Queensland Country Health Fund prides itself on offering products with marketing leading benefits. We review these benefits each year to ensure we maintain a very competitive and value for money product. We also want you to experience the genuine value we offer our Members thanks to our generous benefits that grow each year.
Below you'll find all of the details of the changes to our benefits which will take effect on 1 April 2017.
We understand dental health is important to you, so we’re continuing to reduce the out-of-pocket expenses for diagnostic and preventive dental treatments.
|Dental item description||Current benefit||New benefit|
|Periodic oral exam||$45||$50|
|Scale and clean||$75||$79|
|Periodic oral exam||$32||$35|
|Scale and clean||$53||$55|
|Periodic oral exam||$36||$40|
|Scale and clean||$60||$63|
|Periodic oral exam||$34||$38|
|Scale and clean||$56||$59|
This table doesn't cover all of the changes to dental benefits - please contact the Fund for more details about specific services before treatment.
There’s been a rise between the cost of services and the benefits we pay
for chiropractic services, so we decided to increase what we pay for initial
|Chiropractic item description||Current benefit||New benefit|
|Subsquent consultation (no change)||$35||$35|
|Subsequent consultation (no change)||$25||$25|
|Subsequent consultation (no change)||$28||$28|
|Subsequent consultation (no change)||$30||$30|
Did you know we pay benefits for group therapies when they form a part of a physiotherapy or exercise physiology treatment plan? We’re increasing the sub-limit per Membership Year on group therapies. There is no change to the benefit per service.
|Cover type||Current sub-limit||New sub-limit|
Thanks to regular feedback from Members, we have reviewed the way we pay benefits for orthotics when supplied by an Orthotist or Prosthetist. Orthotics provided by these skilled Allied Health professionals have been till now subject to a lower benefit (claimable under Foot Orthoses and Orthopaedic shoes) than those supplied by a registered Podiatrist (under Podiatry).
This review will now mean that Orthotics supplied by an Orthotist or Prosthetist will now be claimable under Podiatry section of eligible covers. The invoice from the practitioner must quote recognised podiatry item numbers to validate the claim.
Please note, the Orthotist or Prosthetist must have a Medicare provider number and be registered as an Orthotic Supplier.
Foot Levelers and Barefoot Science Foot Strengthening Innersoles
We will now pay benefits for Foot Levelers orthotics and Barefoot Science Foot Strengthening Innersoles when supplied by a Chiropractor, Physiotherapist, Orthotist or Biomechanist. Benefits will be paid under Foot Orthoses and Orthopaedic shoes benefit (Premium and Essential Extras only) up to the respective covers sub-limit. So if you use these foot support devices, we’ll now pay a benefit, after all keeping you on your feet is important.
Healthy Living - benefit for yoga
You’ve been asking for years and it’s finally here! Yoga will be a new addition this year to complement the services that assist with improving existing medical conditions under the Healthy Living benefit. Benefits for yoga will only be payable on referral by your health care professional for you to participate in a Health Management Program* where it is to address or improve a specific health or medical condition.
*To comply with private health insurance legislation, you must have been referred by your health care professional to participate in a health management program to ameliorate a specific medical condition. A Health Management Program Benefit Approval Form (an updated form will be available on our website April 1st 2017) must accompany a claim for these benefits.
Due to rising costs of non-PBS pharmaceuticals, we're increasing the benefit we pay per script. There will be no change however to your annual limit.
|Cover type||Current benefit||New benefit|
Mechanical aids and appliances
On our Top hospital product under our Mechanical aids and appliances cover we now have included benefits for even more devices to aid your recovery and rehabilitation after hospitalisation. We now pay benefits for a knee scooter, curved transfer board, bed rails and gooseneck with grip (self-help pole with triangle). Benefits for these items are calculated at 85% of the purchase cost, under a $250 sub-limit per person per Membership Year within our Mechanical Aids and appliances cover overall limit of $2000 per person per Membership Year.
Mammograms and bone densitometry
Benefits are now available under our Top Hospital cover for an advanced form of breast screening called breast tomosynthesis or three-dimensional (3D) mammography. We have always paid benefits for traditional two-dimensional (2D) mammography on our Top Hospital cover but now we have increased cover for these new breast screening technologies.
We have also increased the benefit to $75 per service up to a limit of $150 per person per Membership Year. Benefit increases also apply for Bone Densitometry tests which will also increase to $75 per service up to $150 per person per Membership Year. All these claims are subject to there being no Medicare benefit claimable for these services.
Changes to Fund rules
Currently, access to information on a couple or family policy is limited to the primary policyholder and can only be accessed by a spouse or de facto partner if we have received prior written consent ("Authority to Operate" or "Delegated Authority").
There’s an increasing need for both partners on a policy to share the responsibility to administer and maintain their health insurance cover, so we’ve reviewed our requirements on the administration and maintenance of a couples or family policy.
From 1 April 2017, both the policyholder and their spouse or de facto partner will be able to gain access to claims information for everyone on the policy (other than dependants 16 years and over) and undertake a variety of policy changes. The only exceptions will be terminating the policy or removing persons from the policy.
Our aim is to simplify the way you manage your health cover.
If however, you don’t want your spouse or de facto partner to have access to policy information from 1 April, please advise us by contacting us through our Contact Centre on 1800 813 415.
If you don’t make the change now you can do so at any time in the future. Please refer to our Membership Guide.
Other Fund rule changes
Sporting and school accidents - removal of two (2) month waits
The two month waiting period applying for treatment arising from a school accident or sporting accident that occurred after joining is now waived. However sporting injuries sustained by professional sportspeople in activities relating to their full-time employment, including training and competitions will still be subject to a two month waiting period.
Hearing aids - limits renewed every 3 years
Previously we imposed a 3 year Benefit Replacement Period on hearing aids on our Top Hospital cover. This meant that a hearing aid or aid could not be replaced within three years of its original purchase date. Now we will provide a benefit amount to use over a period of three (3) Membership years based on the date of which the first purchase of a hearing aid/s is made.
The benefit limit is applied based on your length of membership with Queensland Country Health Fund - Up to 10 years $1000, 10-15 years $1500 and 15+ years $2000. Benefits are per person and calculated at 85% of purchase cost up to the appropriate limit of benefit. This change will allow more flexibility as to how Members utilise their hearing aid benefits.
Your feedback is welcome
The changes to these benefits and some of our Fund rules are determined based on Member and Queensland Country Health Fund staff feedback.
Did you know we aim to increase benefits every year because we pride ourselves on offering products with marketing leading benefits that grow with our Member’s needs and reflect industry changes?
The primary purpose of these changes is to ensure the benefits we pay are competitive and continue to offer great value for money.
We welcome your thoughts and feedback on this year’s changes. And, if you’d like to learn more, contact our friendly team today for a chat