Compare Health Care Insurance (HCI) health insurance

How Health Care Insurance rates for member complaints, gap cover and ambulance cover.

CHOICE staff

On this page:

Who is Health Care Insurance?
Does HCI get many complaints from members?
How good is HCI's gap cover?
How many hospital agreements does HCI have in each state?
Does HCI offer ambulance cover?
Does HCI let you claim online or in-app?

Who is Health Care Insurance?

Health Care Insurance (HCI) is a nonprofit health fund established in 1938. Based in Tasmania, it has more than 10,000 members and is entirely member-owned. It's part of Members Health, an alliance of nonprofit and mutual health funds.

Phone: 1800 804 950

Website: hciltd.com.au

Does HCI get many complaints from members?

HCI has a Medium complaints rating.

When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don't get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.

How good is HCI's gap cover?

A medical gap is the difference between Medicare's recommended fee and what your doctor actually charges for a treatment or service.

Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called 'no gap agreements', or part of that gap, which are called 'known gap agreements' (these will have lower out-of-pocket costs, usually less than $500).

Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.

Rating scale

Well above average
Above average
Average
Below average
Well below average

How many hospital agreements does HCI have in each state?

The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you're treated.

The table below shows how many hospital agreements HCI has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don't have agreements with specific funds and are generally treated as though they're agreement hospitals.

Health Care Insurance hospital agreements

In the Australian Capital Territory this fund has...

6 private hospital agreements out of an industry maximum of 6.

9 day hospital agreements out of an industry maximum of 9.

In New South Wales this fund has...

90 private hospital agreements out of an industry maximum of 92.

105 day hospital agreements out of an industry maximum of 105.

In the Northern Territory this fund has...

1 private hospital agreement out of an industry maximum of 1.

2 day hospital agreements out of an industry maximum of 2.

In Queensland this fund has...

58 private hospital agreements out of an industry maximum of 58.

54 day hospital agreements out of an industry maximum of 54.

In South Australia this fund has...

20 private hospital agreements out of an industry maximum of 20.

31 day hospital agreements out of an industry maximum of 31.

In Tasmania this fund has...

8 private hospital agreements out of an industry maximum of 8.

9 day hospital agreements out of an industry maximum of 9.

In Victoria this fund has...

71 private hospital agreements out of an industry maximum of 71.

80 day hospital agreements out of an industry maximum of 80.

In Western Australia this fund has...

23 private hospital agreements out of an industry maximum of 23.

25 day hospital agreements out of an industry maximum of 29.

Does HCI offer ambulance cover?

HCI Premier Extras and Premier Package policies have cover for emergency ambulance.

Depending on where you live, you may not need a policy with ambulance cover.

Queensland and Tasmania: Emergency ambulance services are covered by the state government.
New South Wales and the Australian Capital Territory: All hospital policies come with emergency ambulance cover – so you'll be covered with any hospital or combined policy you select.
South Australia, Victoria and the Northern Territory: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover.
Rural Western Australia: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover.
Metropolitan Western Australia: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.

Does HCI offer family policies that cover adult children?

Adult children are covered on family policies for free until they turn 23.
Full-time students are covered on family policies for free until they turn 32.
Adult children younger than 32 can be covered on extended family policies for an extra cost.

Does HCI let you claim online or in-app?

You can claim via email or app (iOS and Android). There is no online claiming.

We care about accuracy. See something that's not quite right in this article? Let us know or read more about fact-checking at CHOICE.

Stock images: Getty, unless otherwise stated.

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