living healthy September 11
Queensland Country Health Fund Member Newsletter ed.7
warming up without spreading out!
Q Is your hand
not working the wayÂ it should?
exercise the wonder drug Safeguarding your Contributions!
From the General Manager Health Fund I am pleased to report to Members that Queensland Country
There has been significant political focus on health insurance over
Health Fund has had a successful financial year both in terms
the past few months as the Labor Government progresses with the
of financial performance and membership growth. The Health
introduction of a bill into parliament to means test the Medicare
Fund is a not-for-profit business but some profits are still
Rebate. In brief, the bill if passed will mean that individuals earning
derived from our health benefits fund business to ensure we
more than $80,000 and couples and families above $160,000 would
continue to meet the capital requirements of the regulator, the
receive a reduced or nil Medicare rebate which will obviously add to
Private Health Insurance Administration Council (PHIAC). We
the cost of health insurance considerably. I am very concerned that
experienced strong demand for our health insurance products
the proposed changes will have a significant negative impact on the
during the year with membership growth of 7%, which is more
private health insurance industry and, in particular, on Queensland
than twice the industry average growth for last financial year.
Country Members. This change will mean that many Members who are
Our significant increase in benefits in April combined with a lower than industry average premium increase continues to ensure our products offer excellent value for money and more and more
already struggling with the cost of living may find it even more difficult to remain privately insured and will add to the extreme pressures in the public hospital system.
consumers are recognising this which has contributed to the strong
Thanks for your support of our great Fund and I welcome any
demand for our products. Growing the Fund is an important focus
feedback from Members and suggestions to improve our products
but meeting the expectations of our existing Members is our main
goal and we continue to look for ways to further improve the service and the products we offer. We have included in the Living Healthy magazine an outline of the increased and additional benefits that were introduced earlier this year and I would encourage everyone to take a few minutes to understand how these benefits may be applicable. Aaron Newman
Growth in the number of people we cover is an important part of
managing the business to keep premium increases as low as possible.
Queensland Country Health Fund
With this in mind and to provide better access to services for our
Ph. 4750 3300
Members we are planning to open a branch in Gladstone. This branch
will offer both health insurance and banking services (offered by Queensland Country Credit Union) and we expect the branch to be open by early November. This will add to our service centre network and now provide 5 retail centres that offer the full range of Health Fund services. Health Fund
Queensland Country Health Fund
2 Queensland Country Health Fund | September 11
Did you know? Excess
If you have an excess on your policy you only need to pay that excess
Sleep Apnoea is found to be more prevalent in our society today
if you are admitted to hospital. The excess is payable once per person
than ever before. Queensland Country Health Fund can help ease
and twice in the family membership year. As of April 1st this year,
the financial burden of purchasing a costly CPAP machine by paying
if you have children aged 5 and under, the excess does not apply to
a very generous benefit. It is a requirement that a sleep study is
their admissions. This is another way that Queensland Country Health
performed in a registered hospital or day surgery facility, an approved
Fund is looking after its Members.
clinic or an approved home sleep study. If you have Private Hospital cover with us, we can pay towards firstly the hire then the purchase
of these machines. We will pay 85% of cost to hire and/or purchase
Each year the Government sets the Pharmaceutical Benefits Scheme for pharmacy items. This year the amount is $34.20. This means
the machine, up to $2000* every three years. We will only pay on the initial mask and tubing purchased with the machine, and a humidifier in relation to a CPAP machine. Please see our staff for more details.
that if you are purchasing scripted pharmaceuticals* that exceed this amount, we may be able to pay a benefit towards it. Pharmacy
*this limit covers all mechanical aides and appliances including CPAPÂ machines
items must be scripted, dispensed from a pharmacy or Doctorâ€™s room, accompanied by an official pharmacy receipt and over the PBS amount. We pay benefits from $34.20. This means that you will always pay the first $34.20. For example if you have a script for Aqueous Nasal Spray priced at $44.20 we will pay $10. If you have Premium Extras you can claim up to $50 above the
$34.20, and on Essential Extras you can claim up to $30 above the $34.20. Sub-limits do apply. For further info, please contact us at email@example.com *Contraceptives are not claimable unless they meet specific requirements; please contact us for further details
September 11 | Queensland Country Health Fund 3
N O I TIT E MP O C S AP C I H
0 0 5 $ N I W
ARE YOUR KIDS 21 AND NOT READY FOR THEIR OWN POLICY? Many of our Members have adult children aged between 21 and 25 years that in the past have needed to take out their own health insurance policy on their 21st birthday. Prior to April 1st 2011, a dependant turning 21 and not involved in full time study or an apprenticeship was not eligible to remain on their parent’s policy. At Queensland Country Health Fund, we understand that not every 21 to 25 year old chooses to study full time or embark on
HICAPS is an electronic health claiming and payments system that lets you process your claims immediately after receiving treatment, while you're still at the surgery or practice. With HICAPS you no longer have to make a separate trip to
an apprenticeship. They may be in their first full time job, doing a traineeship, or working and studying part-time. Whatever the reason, health insurance is not a priority for them and more often than not, they don’t have the extra funds needed to cover the cost themselves.
your Queensland Country branch to lodge your claim or send it
Queensland Country Health Fund has the solution. We
in via the post. It’s convenient and easy. There’s no more claim
now offer a policy called Family Plus. This means even
forms to fill in and all you need is your Queensland Country Health Fund Member card.
though your adult child between 21 and 25 may not be studying full time, they can remain on your policy for a little extra cost**.
When using HICAPS, you don't need to pay the full
If you are in this category, or would like to take advantage
consultation fee and wait for the reimbursement of your
of this policy option, please email us at firstname.lastname@example.org.
benefit - you simply swipe your Queensland Country Health
au to arrange a conversion. We can also assist with the
Fund Member card and the claim is finalised on the spot. You
transfer of dependants back onto your policy.
just pay any difference between the full consultation fee and
**Dependants that are married or in a defacto relationship
the benefit amount.
are not eligible to be covered on this policy
Next time you visit your health service provider, ask if you can
use your Queensland Country Health Fund Member card to claim on the spot with HICAPS.
Between the 1st and 31st of October, everyone who
uses HICAPS will automatically go in the draw to win 1 of 3 $500 gift cards.
Terms and conditions apply and are available by calling
1800 813 415.
HICAPS FAST claims...on the spot For more information on HICAPS visit
4 Queensland Country Health Fund | September 11
Queensland Country Health Fund is committed to healthy living, inside and out. We love to get behind our community and support a number of different sporting teams and community events. Included in our sponsorships are North Queensland Athletics, Townsville Fire, Bowen Triathlon and the Charters Towers Gold Fever Le Tour. We also sponsor the Townsville Running Festival, of which a large number of our staff participate in. Our sponsorship of these community events and organisations reflect our strong commitment to promoting healthy lifestyle and wellbeing in our communities.
Anniversary Year We like to think that we give all our Member’s the opportunity to claim all the benefits available to them. That’s why Queensland Country Health Fund operates on a Membership year, rather than a financial or calendar year. Your Membership year is unique to you, it’s the date you joined our fund! This date is now listed on your Membership card to make it even easier for you. For more information on your Membership year, please email us at email@example.com September 11 | Queensland Country Health Fund 5
HEALTHY LIVING BENEFITS ø PSA Test – Some Members who have
If you have Extras cover with us, you are able
Furthermore we will also pay towards
to claim for selected items that help manage
the following items that assist in health
your health and promote a healthy lifestyle.
per year. Medicare pays a benefit for one
We can pay benefits towards some of the
ø M etabolic dieticians and nutritionists
test a year, and we will now pay a benefit
costs involved with joining a weight loss
when providing consultations to assist
program or quitting smoking. In the past we have only paid towards selected programs,
membership fee to any program (gym
ø B owel screening Tests and Bone Density
programs are not included).
towards the un-rebated test.
with weight loss
we will now pay towards registration or memberships or any physical activity
had prostate surgery require 2 PSA tests
Consultation fees for Diabetes Educator
Tests provided through Chemists/ physiotherapists etc
Gladstone Branch As our name implies we have a particular interest in providing health insurance services to Regional Queensland. We have service centres established in Mount Isa, Mackay, Townsville and Ayr. We are now planning to expand our service centre network and have commenced the establishment of a branch in Gladstone. Gladstone is one of the fastest growing centres in Queensland and a location where we already have a significant number of Members residing. The service centre will allow existing Members to receive refunds of claims paid, provide assistance with changes to their policy and provide policies to new Members. The branch will adopt the latest technology and allow Members to receive information using large touch screens, access their personal information online and staff can provide assistance using their iPads. The branch will be located at Shop 39 Gladstone Shopping Centre, 44-55 Dawson Road, Gladstone 4680 and will open on the 7th November.
6 Queensland Country Health Fund | September 11
SAFEGUARDING YOUR CONTRIBUTIONS! Queensland Country Health Fund is committed to supporting the good health of all our Members in lots of different ways; this includes the payment of benefits. As part of our commitment to you, we are working to ensure that we achieve the greatest possible value from your contribution dollars which are used to pay these benefits. Our claims management program is one aspect of our work in this area. Claims are audited to ensure that the treatments or services invoiced are actually the benefits our Members have received. This is delivering good results already and with your help we could do even better!
Why should Members care about inappropriate claims?
with courteous respect. You can choose to remain anonymous if you
Since the funds available for the payment of benefits are finite,
of all parties.
every dollar lost to inappropriate claiming means one dollar less available for payment of your legitimate claim. Ultimately the results of inappropriate claims mean reduced benefits for Members and higher contributions, which nobody wants.
wish. We abide by the highest standards of investigative practice and natural justice, and we will always protect the rightful interests
If you don’t feel comfortable contacting us, please call the Private Health Insurance Ombudsman on 1800 640 695, an independent body formed to help resolve complaints. We greatly appreciate the help we have already received from our
What is inappropriate claiming? It’s important to note that an overwhelming majority of healthcare
Members and look forward to future assistance as we work together to safeguard your contributions.
providers, are doing the right thing. We are talking about a relatively small number of claims where our claims analysis, investigations and audits reveal the unintentional billing for services which are not provided to Members. This is where our focus lies.
What does Queensland Country Health Fund do about this? We take our responsibility to provide our Member’s with a great value product seriously. We have dedicated staff that audit claims and, identify any areas of concern. We investigate claims, detect where inappropriate claiming has occurred and stop this from happening again. These staff liase with providers and claims assessors, aiming to reduce inappropriate claiming and recovering funds.
How can you help? The easiest way to help protect your contributions is to simply be aware of what you are being billed for. For example, are the dates of service on your receipt correct? Did you actually receive the treatment recorded? Like any other invoice or receipt you receive, it’s worth double checking. It’s also important to treat your Membership card like your credit card. Don’t leave your card with the provider, and if you misplace your card, please notify us immediately. If you have any reason to suspect inappropriate claiming please call us on 1800 813 415 or email us at firstname.lastname@example.org to let us know. We guarantee confidentiality and will treat your concerns
September 11 | Queensland Country Health Fund 7
THE WONDER DRUG As the Western World’s health and
earn those sought-after results at a much
If exercise was a pill, it would be one of the
wellbeing continues to diminish and
more rapid pace. As time in the day appears
most effective medications available today,
the desire for a healthy body image and
to be disappearing, added with the stress
only without the negative side effects.
better quality of life continues to rise,
of work and family commitments, thankfully
“medicinal exercise” is being prescribed
research shows that favourable results can
more than ever.
be obtained in minimal time provided the
As most of us are aware, regular exercise
prescription is accurate.
Accredited Exercise Physiologists (AEPs) are widely recognised as the highest qualified health professionals in the design and delivery of exercise whether it be for
plays an integral role in reducing the strain
More specifically, exercise is the key to;
treatment of serious illness and disease
of our overstretched health system but the
ø Increasing circulation
or for general health and wellbeing. An
is becoming more and more evident. Not
ø Promoting lean muscle growth
describes a university-trained and ESSA
only is exercise a well rounded and effective
ø Reducing body fat
extent of which and its ongoing importance
source of rehabilitation and treatment for
Strengthening cardiac muscle
and injuries, but its role in prevention is
Inhibiting the production of Cortisol
becoming much more recognised. Regular
Boosting immune function
our most debilitating chronic diseases
cardiovascular and resistance training has been shown to both prevent and treat life
ø Encouraging joint mobility
threatening conditions such as Hypertension,
ø Enhancing insulin sensitivity
Obesity, Depression, Type II diabetes and Cardiovascular Disease — the leading cause
Developing bone density
of death worldwide.
ø H eightening sexual drive and function
On the other hand, as allied health
professionals aim at shifting the intention of
ø Limiting pain and fatigue
exercise from treatment to prevention, sport and exercise science has come a long way in providing efficient training programs that
8 Queensland Country Health Fund | September 11
Producing power, speed and agility
ø Improving balance and flexibility
Accredited Exercise Physiologist (AEP) (Exercise & Sports Science Australia) accredited exercise specialist who possesses the knowledge, skills and competency to design and deliver general physical activity advice and clinical exercise prescription for apparently healthy persons and for those persons with chronic and complex diseases. The aim of the intervention is to facilitate long-term behaviour change by encouraging the self-management of health through exercise and other lifestyle modifications, with a view to preventing and treating disease. Matthew Stark works at Synergy Health and Fitness Solutions, Townsville
Matthew Stark Accredited Sport and Exercise Scientist Accredited Exercise Physiologist BSpExSci GradDip ExPhys (Clin) ESSAM AEP
> If exer c
of e a n o ise was a s e b n d l u o o pill, it w ati c i d me e v i t c e f th e most ef
ay d to e l ab l i a v
September 11 | Queensland Country Health Fund 9
Is your hand not working the way it should?
and treatment of these conditions. Treatment may include one or combination of the following therapies:
ø Pain management to minimise the use of medication ø Swelling control including massage, compression bandaging and garments
ø Scar management including desensitising scars, improving appearance and ensuring scars do not restrict movement
ø Exercise programs to improve movement, dexterity and strength ø C ustom-made thermoplastic, leather or soft splinting ø Taping or bracing ø Activity modification and equipment prescription to improve independence in daily life
ø Preparation for return to work Some hand therapy services also provide electrical modalities, ultrasound and dry needling. Rehabilitation After an Operation
What is Hand Therapy? Hand therapy is a term used to describe rehabilitation of the upper limb. Despite the name, this includes the shoulder, elbow, wrist and hand. Hand therapists complete a thorough assessment of the affected limb to develop an individualised treatment plan to prevent injury or impairment, restore function and enhance participation in everyday activities.
What is a Hand Therapist?
Hand therapy is beneficial following any surgery to the upper limb to ensure people recover and return to normal everyday life as soon as possible. Hand therapists work very closely with surgeons to plan a rehabilitation program that suits the individual. Hand therapy following an operation can include any of the treatments listed above, as well as wound care to promote healing and prevent infection. Work Rehabilitation Hand therapists are trained to work with employers and their employees to establish injury prevention programs and assist injured
Hand therapists are registered occupational therapists and
employees return to work. Hand therapists can visit the workplace
physiotherapists who, through further education, clinical experience
to recommend environmental modifications and/or alternative work
and independent study have specialised in the treatment of upper limb
conditions resulting from injury or disease.
Common Conditions Treated By Hand Therapists
How can a Hand Therapist Help You?
Hand therapists treat any condition involving the hand, wrist and elbow. Some of the more common conditions seen by a hand
There are three main times when a hand therapist can help you.
Amputations and Detipping Injuries
Dislocations and Ligament Injuries
Preventative or Conservative Treatment There are many conditions and symptoms that hand therapy can improve or resolve, often preventing people from needing an operation. Hand therapists play an important role in both diagnosis
10 Queensland Country Health Fund | September 11
Amanda Trezona Helping Hands Occupational Therapy BOccThy, MAHTA
Common Conditions Treated By Hand Therapists CONTINUED
ø Tendonitis and Tenosynovitis such as Trigger Finger ø N erve Injuries and Compressions such as Carpal Tunnel and
Interesting product Hand therapists specialise in the fabrication of low temperature thermoplastic splints. These splints are custom made for each client. There are many advantages of thermoplastic splints, particularly in the Queensland climate. They are cooler and light-weight compared to casts and can be washed easily.
Complex Regional Pain Syndrome
How to find a Hand Therapist in Your Area?
You can find a Hand Therapist in your local area on the Australian
Wounds to the upper limb
Hand Therapy Association website www.ahta.com.au
Soft Tissue Injuries
The Australian Hand Therapy Association website www.ahta.com.au
Brachial Plexus Injuries
The American Society of Hand Therapists website www.asht.org
ø Autoimmune Conditions such as Scleroderma.
Hand therapists complete a thorough assessment of the affected limb to develop an individualised treatment plan September 11 | Queensland Country Health Fund 11
WARMING UP WITHOUT SPREADING OUT! Winter is certainly here with some
Need a comfort snack during the day?
Carbs at dinner are synonymous with
record low temperatures, early
Why not try:
comfort; think a hearty stew with creamy
snowfall and a frosty bite in the air
mashed potato, a rich tomato pasta or a
Most people will change their eating
Single serve pumpkin or vegetable soup
stop you spreading:
habits with the cool weather — from
Skinny coffee/chai/hot chocolate
ø Steak with grilled vegetable salad e.g.
in the early mornings and evenings.
a bowl of porridge in the morning to soup for lunch and a slow cooked casserole for dinner. Warm, hearty
ø Sachet coffee/chai/hot chocolate made on water with a dash of milk
food has such a comforting effect and
while hiding a flabby stomach under
ø 2–3 grainy crackers with light
many layers can sound very appealing, warmer weather is only a couple of short months away when that stomach
Small handful dried fruit and nuts
ø 1 mountain bread wrap with a sprinkle of cheese (melted in microwave/grill/
will be bare on the beach once again.
Comfort food doesn’t have to be fat and carb laden, in large serving sizes and lead to a
Salad for lunch not cutting the mustard?
spread of the waistline. Many winter foods
Try these warm lunch options to get you
can be nutritious, warming and keep that
through the day:
beach ready body over the cooler months.
ø H omemade or canned soup (go for low
Try these suggestions on for size…
salt/low fat options) such as minestrone, vegetable, chicken or beef
Cold cereal, fruit and yoghurt or a smoothie are not so appealing in winter so to warm up straight out of bed, try:
ø Porridge with honey/cinnamon/fruit/ dried fruit
Baked beans on toast
Poached eggs on toast
Weet-bix with warm milk
ø W arm poached fruit with yoghurt & a sprinkle of nuts
fresh risotto. These dinner options will
zucchini, eggplant, capsicum, onion etc
ø M arinated chicken breast with roasted veggies e.g. sweet potato or pumpkin, capsicum, onion, cauliflower, beetroot, zucchini
ø B eef and veggie soup (packed with whatever veggies you can find!)
ø Slow cooker lamb (choose a lean cut) with plenty of veggies (go easy on potato)
ø G rilled fish with asparagus, broccolini and a small serve of skinny mash (potato mashed with skim milk) A warm pudding on a cold winter’s night — delicious for the taste buds, dire for the
Try toasting your sandwich!
Small serve leftover stew/casserole
such as plums, apples or pears with low fat
ø M ake extra rissoles and make a rissole
custard, a low fat baked custard, a healthy
sandwich with extra salad
ø Toasted wrap with chicken or tuna, a sprinkle of cheese, tomato and spinach
ø Small serve pasta (best on your more active days!)
ø Low fat frozen meal such as Lean
waist-line. Try baked or poached fruits
apple crumble (go easy on the butter in the crumble!) or succumb to a smaller serve of a delicious pudding once a week as a treat. Winter is not only a time to undo your hard work in the nutrition department, but also with fitness. Getting out of a nice, warm bed on a cold, dark Winter’s morning doesn’t
Cuisine, Weight Watchers etc
(: K k L @ 12 Queensland Country Health Fund | September 11
Lauren Nugent Eat Smart Nutrition Consultant
sound so appealing. Instead of skipping your exercise session, change to a Winter friendly option:
ø Take a longer lunch and exercise in the warm part of the day — take a walk, run or ride in the sunshine!
ø Try a gym class or indoor group exercise session
ø Set up a circuit at home in the comfort of a warm room — tricep dips, sit-ups, push-ups, squats, lunges and many other exercises can easily be done at home
ø Try Bikram yoga — it’s definitely warm in a 38-degree room!
Walk to work or home from work
ø U se the weekend for a longer exercise session later in the day — take a long ride, walk or hike
ø G et an exercise DVD or use your Wii fitness programs
ø O rganise a friendly touch, tennis, soccer or netball match with friends, kids or family If you need more suggestions, recipes, tips and hints on keeping lean over Winter check out the Eat Smart blog at www.eatsmartdiet.com.au.
September 11 | Queensland Country Health Fund 13
Queensland Country Health Fund prides itself on offering products with market leading benefits. We spend time each year reviewing these benefits to make sure we are offering competitive benefits and a value for money product. In April this year, we increased a number of our benefits.
Dental Benefit Increases A major focus this year centred on raising individual dental limits and benefits. The aim of increasing these benefits is to encourage better dental health amongst our Members. Examples of new benefits payable on some commonly used dental items can be found below: Our Benefits Dental Item Description
Comprehensive Oral Exam (011)
Periodic Oral Exam (012)
Removal of calculus (114)
Topical fluoride (121)
Surgical removal of tooth (322)
Adhesive restoration/filling (531)
$15 $131 $64
In addition to raising individual item number benefits, we have also increased the sub-limits for diagnostic, preventative and oral surgery services. This ensures that our Members can take full advantage of our increased benefits. For more information on these sub-limits, please don’t hesitate to contact us at email@example.com
Optical Benefits Increase Optical benefits have also been reviewed and increased. You are able to use your whole optical limit towards any current optical item; contacts, lenses, frames, prescription sunglasses, and we will cover up to your available limit per Member, per membership year. Optical Benefits – annual limit per person per membership year Premium Extras
14 Queensland Country Health Fund | September 11
BENEFITS IN FOCUS Exercise Physiology
We have recently introduced a new benefit for Members who participate in Exercise Physiology. Benefits for this therapy are available for both Essential and Premium Extras. The benefits are outlined in the table below: Premium Extras
$550 sub-limit per membership year.
$350 sub-limit per membership year.
(Paid under Physiotherapy)
Limit applies per person covered
Limit applies per person covered
Initial consultation 2 months waits Monthly Program Fee
To be eligible for receive a benefit for exercise physiology, a letter from your medical practitioner is required. It must state that the referral is for an existing medical condition, including rehabilitation, pre & post operative conditions and chronic disease management.
Physiotherapy Physiotherapy is medical treatment for problems of the joints, muscles, or nerves, which involves doing exercises or having part of your body massaged or warmed. Some people require physio as a part of their rehabilitation or recovery following a procedure. Queensland Country Health Fund pays benefits towards Physiotherapy if you have Essential or Premium Extras cover, or hold a Smart Start policy. Please see below for benefits. Premium Extras
$550 sub-limit per membership
$350 sub-limit per membership
$300 sub-limit per membership
year. Limit applies per
year. Limit applies per
year. Limit applies per
Physiotherapy Initial consultation 2 months waits Monthly Program Fee
Occupational Therapy Occupational therapy is a profession focused with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists, or OT’s, achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment to better support participation. Queensland Country Health Fund covers Occupational Therapy consultations under Premium or Essential Extras. Please see below for more benefit information: Premium Extras $1400 overall limit per membership
Occupational Therapy Initial consultation
year. Limit applies per person covered
Essential Extras $900 overall limit per membership year. Limit applies per person covered
2 months waits Subsequent consultation
September 11 | Queensland Country Health Fund 15
Worried about retirement? relax.
Your super is safe with Queensland CountrY’s superannuation solution. • No share market exposure • Capital guaranteed by QCCU • No administration fees and a competitive rate
a refreshing attitude to banking Visit your local Queensland Country Credit union branch or qccu.com.au for more information
qccu.com.au Terms, conditions and fees apply. This product is issued by Queensland Country Credit Union Limited ABN 77 087 651 027 AFSL/ACL 244533 A copy of the Product Disclosure Statement can be obtained from your local branch. Before acquiring this product you should consider whether or not its appropriate for you.
Queensland Country Health Fund Living Healthy Magazine August 2011