| HCF | |
|---|---|
| Registered insurer | HCF |
| Who can join | Open to anyone |
| Business structure | Member-owned mutual, not-for-profit |
| Hospital policies (30 June 2025) | 842,024 (13.7% of all hospital policies), covering 1,821,414 people. Figure is for HCF, which includes RT Health |
| Hospital tiers on sale (1 September 2026) | Gold, Silver Plus, Bronze Plus, Bronze, Basic Plus, Basic |
| Excess options on open hospital policies | $250, $500, $750 |
| Age-based discount (18–29) | Not offered on its open hospital policies |
| Ambulance | Emergency ambulance on its open hospital policies; some also cover non-emergency transport |
Structure: a Sydney-based mutual
PrivateHealth.gov.au describes HCF as a mutual organisation operating on a not-for-profit basis, based at George Street, Sydney. The fund says it was established in 1932. RT Health is a division of HCF and is reported within its figures. HCF sells in every state and territory and offers overseas visitors and corporate products as well as retail cover.
Benefits: more of each premium dollar back to members
HCF paid 87.8% of its premium income back as benefits in 2024–25, above the industry's 84.5%, and the highest of the five largest insurers. Its management expenses were 12.4% of contribution income against an industry 10.9%. Hospital charges covered were 88.3% (industry 89.0%), and 85.4% of in-hospital medical services had no gap (industry 87.1%).
Complaints: in proportion, but more investigations
HCF drew 12.1% of all Ombudsman complaints about insurers in 2024–25, slightly below its 12.8% market share. But its share of complaints the Ombudsman went on to investigate was 23.6%, nearly double its market share and the highest of any insurer. An investigated complaint is one the Ombudsman couldn't resolve by referring it back to the fund. The State of the Health Funds report is the place to read what those complaints were about.
Member retention was 83.7%, a little below the industry's 85.0%.
What HCF sells
HCF's open hospital policies at 1 September 2026 cover Gold, Silver Plus, Bronze Plus, Bronze, Basic Plus and Basic, with $250, $500 and $750 excess options. None were listed with the age-based discount. Emergency ambulance is included on its open hospital policies; some also include non-emergency transport.
HCF against the industry: 2024–25 data
Every year the Private Health Insurance Ombudsman compares all insurers on the same measures, and PrivateHealth.gov.au republishes the results on each insurer's profile. The table below is HCF's (reported at the level of the registered insurer), with the industry result beside each figure. Its complaints-to-market-share ratio was 0.95: a figure of 1.00 means complaints exactly in proportion to size.
| Measure | HCF | Industry | Reading |
|---|---|---|---|
| Share of all Ombudsman complaints | 12.1% | Market share 12.8% | In proportion to its size |
| Share of investigated complaints | 23.6% | Market share 12.8% | |
| Member retention (hospital cover) | 83.7% | 85.0% | Weaker than industry |
| Benefits paid as % of premiums | 87.8% | 84.5% | Better than industry |
| Management expenses % of premium income | 12.4% | 10.9% | Weaker than industry |
| Hospital charges covered | 88.3% | 89.0% | Weaker than industry |
| Medical services with no gap | 85.4% | 87.1% | Weaker than industry |
| Medical services with no gap or a known gap | 96.8% | 97.1% | In line with industry |
| Extras (general treatment) charges covered | 50.7% | 50.7% | In line with industry |
How to read it: complaint share is the fairest single comparison of service across funds of different sizes, because it's measured against market share. Benefits as a % of premiums shows how much of the premium pool went back to members as claims; a mutual that returns more is not necessarily cheaper, and a fund can move this figure by changing prices. The gap measures show how often members avoided an out-of-pocket medical bill after a hospital stay, which is what most people mean by "good cover".
Hospital agreements
| ACT | NSW | VIC | QLD | SA | WA | TAS | NT | |
|---|---|---|---|---|---|---|---|---|
| Private hospitals | 6 | 95 | 69 | 52 | 17 | 21 | 5 | 1 |
| Most held by any insurer | 7 | 97 | 74 | 58 | 17 | 23 | 7 | 2 |
| Day hospitals | 9 | 98 | 57 | 47 | 25 | 22 | 10 | 2 |
| Most held by any insurer | 9 | 98 | 64 | 50 | 30 | 28 | 11 | 2 |
What to check before you join HCF
- HCF's share of investigated complaints (23.6%) was well above its market share in 2024–25. Keep records of claims and correspondence.
- No age-based discount on HCF's open hospital policies, so under-30s may find the discount elsewhere.
- RT Health policies are HCF products under a different name; compare them as separate products.
- Over 31 and joining for the first time? Work out your Lifetime Health Cover loading first, and if you earn over the threshold, check the Medicare Levy Surcharge you'd avoid.
Common questions about HCF
Is HCF a not-for-profit health fund?
Yes. PrivateHealth.gov.au lists HCF as a mutual organisation that operates on a not-for-profit basis. By hospital policies it is the largest not-for-profit insurer in APRA's June 2025 data.
How much of its premiums does HCF pay out?
87.8% of premium income was paid as benefits in 2024–25, against an industry result of 84.5%.
Is RT Health part of HCF?
Yes. RT Health is a division of The Hospitals Contribution Fund and shares its reported figures.
Other fund reviews
See every registered health insurer compared on complaints and benefits, or read how the private health insurance rebate and hospital cover tiers work.
This review is general information based on published government and regulator data. We don't rate or rank funds, and it doesn't consider your circumstances. Check a policy's Private Health Information Statement before you buy.
