Hunter Health Insurance (CDH Benefits Fund) Review

Overview

Hunter Health Insurance, also trading as CDH Benefits Fund (Cessnock District Health Benefits Fund) was established as a regional health fund over 65 years ago to provide affordable health coverage for the coal mining sector in New South Wales.

This fund is now operating as Hunter Health Insurance and while they still cater predominantly to the coal mining industry in their region, Hunter Health Insurance (CDH) is open to all Australian residents.

Hunter Health Insurance Key Facts

Founded: 1952

For-Profit or Not-For-Profit? Not-For-Profit

Private Hospital Agreements Nationwide: 226

Day Hospital Agreements Nationwide: 114

Health Deal Represented? No

Headquarters: Newcastle, NSW

Hunter Health Insurance Hospital Cover

Hunter Health Insurance has 5 hospital policies to suit all individual and family needs. These range from Basic Hospital Cover all the way up to Gold Hospital Cover. Here is a list of the hospital covers currently available from Hunter Health Insurance:

  • Basic Hospital Cover
  • Silver+ Hospital Cover
  • Silver+ Young Hospital Cover
  • Thrifty Silver+ Hospital Cover
  • Gold Hospital Cover

Hunter Health Insurance Extras Cover

Extras Cover takes care of the everyday healthcare service expenses that are not generally covered under Medicare such as dental services, prescription glasses, and physiotherapy. Here is a list of some of the current extras covers available:

  • Classic Extras Cover
  • Elite Extras Cover
  • Healthy Extras Cover
  • Supplementary Cover

Hunter Health Insurance Waiting Periods

Hunter Health recognises the waiting periods you have already served with a previous health fund if you switch; this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:

Hospital Waiting Periods

  • Ambulance services: 1 Day
  • Accidental Injury: 1 Day
  • New Conditions: 2 Months
  • Pregnancy and birth-related services: 12 months
  • Pre-existing conditions: 12 months
  • Rehabilitation & Palliative care: 2 months
  • Weight Loss Surgery: 12 months

How Do You Claim Extras With Hunter Health Insurance?

Claiming with Hunter Health Insurance is simple and easy. There are 4 ways to claim, which are:

On the spot: You can swipe your membership card at your service provider’s HICAPS electronic claims system. This will enable you to have your claim processed immediately.

Online:  You can make a claim through their website by providing the details on your receipt.

Email or fax: Claims can be made by scanning and faxing a completed Health Cover Claim form to Fax (02) 4991 2155 and attaching receipts to the form

By post: Claims can be lodged by submitting a completed claim form along with your receipt from your health provider.

151-153 Vincent St, Cessnock NSW

PO Box 183, Cessnock NSW 2325

Benefits can be paid by bank transfer or cheque.

Hunter Health Insurance Gap Cover

Hunter Health’s gap cover is called the Gap Cover Scheme. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense.  Gap Cover can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.

Gap Cover Ratings By State

To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme. 

Medical Services with No Gaps — the percentage of claims that were fully refunded.

Medical Services with No or Known Gaps — the percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.

The information below outlines the percentages of services covered under no-gap and known-gap.

Hunter Health Insurance medical services with No Gap: 0%

Industry Average: 79.1%

Hunter Health Insurance medical services with No or Known Gap: 50%

Industry Average: 90.5%

Hunter Health Insurance medical services with No Gap: 88.1%

Industry Average: 89.5%

Hunter Health Insurance medical services with No or Known Gap: 97.6%

Industry Average: 95.7%

Hunter Health Insurance medical services with No Gap: 59.3%

Industry Average: 86.7%

Hunter Health Insurance medical services with No or Known Gap: 84.8%

Industry Average: 95.1%

Hunter Health Insurance medical services with No Gap: 66%

Industry Average: 89.2%

Hunter Health Insurance medical services with No or Known Gap: 90.1%

Industry Average: 94.5%

Hunter Health Insurance medical services with No Gap: 70.8%

Industry Average: 89.5%

Hunter Health Insurance medical services with No or Known Gap: 95.8%

Industry Average: 96.6%

Hunter Health Insurance medical services with No Gap: 59.1%

Industry Average: 84.4%

Hunter Health Insurance medical services with No or Known Gap: 100%

Industry Average: 96.2%

Hunter Health Insurance medical services with No Gap: 65.2%

Industry Average: 90.2%

Hunter Health Insurance medical services with No or Known Gap: 100%

Industry Average: 96.7%

Hunter Health Insurance medical services with No Gap:

Industry Average: 84.2%

Hunter Health Insurance medical services with No or Known Gap:

Industry Average: 93.8%

Continue Reading...

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