HCi Hospital Cover
// HCi HOSPITAL COVER
HCi hospital cover helps pay for any necessary hospital treatment for your and your dependants. And you choose the level of cover to suit your needs.
So you can have confidence that if you go to hospital, you can concentrate on getting better, knowing we’ll take care of the rest.
HCi hospital cover in summary
For full details of HCi hospital cover options and accident cover, including all terms and conditions, excess details, definitions and exclusions, please refer to our Guide to Cover and the specific product summary.
Some HCi hospital cover or excess options are no longer available for purchase. So please refer to our closed products page if you have that cover.
$500 | $750
HCi’s Silver Plus Advantage Hospital cover is top cover without things like joint replacements.
Perfect cover while building your family!
This cover gives you access to the best possible treatment.
$500 | $750
HCi’s Silver Plus Secure Hospital cover is top cover without pregnancy and related procedures.
If you’re not planning any babies soon, this cover is for you!
This cover gives you access to the best possible treatment.
$750
- HCi’s Bronze Plus Hospital cover is simple hospital cover that won’t break the budget.
- Not all procedures and services are covered, but accident cover is included.
Accident cover
If you have an accident requiring hospital for treatment not related to any pre-existing illness, injury or condition, HCi will pay towards your treatment and accommodation fees.
$750
- HCi’s Basic Plus Hospital cover is a low cost option for the absolute basics, plus accident cover.
- This cover may reduce your tax by avoiding a Medicare levy surcharge and/or a Lifetime Health Cover loading.
Accident cover
If you have an accident requiring hospital for treatment not related to any pre-existing illness, injury or condition, HCi will pay towards your treatment and accommodation fees.
You can combine HCi Silver Plus Advantage, Silver Plus Secure, Bronze Plus or Basic Plus Hospital cover with our Extras cover for more comprehensive health cover.
HCi hospital cover options compared
Tip – click the option’s name for more details.
Procedure | |
|
|
|
|
---|---|---|---|---|---|
Assisted reproductive services | ✔ |
✔ |
✘ |
✘ |
✘ |
Back, neck and spine | ✔ |
✔ |
✔ |
✘ |
✘ |
Blood | ✔ |
✔ |
✔ |
✔ |
✔ (R) |
Bone, joint and muscle | ✔ |
✔ |
✔ |
✔ |
✘ |
Brain and nervous system | ✔ |
✔ |
✔ |
✔ |
✘ |
Breast surgery (medically necessary) | ✔ |
✔ |
✔ |
✔ |
✘ |
Cataracts | ✔ |
✘ |
✔ |
✘ |
✘ |
Chemotherapy, radiotherapy and immunotherapy for cancer | ✔ |
✔ |
✔ |
✔ |
✘ |
Dental surgery | ✔ |
✔ |
✔ |
✔ |
✘ |
Diabetes management (excluding insulin pumps) | ✔ |
✔ |
✔ |
✔ |
✘ |
Dialysis for chronic kidney failure | ✔ | ✘ |
✔ |
✘ | ✘ |
Digestive system | ✔ | ✔ |
✔ |
✔ | ✘ |
Ear, nose and throat | ✔ |
✔ |
✔ |
✔ | ✘ |
Eye (not cataracts) | ✔ |
✔ |
✔ |
✔ | ✘ |
Gastrointestinal endoscopy | ✔ | ✔ |
✔ |
✔ | ✘ |
Gynaecology | ✔ | ✔ |
✔ |
✔ | ✘ |
Heart and vascular system | ✔ | ✔ |
✔ |
✘ | ✘ |
Hernia and appendix | ✔ | ✔ |
✔ |
✔ | ✘ |
Hospital psychiatric services | ✔ | ✔ (R) |
✔ (R) |
✔ (R) |
✔ (R) |
Implantation of hearing devices | ✔ | ✔ |
✔ |
✘ | ✘ |
Insulin pumps | ✔ | ✘ |
✘ |
✘ | ✘ |
Joint reconstructions | ✔ | ✔ |
✔ |
✔ | ✘ |
Joint replacements | ✔ | ✘ |
✔ |
✘ | ✘ |
Kidney and bladder | ✔ | ✔ |
✔ |
✔ | ✘ |
Lung and chest | ✔ | ✔ |
✔ |
✘ | ✘ |
Male reproductive system | ✔ | ✔ |
✔ |
✔ | ✘ |
Miscarriage and pregnancy termination | ✔ | ✔ |
✔ |
✔ | ✘ |
Pain management | ✔ | ✔ |
✔ |
✔ | ✘ |
Pain management with device | ✔ | ✘ |
✘ |
✘ | ✘ |
Palliative care | ✔ | ✔ |
✔ |
✔ | ✔ (R) |
Plastic and reconstructive surgery (medically necessary) | ✔ | ✔ |
✔ |
✘* | ✘ |
Podiatry surgery (by a registered podiatric surgeon) | ✔ | ✔ |
✔ |
✘ | ✘ |
Pregnancy and birth | ✔ | ✔ |
✘ |
✘ | ✔ (R) |
Rehabilitation | ✔ | ✔ (R) |
✔ (R) |
✔ (R) | ✔ (R) |
Skin | ✔ | ✔ |
✔ |
✔ | ✘ |
Sleep studies | ✔ | ✔ |
✔ |
✔ | ✔ (R) |
Tonsils, adenoids and grommets | ✔ | ✔ |
✔ |
✔ | ✘ |
Weight loss surgery | ✔ | ✘ |
✘ |
✘ | ✘ |
All other inpatient services where Medicare pays a benefit | ✔ | ✘ |
✘ |
✘ | ✘ |
(R) This is a Restricted Service.
* For Bronze Plus Hospital, plastic surgery which is medically necessary and related to the treatment of a skin-related condition is covered under the “Skin” clinical category.
HCi hospital cover and accident cover
Basic Plus and Bronze Plus Hospital cover include Accident Cover to help you pay for any necessary hospital admission due to an accident. An accident is any unforeseen event due to chance or caused by an external force or object, which results in an involuntary injury to the body requiring immediate or urgent medical treatment in hospital.
For the services listed above, HCi hospital cover includes
- Up to 100% of hospital accommodation costs and theatre fees in all contracted hospitals and day surgery facilities in Australia.
- Private room accommodation (if available).
- Up to 100% of the cost of surgically implanted prostheses (as listed by the Federal Government).
- Dental theatre costs for surgical tooth extraction by an oral surgeon.
- Up to 100% of the cost of most hospital prescriptions relating to the admission, subject to hospital agreement details.
- 100% of the cost of the difference between the Medicare refund and the Commonwealth Medical Benefit Scheme (MBS) fee for medical services provided during a hospital admission.
- Up to 100% of the cost of medical services provided during a hospital admission where the doctor charges above the Commonwealth Medical Benefit Scheme (MBS) fee and chooses to use Access Gap Cover.
All the above applies to you and any dependants listed as part of your membership.
HCi hospital cover excludes the following:
- Cosmetic surgery
- Extra services beyond the hospital treatment plan
- Personal expenses like phone calls, newspapers and TV rental
- Hospital services not eligible for Medicare benefits
- Pharmaceutical items supplied or prescribed on discharge
- Medicare gap (ie out of pocket expenses)
- Surgically implemented prosthesis gap
- Medical treatment provided in a doctor’s rooms out of hospital
- Services, treatments and appliances purchased from non-Australian suppliers or websites
Managing hospital costs
Remember Medicare covers public hospital treatment for Australian residents, and emergency patients usually go to a public hospital with Intensive Care Units.
With HCi hospital cover, you can elect to be a private patient in a public hospital.
You can choose your doctor and have a private room if available. However, you will still be subject to waiting lists for elective procedures.
Medical fees
HCi hospital cover enables you to get full private hospital access to services, a doctor of your choosing at a convenient time with no (or reduced) waiting periods.
Under the Commonwealth Medical Benefits Schedule (MBS) fees are determined and accordingly split between HCi and Medicare. It is important to discuss fees with your doctor prior to treatment as there may be out of pocket expenses. If your doctor charges above the MBS fee, HCi does not cover these expenses. Read our factsheet on The Gap for more information.
HCi’s Access Gap
HCi has relationships with over 500 private hospitals and day hospital facilities around Australia. So there’s bound to be one in your area!
If you need specialist care in hospital, your doctor can use HCi’s Access Gap Cover – a much simpler billing system to eliminate out of pocket expenses altogether – or let you know exactly what you have to pay prior to treatment.
Remember to ask your doctor:
- Will you treat me under HCi’s Access Gap?
- Can you treat me in a HCi agreement hospital?
- Will I have any out-of-pocket expenses? Please provide a formal quote of these costs.
- If I need any assisting doctors or specialists, how can I obtain a quote for their services? If so, will they also use Access Gap Cover?
Gap Cover and surgically implanted prostheses
Surgically implanted prostheses are sometimes required during a medical procedure, such as a replacement lens for a cataract surgery, an artificial hip joint, a pacemaker, or a heart valve.
For medical procedures covered by Medicare, HCi fully covers the cost of at least one prostheses – this is referred to as a ‘no gap’ prostheses. However, some items listed on the Prostheses Schedule are not or only partially covered. Therefore, please review the list with your doctor prior to surgery.
Based on your level of HCi hospital cover, you have a choice of excess options. An excess is what you pay towards your hospital treatment. HCi applies an excess once per calendar year for adult members and dependants – not for under 18s.
$250 Excess | $500 Excess | $750 Excess | |
---|---|---|---|
Gold (closed 20/12/24) | ✘ | ✔ | ✔ |
Silver Plus Advantage | ✘ (closed from 1/9/25) |
✔ | ✔ |
Silver Plus Secure | ✔ | ✔ | ✔ |
Bronze Plus | ✘ | ✘ | ✔ |
Basic Plus | ✘ | ✘ | ✔ |