Does my Overseas Visitors Cover comply with my visa condition?

Overseas Visitors Cover may be a requirement for your visa – you may need to get it as part of your visa application. We offer Overseas Visitors Cover that’s visa compliant, including:

• Basic Hospital
• Mid Hospital
• Top Hospital
• Top Plus Hospital

That means if you need private health insurance to get your visa, we can provide cover that meets the requirements of the Department of Home Affairs. 

Once you’ve applied for visa compliant cover we’ll send you the letter you need for the Department of Home Affairs, so you can apply for your visa sooner.

What if I don’t need cover as a condition of my visa?

Even if you don’t need private health insurance to get your visa, it can provide peace of mind. Whether your stay is long or short, you can enjoy your time working or travelling in Australia knowing you can easily access the health care services you’re covered for, and that your cover can help you avoid paying large costs if you unexpectedly get sick or injured.

With HCF, you can choose the level of cover that meets your health and lifestyle needs. Your options include:

• Short Stay
• Essentials
• Essentials Plus

These options are non-visa compliant. If you choose one of these, we won’t be able to give you a letter saying your cover meets the Department of Home Affairs’ requirements. 

Who can get Overseas Visitors Cover?

To get HCF Overseas Visitors Cover (and be the policyholder) you need to:

• be aged 18 or over
• have a valid work or holiday visa

You can’t:

• be an Australian citizen
• hold an Australian passport 
• live permanently in Australia
• be eligible for Medicare

Learn more about Overseas Visitors Cover eligibility

What’s the HCF Overseas Visitors Helpline?

If you have any questions about your health or need to find hospitals or doctors in the HCF network, our friendly advisors are at your service 24 hours a day, 7 days a week. Just call us on 13 68 42.

Our advisors can help you find:

• hospitals 
• regular (GP) and specialist doctors 
• after-hours GP services.

They can also give you information on a range of other services and the benefits that are available to HCF customers, so you can get the most from your cover. Learn more about the HCF Overseas Visitors Helpline.

What’s hospital cover?

Medical treatment in Australia can be expensive if you can’t access Medicare (the Australian public health care system). HCF hospital cover provides peace of mind that you can get affordable treatment when you need it (for treatment that’s covered by your insurance).

The services you’re covered for depend on the level of Overseas Visitors Cover you choose. When you’re admitted to hospital, the things you may be able to claim for include:

• accommodation
• operating theatre or intensive care costs
• government-approved prostheses
• specialist doctors’ fees 
• medicines

And when you just need medical care but don’t need to be admitted to hospital you may be able to claim for:

• emergency ambulance services
• emergency department facility fees (when required)
• GP regular doctors’ visits
• outpatient medicines.

What’s extras cover?

HCF extras cover allows you to claim for a range of everyday services that help you to look after your health. Depending on the level of cover you choose, you may be able to claim for:

• dental treatment
• glasses and contact lenses
• physiotherapy
• chiropractic
• osteopathy
• acupuncture
• natural therapies
• Chinese herbal medicine.

What’s an excess?

An excess is the amount you have to pay when you go to hospital, for a day admission or an overnight stay.

HCF offers a nil and/or $250 excess option – whether you can choose your excess depends on your level of cover.

Your excess amount impacts the cost of your health insurance. A $250 excess means you’ll pay less for your cover than a nil excess (for the same cover).

You only need to pay an excess once per calendar year, per person (a maximum of 2 excess payments for families per year). If you’ve already paid an excess and go to hospital again that same year you won’t have to pay another excess.

What’s a waiting period?

When you get your HCF Overseas Visitors Cover, or upgrade to a higher level of cover, you’ll have waiting periods. This is the time you need to wait before you can claim for the services you’re covered for.

If you’re already in Australia your waiting periods will begin on the date your Overseas Visitors Cover starts.

If you’re overseas when you get your cover, your waiting periods won’t begin until you arrive in Australia (and activate your cover). The time you’re overseas after choosing your cover and before activating your cover in Australia doesn’t count.

Waiting periods vary depending on the treatment you need and if your illness or condition was pre-existing.

Waiting periods for visa compliant Overseas Visitors Cover:

Hospital waiting periods:

• 2 months for psychiatric, rehabilitation and palliative care
• 12 months for pregnancy and birth-related services
• 12 months for pre-existing ailments or conditions (except for psychiatric, rehabilitation or palliative care).

Extras waiting periods:

• 12 months for major dental services (crowns and bridges, dentures, endodontics, indirect fillings, occlusal therapy, oral surgery, orthodontics, periodontics, veneers, implants), foot orthotics and pre-existing ailments or conditions
• 2 months for all other extras services included on your cover.

Outpatient medicine waiting periods:

• 2 months for medicines received as an outpatient (where your policy doesn’t cover outpatient medicines no benefits are payable after any amount of time).

Waiting periods for non-visa compliant Overseas Visitors Cover

• 12 months for pre-existing ailments or conditions (where your policy doesn’t cover pre-existing ailments or conditions no benefits are payable after any amount of time)
• 2 months for medicines received as an outpatient (where your policy doesn’t cover outpatient medicines no benefits are payable after any amount of time).

What’s a pre-existing ailment or condition?

A pre-existing ailment or condition is an ailment, illness or a condition that you had signs or symptoms of in the 6 months before you got your HCF Overseas Visitors Cover, or upgraded to a higher level of cover, even though you may not have got a diagnosis.

If it’s unclear if your ailment or condition is pre-existing, we’ll appoint a medical practitioner to review information provided by your doctor, and any other details relevant to your claim.

What are Minimum Benefits?

Minimum Benefits (symbolised by MB in your product summary), are reduced benefits that are paid when you don’t have full cover for a hospital procedure or when you go to a hospital that is not in the HCF Network. You are likely to experience significant extra costs – gaps.

What Minimum Benefits will cover:

• In a private hospital
  
  • The Australian Government rate for shared room accommodation (even for intensive care); and
  • The minimum benefit for items on the Government-approved prosthesis list
  • No benefits for theatre or labour ward
• In a public hospital
  • Depending on your level of cover, either the State or Territory shared room accommodation rate or the Australian Government shared room accommodation rate, and
  • The minimum benefit for items on the Government-approved prosthesis list
  • Depending on your level of cover, no benefits for theatre or labour ward

What’s ‘the gap’?

If you go to a hospital that’s not in the HCF Network or are covered only for Minimum Benefits (MB), you are likely to experience large out of pockets (extra costs on top of any Excess). Or if you’re treated in hospital by a doctor who isn’t part of the HCF network you may also have to pay extra costs. These extra costs, that aren’t covered by your HCF Overseas Visitors Cover, are known as ‘the gap’.

Going to a hospital in the HCF network ensures any ‘gap’ is minimised. To find a hospital in the HCF network go to Participating hospitals or call our Overseas Visitors Helpline on 13 68 42.

Doctors who are part of the HCF network can choose to treat you in hospital with ‘no-gap’, or a ‘known-gap’.

• No-gap means you shouldn’t have to pay any extra costs for treatment by that doctor.
• Known-gap means you could pay up to $500 per doctor for your treatment.

Doctors participating in the HCF network can decide not to treat you through either the no-gap or known-gap arrangement, so check if there’ll be any extra costs to pay (and if so how much they’ll be) before you start treatment. If there is a gap your doctor should ask for your consent before treating you.

To find a specialist doctor from the HCF network visit the Healthshare website or call our Overseas Visitors Helpline on 13 68 42.

What’s emergency ambulance?

All HCF Overseas Visitors Covers include cover for emergency ambulance services.

Emergency ambulance services include on-the-spot treatment or emergency transportation to the nearest appropriate hospital able to provide the level of care you need.

On some covers, you may also be able to claim for emergency transfers between hospitals to have access to the services you need.

Who does my policy cover?

The people covered under your HCF Overseas Visitors Cover will depend on the cover you choose.

Your policy will be one of the following:

• Single – covers only you (the overseas visitor)
• Couple – covers you, and
  • 1 adult spouse or de facto partner
• Family – covers you, and
  • 1 adult spouse or de facto partner, and
  • 1 or more dependant children aged 22 or under
    
• Single parent family - covers you, and
  • 1 or more dependant children aged 22 or under
    

Dependant children can remain covered on your family or single parent family policy until they’re 23.

Please make sure you understand who’s covered by your Overseas Visitors Cover. You can log in to check your policy any time, or call our Overseas Visitors Helpline on 13 68 42.

What’s a child dependant?

Your child can be on your policy as a dependant if they’re:

• aged 22 or under; and
• unmarried and not in a defacto relationship;
• primarily reliant on you for maintenance and support; and
• related to you as a child, step child, foster child or other child you have legal guardianship over.

What’s Medicare?

Medicare provides a high level of health care for all Australian residents. It is funded through the Australian taxation system and it offers residents access to hospital treatment and lowers the cost of medical treatment outside of hospitals.

Medicare doesn’t cover treatment in private hospitals, emergency ambulance or services like dental treatment and physiotherapy. 

Medicare is available to visitors who come from countries that have a Reciprocal Health Care Agreement (RHCA) with Australia. If you come from a country that doesn’t have a reciprocal agreement with Australia, you may have to get private health insurance before you can apply for your visa.

What does Medicare cover?

Medicare covers some medical, hospital and pharmaceutical costs, plus x-rays and pathology.

It only provides treatment as a public patient in public hospitals.

Reciprocal Health Care Agreements

The Australian Government has Reciprocal Health Care Agreements (RHCA) with 11 countries. They allow eligible people visiting from those countries to access some free or reduced cost health care services through Australia’s Medicare System.

For many visitors, private health insurance is also a visa requirement so you should check this before you apply for your visa. You can do this through the Department of Home Affairs.

If I can access Medicare why do I need private health insurance too?

If you’re covered by an RHCA, you’ll have access to some Medicare services when you’re in Australia, but it’s important to know that Medicare doesn’t cover all health services. So it's a good idea to get private health insurance for your peace of mind.

If your HCF insurance includes extras cover you may also be able to claim for services that Medicare doesn’t cover like dental treatment, physiotherapy, glasses and contact lenses, acupuncture, Chinese herbal medicine and more.

All levels of HCF Overseas Visitors Cover also include emergency ambulance cover, which is not covered by Medicare.

If you are eligible for Medicare under a RHCA and earn over $90,000 per year, you may be subject to the Medicare Levy Surcharge (MLS) an additional Australian taxation levy that help funds Medicare. Overseas Visitors Cover will not exempt you from the MLS however we can offer a product that will, so please contact our Overseas Visitors Helpline on 13 68 42 for more information.

To find out if you will be impacted by the MLS visit www.ato.gov.au

What does HCF Overseas Visitors Cover include that Medicare doesn’t?

The treatments and procedures you can claim for will depend on the level of insurance you choose.

Some of the things that can be covered by private health insurance that aren’t covered by Medicare include:

• treatment as a private patient in a private or public hospital (including surgically implanted prostheses)
• emergency ambulance
• glasses and contact lenses
• other extras like acupuncture, chiropractic, remedial massage, and more.

What’s the Pharmaceutical Benefits Scheme?

The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that provides a payment towards the cost of approved medicines.

If you’re eligible for Medicare through a Reciprocal Health Care Agreement, you’ll pay less for a range of prescription medicine.

HCF Overseas Visitors Cover includes benefits for medicines listed on the PBS:

• given to you when you’re a patient in hospital 
• given to you when you’re discharged from hospital if they’re part of your ongoing treatment. We’ll cover you up to the PBS listed price after you pay an amount equivalent to the current PBS general patient co-payment per medicine. Cover for discharge medicine may be capped at a certain amount depending on the level of cover you choose
• some levels of HCF Overseas Visitors Cover may cover medicine prescribed by a regular doctor (GP).

If you have any questions about the PBS call our Overseas Visitors Helpline on 13 68 42.