Compare Health Care Insurance (HCI) health insurance


HCI is a nonprofit, member-owned health fund that was established in 1938.

Fund information


HCI summary

Is HCI nonprofit? 

Does HCI get many complaints from members? 

How good is HCI's gap cover? 

How many hospital agreements does HCI have in my state? 

Does HCI offer any discounts?

Does HCI offer ambulance cover?

Does HCI offer family policies that cover adult children?

Does HCI let you claim online or in-app?

What CHOICE Community says about HCI


HCI summary

HCI

Health Care Insurance (HCI) is a nonprofit health fund established in 1938. Based in Tasmania, it's owned entirely by its members and has more than 10,000 members.

HCI contact details

Phone: 1800 804 950

Email: enquiries@hciltd.com.au

Website: hciltd.com.au


Is HCI nonprofit?

Yes.


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Does HCI get many complaints from members?

HCI complaints rating: Medium

  • 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

  • Above average
  • Average
  • Below average
  • Well below average

We also display the percentage of medical services that Health Care Insurance covers with no gap, and compare it to the industry average. The higher the percentage, the more effective the fund's gap scheme is in a state or territory.

Health Care Insurance gap cover performance by state

New South Wales (NSW)

Average

Australian Capital Territory (ACT)

Above average

Victoria (Vic)

Above average

Queensland (Qld)

Average

South Australia (SA)

Above average

Western Australia (WA)

Above average

Tasmania (Tas)

Above average

Northern Territory (NT)

Above average

Percentage of medical services covered with no gap

New South Wales (NSW)

Health Care Insurance – 88.8%

Industry average – 86.3%

Australian Capital Territory (ACT) 

Health Care Insurance – 86.3%

Industry average – 76.7%

Victoria (Vic) 

Health Care Insurance – 90.4%

Industry average – 85.0%

Queensland (Qld) 

Health Care Insurance – 89.4%

Industry average – 85.1%

South Australia (SA) 

Health Care Insurance – 90.4%

Industry average – 86.8%

Western Australia (WA) 

Health Care Insurance – 93.0%

Industry average – 90.1%

Tasmania (Tas) 

Health Care Insurance – 93.9%

Industry average – 83.0%

Northern Territory (NT) 

Health Care Insurance – 97.0%

Industry average – 80.1%

How many hospital agreements does HCI have in my 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.

HCI has

ACT

6 private hospital agreements out of an industry maximum of 7

8 day hospital agreements out of an industry maximum of 8

NSW

100 private hospital agreements out of an industry maximum of 100

100 day hospital agreements out of an industry maximum of 100

NT

2 private hospital agreements out of an industry maximum of 2

1 day hospital agreements out of an industry maximum of 2

Qld

58 private hospital agreements out of an industry maximum of 58

52 day hospital agreements out of an industry maximum of 53

SA

27 private hospital agreements out of an industry maximum of 27

28 day hospital agreements out of an industry maximum of 28

Tas

8 private hospital agreements out of an industry maximum of 8

5 day hospital agreements out of an industry maximum of 6

Vic

79 private hospital agreements out of an industry maximum of 79

79 day hospital agreements out of an industry maximum of 79

WA

21 private hospital agreements out of an industry maximum of 23

26 day hospital agreements out of an industry maximum of 29

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Does HCI offer any discounts?

Discount for direct debit: None

Discount for annual prepay: None

Total discount for annual prepay via direct debit: None


Does HCI offer ambulance cover?

HCI Premier Extras and Premier Package policies have emergency ambulance.

Do you need ambulance cover?

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

  • In Queensland or Tasmania, emergency ambulance services are covered by your state government. 
  • In NSW and the ACT, all hospital policies come with emergency ambulance cover – so you'll be covered with any hospital or combined policy you select. 
  • In 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 WA: 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 WA: 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?

Yes, adult children are covered up to age 23 if not living with a partner and up to age 25 if in full-time study and not living with a partner.


Does HCI let you claim online or in-app?

Claim via email or app (iOS and Android). No online claiming.


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What CHOICE Community says about HCI

CHOICE Community is the online forum for Australian consumers, open to CHOICE members and supporters. Join the conversation about Health Care Insurance to share your experiences or gain more insights into this health fund.