Cover for over 5000 medical procedures,
including ear, nose and throat procedures, knee
and shoulder reconstructions,
and chemotherapy
Theatre fees
1
Joint replacement surgery
(partial or total)
Heart treatment
If you don’t hold one of these visas, you should
contact us to talk about other cover options.
Cataract and eye lens procedures
Maternity and birth-related services
Rehabilitation
To be covered on Working Visa Hospital and Medical or Working Visa Hospital
you must hold one of the following visa types:
• 163 State/Territory Sponsored Business Owner
• 401 Temporary Work International Relations
• 402 Training and Research
• 403 Temporary Work Long Stay Activity
• 406 Government Agreement
• 411 Skilled Exchange
• 415 Foreign Government Agency
• 416 Special Program
• 420 Entertainment
• 421 Sport
• 423 Media and Film Staff
• 426 Domestic Worker (Diplomatic/Consular)
• 427 Domestic Worker (Executive)
• 428 Religious Worker
• 442 Occupational Trainee
• 457 Temporary Business Long Stay
• 475 Regional Sponsored
• 485 Temporary Graduate
• 489 Skilled Regional (Provisional)
2
Repatriation
Psychiatric
4
In-hospital pharmacy3
PBS pharmacy – outpatient3
Out-of-hospital medical
Waiting periods apply for all services – to find out more please see page 14. 1No benefit for procedures that are restricted or excluded
on your level of cover.
2Benefits for rehabilitation services related to restricted or excluded procedures will be limited. 3Refer to page
12 for more details about pharmacy benefits. 4Please note: Restricted benefits apply for psychiatric. Significant out-of-pocket
expenses may apply.
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Your benefits at a glance
Here’s a quick guide to the hospital costs that you can receive a benefit towards.
The following pages provide details on the specifics of your cover.
Accommodation
Includes the fees charged for your room in a private or public hospital
Theatre
Includes the fees charged for the theatre in which your procedure is performed
Pharmacy
Includes the cost of some of the medication administered during your hospital stay
Prostheses
Includes the costs of any prostheses (surgically implanted devices you may need if you
have a procedure such as joint replacement or cataract surgery)
Medical
Includes the fees charged by your surgeon, anaesthetist and pathologist
Ambulance
Full cover for unlimited urgent ambulance transport. Please see page 13 for more details
Accommodation benefits
HBF members with Comprehensive Overseas
Visitors cover and Working Visa Hospital
and Medical cover are 100% covered in
a private room in both private and public
hospitals. HBF members with Standard
Overseas Visitors cover and Working Visa
Hospital cover are 100% covered for a
shared room in a public or private hospital.
Hospital excess
Hospital boarders
There may be times when you’ll need
someone like a parent, partner or carer
to stay with you overnight in hospital.
HBF will cover the costs for a hospital
boarder whose presence is needed to help
manage your condition. Costs covered
include meals (in some private hospitals)
and accommodation in your room.
There is a $300 excess on Working Visa
Hospital, which you pay if you stay in hospital
overnight. You only pay it once per member
per calendar year (to a maximum of twice per
family per calendar year), regardless of how
many times you stay in hospital. You won’t
need to pay an excess for any dependent
children on your policy.
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Theatre benefits
Prostheses benefits
HBF members with Comprehensive Overseas
Visitors cover, Working Visa Hospital and
Medical cover, and Working Visa Hospital
cover are fully covered for all theatre benefits,
including labour ward fees for maternity.
HBF members with Standard Overseas Visitors
cover are fully covered for theatre fees,
unless the procedure is specifically restricted
or excluded.
Prostheses are surgically implanted devices
you may need if you have a procedure such
as a joint replacement, cataract surgery or
heart treatment. You’re covered for items listed
on the Government Prosthesis List that are
implanted while you’re in hospital. No benefit
is payable for prostheses implanted during a
procedure specifically excluded from your level
of cover.
Pharmacy benefits
Pharmacy benefits while in hospital
When you’re in hospital, it’s likely you’ll
receive medication. We’ll pay a benefit for
medication you receive for treatment covered
on your policy. For Pharmaceutical Benefit
Scheme (PBS) medications you receive while
admitted to hospital, you may need to pay
a co-payment but have no annual limit. We
fully cover any non-PBS pharmaceuticals
you receive while a patient in hospital, up to
$2000 per person, per year. Please note that
these pharmaceuticals must be approved by
the Therapeutic Goods Administration and not
used on an experimental basis.
Pharmacy benefits outside of hospital
For members on Working Visa Hospital and
Medical cover or Comprehensive Overseas
Visitor cover, you’ll receive a benefit towards
pharmaceuticals prescribed outside of
hospital by a medical practitioner that are
normally covered by the Government’s
PBS for Australians. You may need to pay
a co-payment, but have no annual limit for
out-of-hospital pharmaceuticals.
You won’t receive a benefit for non-PBS
pharmaceutical outside of hospital.
Most prostheses are fully covered, however
some prostheses may attract an out-ofpocket expense. To find out whether you have
an out-of-pocket expense, you’ll need to know
the item number and cost of the prostheses,
as well as the item number of the procedure
you’ll be having. Please call HBF on 133 423
before your procedure.
Medical benefits
HBF pays benefits towards two types
of medical fees:
1. O
ut-of-hospital medical fees (such
as a visit to a general practitioner)
2. In-hospital medical fees (such
as surgeon’s fees)
Out-of-hospital medical fees
Includes treatment from a medical practitioner
when you’re not admitted into a hospital or
day-hospital facility. This also includes visits
to your specialist before you’re admitted into
hospital for any treatment or surgery.
In-hospital medical fees
Includes treatment by doctors, specialists,
surgeons, anaesthetists, radiographers and
pathologists when you are admitted into
a hospital or day-hospital facility.
It’s important to understand medical gaps
before you select your medical practitioners.
If your medical practitioner (your surgeon,
specialist or anaesthetist for example) charges
more than the Medicare Benefits Schedule
(MBS) fee, there’ll be a ‘gap’ you need to pay
to the doctor.
Depending on the agreement we have with
the doctor, they will fall into one of three
categories:
• Fully covered – no out-of-pocket expense
• Known gap doctors – there may be
an out-of-pocket expense
• No agreement with HBF – there will be
an out-of-pocket expense
You should call us or speak to your doctor
before being admitted to hospital to check
what arrangement they have with HBF and
what (if any) gap you’ll have to pay.
Crutches and
wheelchairs
HBF will pay up to $400 per person, per
calendar year towards the cost of hiring or
purchasing crutches or wheelchairs, on each
of our four levels of overseas visitor cover.
Rehabilitation
You’ll receive benefits for rehabilitation
as per normal accommodation rules.
Benefits for rehabilitation related to treatment
restricted or excluded on
your cover will be limited.
Repatriation
Comprehensive Overseas Visitors cover
provides a benefit towards the cost of your
transport back to your home country if you
become terminally ill or suffer a substantial
life-altering illness or injury. Repatriation
benefits are limited to once per member per
lifetime and to a maximum of $40,000.
Some conditions apply, so please ask
us for details.
Ambulance
Members on Standard Overseas Visitors are
covered for urgent ambulance transport
by road (urgent means circumstances
classified by St John Ambulance as requiring
urgent attention). Members on other levels
of overseas visitor cover receive unlimited
cover for urgent ambulance transport by
road or air with a government approved
ambulance service when medically necessary
for admission to hospital, emergency
treatment on-site or inter-hospital transfer for
emergency treatment.
Standard Overseas Visitors cover and Working
Visa Hospital and Medical cover provide a
benefit of 85% to 100% of the Medicare
Benefits Schedule (MBS) fee.
Comprehensive Overseas Visitors cover
provides a benefit of 100% of the MBS fee.
Members on Working Visa Hospital cover
do not receive a benefit for out-of-hospital
medical fees.
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How to claim
Would you benefit from additional cover?
Most hospitals and medical practitioners bill HBF
directly. But if you need help making a claim, just
contact us.
Add extra cover for treatments that can make
a big difference to your everyday wellbeing.
How soon can you claim?
As with all health insurance, waiting periods
apply before you can receive benefits.
Waiting periods protect our members by
preventing new members making a large
claim shortly after joining or upgrading their
cover and then dropping their membership,
which would result in increased premiums
for all members.
The table below provides an overview of
the standard waiting periods that may apply
to your hospital treatment. If you haven’t
completed the necessary waiting period,
we may not be able to pay a benefit or will
pay a benefit applicable to your previous
level of cover.
Treatment
Waiting period
Pre-existing ailments or conditions
Defined as an illness or condition which, in the opinion of a medical practitioner
(appointed by HBF), was known to exist, or where signs or symptoms were evident during
the six month period before you became an HBF member, including on the day you joined
12 months
Maternity and birth-related services
12 months
Rehabilitation, psychiatric care and palliative care
2 months
Other hospital treatments
Including surgery
No waiting period
Other medical treatment
Not provided at a hospital
No waiting period
Ambulance
Cover for urgent ambulance transport
7 days
Repatriation
Transport for you back to your home country in event of a substantial life altering injury or
illness or terminal illness^
6 months
Extras
Ambulance Plus
From $6.251 per week
From around 65¢3 per week
Add HBF Extras to be covered for
day-to-day services, such as dental,
optical, physio and chiro.
Ambulance Plus covers non-urgent
ambulance services.
GapSaver
Wellness
From around $1.90 per week
From around $5.654 per week
You can pay a little extra to help cover any
out-of-pocket expenses when you use your
Extras cover.
HBF Wellness cover can be added to most
Extras policies and covers preventative
and wellbeing therapies such as yoga
programs, remedial massage, exercise
physiology, nutritionist consults,
psychology and travel vaccinations.
2
Price based on WA rates for a single Essentials Saver policy paid annually by direct debit and equates to $324.00 per year.
Price based on WA rates for a single GapSaver $100 policy paid annually by direct debit and equates to $98.80 per year.
3
Price based on WA rates for a single Ambulance Plus policy paid annually by direct debit and equates to $33.60 per year.
4
Price based on WA rates for a single Wellness policy paid annually by direct debit and equates to $292.80 per year.
1
2
A terminal illness is an illness which in the opinion of a medical practitioner is likely to result in death within 12 months.
^
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How to join HBF
Ways to pay
Exclusions on benefits
Glossary
It’s quick and easy to take out HBF cover:
Direct debit
There are a few circumstances when
HBF won’t pay a benefit:
• If your membership is unfinancial
at the time of treatment or service
• On claims covered by worker’s
compensation, third party or other
legal right
• For treatment or services required
by your employer or potential employer
to be provided to you as a condition
of your employment, or by your insurer
as a condition of your policy
• For treatment or services provided
outside of Australia
• For care and accommodation in
a nursing home
• Before a treatment or service has
been received
• If a claim is not lodged within two years
of the date of service
• For hospital treatment not covered by
Medicare for Australian residents, such
as cosmetic surgery
• For treatment arranged in advance
of your arrival in Australia
Benefit
• C
all us on 133 423 or +61 8 9265 6111
if you’re calling from outside Australia
• Go to hbf.com.au
• V
isit an HBF branch (the addresses
are on the back of this booklet)
You can choose to pay your premium by
automatic debit from your savings, cheque
or credit card account. Paying by direct debit
is not only easy, it will save you 4% on your
health insurance premium (except GapSaver).
Statement
You can pay by monthly, quarterly, half yearly
or annual statements online at hbf.com.au, or
via Bpay, or cheque. Or choose to pay over the
phone by calling us on 133 423 or pay at an
HBF branch.
Pay deductions
You may be able to have your health
insurance premium deducted directly from
your pay. For details, please check with your
payroll officer.
This is the amount HBF will pay eligible
members towards the cost of a health service.
Premium
Your premium is what you pay for your
health insurance.
Medicare Benefits Schedule
In Australia, all types of medical treatment
are reviewed by the Federal Government
and, once approved, added to the Medicare
Benefits Schedule (MBS) where they are
assigned an item number and a schedule fee.
No benefit can be paid for medical procedures
not allocated an MBS item number.
Out-of-pocket expenses
An out-of-pocket expense is the difference
between the cost of a Hospital or Extras service
and the benefit you receive from HBF.
We’re here to help,
so please contact us
if you’re having trouble
understanding anything
in this brochure.
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Will I be covered
outside of Australia?
No Australian health fund is legally permitted
to pay benefits for treatment or services
provided outside Australia, including general
treatment such as dental and glasses and any
hospital or medical treatment.
If you are away for longer than two months
you can suspend your health cover without
losing any benefits or having to re-serve
waiting periods when you return. It won’t cost
you anything to suspend your cover, and you
won’t need to pay for your health insurance
while you’re out of Australia. You can suspend
your cover for up to six months, once every
three years. Please contact us if you’d like to
suspend your cover.
Will I be exempt from
the Medicare Levy
Surcharge (MLS)?
The Medicare Levy Surcharge (MLS) is charged
to anyone who does not have appropriate
private hospital cover (according to the Federal
Government) and who earns above a certain
income. Overseas visitors cover does not
provide exemption from the MLS. For more
information, please call 133 423.
Your rights and obligations
At HBF when we provide you with products
and services, we believe you should have
access to information about your rights and
obligations. The following pages explain
some of your key obligations and rights, as
well as HBF’s obligations to you. You’ll also
find information about how we operate and
how we collect information. Specifically, the
information will help you to understand the
Private Health Insurance Code of Conduct,
and how we protect your privacy. If you refer
to the list of contents you’ll see where you
can access more information or how to raise a
concern or a complaint.
HBF Fund Rules
All registered health funds are required
to have fund rules under the Private Health
Insurance Act 2007. These Fund Rules set out
the general principles and rules of membership
under which each fund conducts its business.
When you take out private health insurance
with HBF, you become a member of our
fund and you agree to our Fund Rules. As a
member of HBF, you have rights and obligations
concerning your health insurance policy and
membership. It’s important that you’re aware
of the contents of the Fund Rules as they form
the terms and conditions of your policy. Please
ensure you read them. We recommend that
these Fund Rules be read together with your
Policy Certificate and the brochures relevant to
your cover.
Private Health Insurance
Code of Conduct
HBF is a signatory to the Private
Health Insurance Code of Conduct (the Code).
The Code is designed to help you by providing
clear information and transparency in your
relationships with health funds. The Code
covers four main areas of conduct in private
health insurance. They are:
• People selling private health insurance
are properly trained.
• Members are aware of the internal and
external dispute resolution procedures in
the event that they have a dispute with
their health fund.
• Policy documentation contains all the
information that members require in
a way that enables them to make a fully
informed decision about their purchase.
• Members purchasing health insurance from
persons other than the health
funds’ employees understand the nature
of the arrangement between the fund
and the person selling the insurance
on the fund’s behalf.
To obtain the HBF Fund Rules, visit
hbf.com.au/fundrules or call us on 133 423.
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Your privacy
HBF’s obligation to you under the Code
We will endeavour to:
• work towards improving the standards
of practice and service within HBF,
• provide information to our members
in plain language,
• promote better informed decisions about
our private health insurance products
and services:
-- by ensuring that our policy documentation
is full and complete,
-- by providing an effective and clear verbal
or written explanation of the contents of
the policy documentation, and
-- by ensuring that our employees providing
information on health insurance are
appropriately trained,
• provide information to members on
their rights and obligations under their
relationship with HBF, including information
on the Code, and
• provide members with easy access to
our internal dispute resolution procedures,
which will be undertaken in a fair and
reasonable manner and advise them of
their rights to take an issue to an external
body such as the Private Health Insurance
Ombudsman.
How the Code helps HBF members
Apart from promoting improved standards
in clarity and usefulness of information given
to members, the Code is designed to help
solve problems between members and HBF.
HBF has a complaints handling process for
members who may have a dispute with HBF.
Examples of disputes include:
• contents of advertising by HBF,
• representations made to the member when
they purchased a product,
• features of their product, and
• benefits paid under their product.
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You can access HBF’s complaint handling
process by visiting your nearest HBF branch,
by contacting HBF on 133 423 or by writing
to us at GPO Box C101, Perth 6839.
If you’re not satisfied with the outcome of
your concern you can ask to have it reviewed
by the internal dispute resolution process.
Complaints should be addressed to:
HBF Dispute Manager
GPO Box C101, Perth 6839
Phone: 133 423
Fax: 08 9265 6356
Email: [email protected]
If a resolution is still not reached to your
satisfaction you can:
• contact the Private Health Insurance
Ombudsman by ringing toll free on
1800 640 695, or by writing to
Suite 2, Level 22, 580 George Street,
Sydney NSW 2000,
• forward the problem to a health care
complaints commission or fair trading body
in your state of residence, or
• report HBF’s behaviour to the Australian
Competition and Consumer Commission.
Your documentation
All documentation regarding your policy
is important, so please read it carefully
and contact us if you require any further
information. Please keep your policy
certificate in a safe place for future reference.
How can I get a copy of the Code?
A full copy of the Code is available at:
privatehealth.com.au/codeofconduct
or by calling HBF on 133 423.
We are HBF Health Limited ABN 11 126 884 786
which provides private health insurance (under
the brands HBF Health and GMF Health).
References to HBF ‘us’, ‘we’ or ‘our’ include HBF,
HBF Health, GMF Health, and other business
names, and where the context requires, other
related bodies corporate (collectively HBF).
At HBF, we comply with the Privacy Act 1988
(Cth) (Privacy Act). We respect the privacy of
your personal information. We process personal
details on a daily basis and are committed to
ensuring that the privacy and security of personal
information remains protected. Personal
information is information or an opinion about
an individual, or an individual who is reasonably
identifiable, whether the information or opinion
is true or not, or is recorded in a material form
or not. It includes your name, age, gender
and contact details as well as your sensitive
information (which includes health information).
Collection, use and disclosure of your
personal information
HBF collects and uses your personal (including
sensitive) information (Information) to provide
you with private health insurance and health
and wellness related services, including to:
• manage our ongoing relationship with you;
• administer, process and audit private health
insurance premiums and claims and pay
benefits;
• assess your suitability for, enrol you in and
administer health and wellness related
services such as chronic disease management
programs and health management programs;
• provide you with access to smartphone
applications and website portals in relation
to managing your health, your private
health insurance membership and your
relationship with us;
• conduct market research that informs the
strategic direction of HBF, by seeking to
understand ways to improve the health of
members, the effectiveness of marketing
activities, the member experience and the
products and services HBF offer;
• manage, review and develop our private
health insurance products and related
services whether provided by us or other
parties on our behalf;
• manage, review, develop and improve
our business and operational processes,
including training and systems, provided by
us or other parties on our behalf;
• resolve any legal and/or commercial
complaints or issues including
compensation recovery;
• prevent, detect and follow up fraudulent or
invalid claims or misrepresentations;
• meet legislative requirements relating to
private health insurers; and
• perform any of our other functions and
activities relating to our private health
insurance and health and wellness businesses.
HBF may collect your Information from you,
the person responsible for the management
of your private health insurance membership
(Principal Policyholder) or a person
authorised to provide us this information
on your behalf in order to, amongst other
things, provide you with private health
insurance cover and pay you benefits. HBF
may also collect your Information from one
of its related bodies corporate (in order to,
amongst other things, investigate potential
fraudulent claims and misrepresentations)
or a third party such as a health service
provider, broker or employer (in order to,
amongst other things, provide you with
private health insurance cover and pay you
benefits). HBF also engages third parties to
carry out functions on behalf of HBF (such
as claims administration, membership
management services, facilitators to
organise and manage hospitals, doctors and
health service providers, providers of claims
advice and chronic disease management
program providers) and they may collect
your Information from you and pass this
Information to HBF.
21
In order to carry out the purposes described
in this statement, HBF may disclose your
Information to persons or organisations such as:
• other related bodies corporate;
• our brokers and agents who refer your
business to us;
• our service providers (who may provide
some services directly to you on our behalf)
including mailhouses, market researchers,
manufacturers of membership cards, claim
administrators, claim auditors, claim advisers,
our membership management service
providers, the facilitators of our arrangements
with health providers and IT support (including
by way of cloud computing);
• our professional advisors;
• health and wellness service providers (such
as hospitals, our pharmacies, general
practitioners, allied health providers, and
chronic disease and health management
program providers);
• payment system operators and financial
institutions;
• persons authorised by you, including other
persons covered by your private health
insurance membership, and your agents
and professional advisors such as legal
practitioners;
• if you have a compensation claim, the
insurer or statutory body responsible
for paying your compensation claim or
compensation recovery organisations;
• if you have an overseas visitors product,
your educational institution, migration
agent or broker;
• if you have a corporate private health
insurance product, your employer;
• regulatory bodies and government
agencies (such as the Department of Health
& Ageing, the Private Health Insurance
Ombudsman and Medicare Australia);
• parties involved in a prospective or actual
transfer of any part of our assets or
business; and
• other parties to whom we are authorised or
required by law to disclose information.
These third parties may also collect your
Information directly from you.
22
HBF may transfer your Information overseas
in the following circumstances. At your
request, HBF may provide a transfer certificate
or claims history containing your Information
to an overseas insurer nominated by you. By
making such a request, you give consent for
your Information to be transmitted overseas
in these circumstances. HBF also sometimes
use service providers who either host or store
personal information overseas. This means
HBF may transfer Information about you
between countries to those service providers
for the purposes described in this statement.
In the event HBF transfers your Information
outside Australia, we will comply with the
requirements of the Privacy Act that relate to
transborder data flows.
If you are not the Principal Policyholder of your
private health insurance membership, HBF may
also disclose your personal information to the
Principal Policyholder as part of administering
the membership and paying benefits. This may
include the disclosure of sensitive information
about benefits claimed by you under your policy.
If the Principal Policyholder has authorised his/
her spouse/partner to administer the private
health insurance membership, HBF may disclose
the Principal Policyholder’s Information to his/
her spouse/partner.
If you do not provide Information requested
of you to HBF, we may be unable to provide
you with private health insurance cover, pay
you benefits, assess or waive lifetime health
cover loading or apply an entitlement to the
Australian Government rebate on private
health insurance as a premium reduction.
Marketing
HBF may use your Information to contact you
(including by telephone call, text message or
email) in relation to other products or services
we think may be of interest to you. This may
include our own products and services, the
products or services of any related bodies
corporate or the products or services of third
parties. By way of example, HBF may contact
you in relation to a general insurance offering
that we think may be of interest to you.
Personal information is shared between related
bodies corporate. Related bodies corporate
may use your Information to contact you
(including by telephone call, text message or
email) in relation to their products or services
or the products or services of third parties.
HBF and its related bodies corporate may
contact you about products and services we
think may be of interest to you during the period
you are a private health insurance member and
after you cease your private health insurance
membership. For example, if you cease your
private health insurance cover with us, HBF may
contact you about its private health insurance
offering under other brands such as GMF Health.
You may opt-out of receiving marketing
information from HBF and its related bodies
corporate at any time by:
For HBF:
• calling us on 133 423;
• emailing us on [email protected]
• ‘ticking the box’ on the relevant form when
you apply for a product or service.
For GMF Health:
• calling us on 1300 653099;
• emailing us on [email protected]
• ‘ticking the box’ on the relevant form when
you apply for a product or service.
Please allow five working days for your
request to be actioned.
Service Related Communications
Where you provide us with an email address or
use our member web portals myhbf or mygmf,
we send most service-related communications
to you by email or those web portals. Servicerelated communications are the essential
things you need to know about your cover,
like annual tax statements and changes to
premiums and policy details. You can manage
how we communicate with you by contacting
us as detailed in the previous section.
If you are the Principal Policyholder
As the Principal Policyholder, you must ensure
that your spouse/partner and dependant
children (if any) are aware of, and consent
to, how their Information is handled under
this Privacy Statement and the HBF Privacy
Policy (current as at 1 July 2015) which can be
accessed at www.hbf.com.au (Privacy Policy).
You and your spouse/partner and dependant
children (if any) should not provide us with
any Information unless you and they consent
to it being handled in accordance with this
Privacy Statement and the Privacy Policy.
By:
• taking out or maintaining your private
health insurance policy; or
• providing your Information to HBF, or you
or your spouse/partner and/or dependant
children (if any) providing their Information
to HBF, for whatever purpose,
you consent to, and warrant that your
spouse/partner and/or dependant children
have consented to, HBF collecting, using
and disclosing your and their Information,
however collected by us, in accordance with
this Privacy Statement and the Privacy Policy.
Access to your information and
contacting us
HBF will allow you to access and correct
personal information we hold about you as
required by law. If you have any queries about
how HBF handles your personal information,
or would like to request access to that
information, please contact us:
• By mail - HBF Privacy Officer, GPO Box C101,
Perth WA 6839; or
• By telephone – 1300 883 530.
If you have any concerns or complaints about the
manner in which your personal information has
been collected or handled by HBF, please contact
the Privacy Officer using the details above.
The Privacy Policy contains further
information about how HBF generally handles
your personal information including:
• how you can access and correct personal
information we hold about you; and
• how you can submit a privacy complaint to HBF
and how HBF will deal with your complaint.
23
Ni hao!
Go to hbf.com.au
Visit a branch
Mon to Fri: 9am to 5pm
Sat: 9am to 12.30pm*
Call us 133 423
Mon to Fri: 7am to 6pm
Sat: 8am to 2pm
Postal address
GPO Box C101 Perth 6839
Stay in touch
Find us at HBF Health
Metropolitan
branches
Mandurah
32 Pinjarra Rd
We speak
your language
Perth
96 William St
Midland*
Midland Gate
Shopping Centre
If English is
not your first
language, our
multilingual
team is fluent in
many languages
including
Mandarin,
Cantonese and
Hindi. Call us on
1300 735 137.
Belmont
Belmont Forum
Shopping Centre
Booragoon*
Garden City
Shopping Centre
Cannington*
Carousel
Shopping Centre
Morley*
Galleria
Shopping Centre
Rockingham*
Rockingham
Shopping Centre
Subiaco
142 Rokeby Rd
Fremantle
Corner Market St
and High St Mall
Success
Cockburn Gateway
Shopping Centre
Hillarys
Whitford City
Shopping Centre
Regional
branches
Innaloo
Innaloo
Shopping Centre
Joondalup
Lakeside
Joondalup
Shopping City
*
Karrinyup*
Karrinyup
Shopping Centre
Albany
21 Albany Hwy
Bunbury
12 Arthur St
Busselton
2/90-92 Queen St
Geraldton
Northgate
Shopping Centre
Even the healthiest bodies need looking after. HBF is the Official Health Partner
of WA’s favourite teams, the Fremantle Dockers and the West Coast Eagles.
HBF Health Limited ABN 11 126 884 786. The information in this brochure is correct at time of print.
Minor changes may have occurred since that date. If major changes occur, the brochure will be replaced.
Details of any minor changes can be obtained from HBF on request.
C105418
HI-009 01/07/15
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