Queensland Country Health: Fund Review
Queensland Country Health were set up in 1977 as the MIM Employees Health Society. The Employee’s Health Society merged with Queensland Country Credit Union in 1999 and Queensland Country Health Limited was formed from this. They began to operate as an open health fund under the management of Queensland Country Credit Union. They are the only health fund in regional Queensland.
They are a not-for-profit health fund and reinvest their profits back into the business. They are committed to offering quality services and products for their members.
- Access Gap Cover means no out-of-pocket costs for using participating practitioners.
- Queensland Country Health have negotiated Purchaser Provider Agreements with a wide network of private and day hospitals and Premier Provider Agreements with some health care providers.
- The Strive for Health programme offers chronic disease management telephone support.
- The Home Support Services program offers home based care for members with chronic and complex conditions. It includes telephone support from registered nurses and allied health professionals, and extends to home visits if needed. Participants are encouraged to use the Strive for Health web portal to track health readings and highlight abnormal or worrying results to initiate support.
- Healthy Living Benefits of up to $150 per policyholder (per membership year) for members with Premium Extras cover.
- Healthy Living Benefits up to $150 per person per membership year are available for members with Essentials or Premium Extras cover. This includes support to manage weight, quit smoking, mole mapping for skin cancer, Bowel Cancer screening checks, Bone Density checks, PSA tests and consultations with Diabetes Educators and metabolic dieticians and nutritionists.
- Queensland Country Health were awarded a CANSTAR 5-star rating for outstanding value hospital cover for Queensland.
Public Hospital cover allows members to be treated as a private patient in a public hospital and includes private or shared room accommodation.
Intermediate Hospital restricts certain services – notably pregnancy, IVF, heart surgery and major eye surgery. It excludes joint replacements. There is an optional excess of $250 or $500 to keep premiums down.
Top Hospital is the most comprehensive hospital-only cover and has no notable restrictions or exclusions. There is an optional excess of $250 or $500 to keep premiums down.
Young Extras includes popular extras such as dental, optical, physio and massage. It offers mid-level limits on these. This is the only standalone Extras cover available; other options must be bought in conjunction with Hospital cover.
Essential Extras is only available in combination with hospital cover and offers a basic level of extras cover. Included Extras are general and major dental, orthodontics, optical, therapies (including acupuncture, chiro, massage therapy, osteo, naturopathy, dietician, occupational therapy, physio, exercise physiology, podiatry, psychology and speech therapy), pharmaceuticals and childbirth education. As a basic level of Extras cover, the annual limits are on the low side.
Premium Extras is only available in combination with hospital cover and offers a comprehensive level of extras cover with relatively generous limits. Included Extras are general and major dental, orthodontics, optical, therapies (including acupuncture, chiro, massage therapy, osteo, dietician, occupational therapy, physio, exercise physiology, podiatry, speech therapy, psychology and speech therapy), pharmaceutical and childbirth education.
Intermediate and Top Hospital (Private Hospital) policies can be combined with Essential, Premium or Young Extras cover to create a combined Hospital and Extras packages.
For members that are looking for pre-packaged combination cover, there is just one option at present:
Singles and Couples Combined Cover is a relatively broad option and includes in-hospital rehabilitation, plastic and reconstructive surgery, colonoscopies, intensive care and brain surgery. It restricts some services, notably psychiatric, cardio-thoraic procedures, major eye surgery, obstetrics, assisted reproductive services, gastric banding and obesity services and renal dialysis. Joint replacements and cosmetic surgery are excluded. There is an optional $250 or $500 excess to keep premiums down. For Extras, it includes general and major dental, orthodontics, optical, physio, chiro, remedial massage, acupuncture, dietician, podiatry, pharmaceutical and healthy living benefits. There are relatively low limits on Extras benefits.
Queensland Country Health allow families to cover dependent children up to the age of twenty-five, provided that they are full-time students or apprentices. If they are working, the Extended Family/Extended Single Parent premium option allows them to stay on the policy until they are twenty-five for slightly higher premiums. This is only available on Private Hospital, Premium Extras and Essential Extras packaged covers.
For extras services, claims can usually be made on-the-spot at the provider. Other claim options include downloading and completing a claim form and sending it to Queensland Country Health by email, fax or by mail. For members with more than three months of cover, claims can also be made via Online Member Services. They can also be lodged in person at a Queensland Country Health service centre or any Queensland Country Credit Union branch.