Are you from Queensland? Compare Queensland Country Health Fund and see the benefit of a not-for-profit fund
Queensland Country Health Fund is a not-for-profit fund that is run to benefit its more than 35,000 members. Based in regional Queensland, this health benefits fund offers policies to suit singles, couples, families and even single parent families, providing the peace of mind that comes with knowing your health will be looked after whenever you need.
Proudly based in regional Queensland, Queensland Country Health Fund has retail service centres in Townsville, Ayr, Mackay, Gladstone and Mount Isa. Taking out private health insurance with the fund allows you to choose your doctor and hospital and to get the medical treatment you need whenever you need it. It also means you can avoid lengthy waiting periods in public hospitals and lock in your Lifetime Health Cover age and avoid being slugged with extra charges by the government.
With an emphasis on providing the health cover options and value for money to its members, Queensland Country Health Fund is run to benefit its customers rather than to earn a profit for shareholders. From its easy-to-understand product range to its simple claiming procedures, this fund aims to take the hassle out of health cover.
From basic public hospital cover through to premium hospital protection, it offers cover choices to suit members of varying ages and budgets. Three extras cover options are also available, with some able to be purchased on their own and others only available with hospital cover. Finally, Queensland Country Health Fund also offers a range of combined and packaged policies to meet the needs of its customers at different life stages.
Queensland Country Health Fund offers the following hospital cover options:
- Top Hospital Cover. This high-level option covers services provided in a public or private hospital and is available with your choice of a $0, $250 or $500 excess. It covers theatre fees, surgically implanted prostheses, intensive care, obstetrics, assisted reproductive services, in-hospital psychiatric treatment, in-hospital rehab treatment, cardio-thoracic procedures, major eye surgery, joint replacements and reconstructions, renal dialysis, nursing home type patients and much more. If you want complete peace of mind, this cover is designed to suit you.
- Intermediate Hospital Cover. The next step down from Top Hospital Cover, this option is more affordable but does not cover as many high-cost treatments. Offered with a $250 or $500 excess, it covers theatre fees, surgically implanted prostheses, in-hospital rehab treatment, plastic and reconstructive surgery, and nursing home type patients. Restricted cover is also included for things like obstetrics, cardio-thoracic procedures and major eye surgery.
- Public Hospital Cover. This basic cover option only covers the cost of treatment you receive in a public hospital. There is no excess payable on this policy and it covers surgically implanted prostheses, intensive care, obstetrics, assisted reproductive services, cardio-thoracic procedures, major eye surgery and more.
Both Top Hospital Cover and Intermediate Hospital Cover can also be paired with one of the following extras options to create a combined policy.
- Premium Extras. Premium Extras offers the highest level of extras cover available from Queensland Country Health Fund. It covers general dental, major dental, orthodontics, optical, physio, chiro, acupuncture, audiology, remedial massage, osteopathy, foot orthoses, occupational therapy, exercise physiology, podiatry, psychology, speech therapy and more. This can only be purchased in conjunction with one of Queensland Country Health Fund’s hospital cover options.
- Essential Extras. Essential Extras is a mid-level cover option, providing a balance between affordability and a range of benefits. It covers all the same benefits as a Premium Extras policy but offers lower benefit limits. This can only be purchased in conjunction with one of Queensland Country Health Fund’s hospital cover options.
- Young Extras. Young Extras Cover from Queensland Country Health Fund covers general dental, optical, physio, chiro, acupuncture, dietician, podiatry and more. This product can be purchased on its own if you wish.
Queensland Country Health Fund also offers a Family Plus Cover option and Extended Family/Extended Single Parent Cover for those who wish to cover adult dependents up until the age of 25, as well as Singles and Couples Combined Cover for those aged 35 and under.
Are there any additional benefits?
- Optical discounts. Queensland Country Health Fund members can access a range of optical discounts and benefits through providers like OPSM, Laubman & Pank, The Optical Superstore, Specsavers and more.
- Living Healthy magazine. This twice-yearly publication offers health tips and advice, discounts and event news to members.
- Online health assessment. The fund’s Wellness and Prevention Web Portal allows members to identify risk factors that could lead to disease and to better manage their overall health.
- Healthy Living Benefits. Under this initiative, Premium Extras fund members can receive up to $150 each year to help them participate in weight loss programs, quit smoking, get checked for skin cancer, undergo diabetes education and more.
There are several circumstances under which Queensland Country Health Fund will not pay your claim, including if:
- It is for services received outside of Australia.
- It is for a treatment or procedure for which Medicare does not offer a benefit, for example cosmetic surgery that is not medically necessary.
- It is for treatment that was received more than two years prior to the date you lodge your claim.
- It is for a treatment or procedure that is specifically excluded from your cover.
- You have already reached your annual extras benefit limit.
- It is for treatment you have received from a provider who is your relative or business partner.
Before you sign up for private health insurance it;s also important that you familiarise yourself with the waiting periods that apply to your policy. Ambulance cover and cover for treatment following an accident are both provided immediately, but you’ll have to serve a two-month waiting period before you are eligible to receive most hospital and extras benefits. Other treatments and procedures cannot be accessed until you have served longer waiting periods, such as a 12-month waiting period for obstetrics services, hearing aids, major dental services and treatment for pre-existing conditions.
Queensland Country Health Fund excess
Many private health insurance policies will require you to pay an excess whenever you are admitted to hospital, which basically means you will be contributing a small amount to the cost of your hospital stay. While some Queensland Country Health Fund policies are available without an excess, others allow you to choose the excess amount you want. The higher the excess you choose, the lower your premium payments will be.
With Queensland Country Health Fund, the maximum excess that applies to any one person per year is $250 or $500, depending on the excess amount you choose. In addition, if you have Top Hospital Cover, you will not have to pay an excess if your child of 10 years or under is admitted to hospital.
Queensland Country Health Fund will use the medical service you are claiming for to assess the benefit amount payable. This will generally increase in proportion to the seriousness and complexity of your condition and the subsequent treatment required. For example, the payment for brain surgery will be higher than the payment for appendix removal.
The results of the Australian Medical Association's Private Health Insurance Report Card of 2016 is displayed below, and shows the benefit amounts that the Queensland Country Health Fund and Medicare (MBS) will will pay on 22 medical treatments and services.
As a member of the Australian Health Service Alliance (AHSA), Queensland Country Health Fund is listed under that organisations name in this report card. More information on the AHSA can be found at the bottom of the table:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genetalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health
Queensland Country Health Fund offers several simple options when you need to make a claim. If your healthcare provider offers the convenience of electronic claiming you can simply swipe your Queensland Country Health Fund membership card to immediately receive your benefits.
The next option is the fund’s online claiming service, which is available through Online Member Services and allows you to claim up to $400 per day of services received within the previous three months. Claim forms can also be downloaded, completed and then submitted, by email, fax or post, or you can visit one of Queensland Country Health Fund’s five retail centres or a Queensland Country Credit Union branch to drop off your claim form in person.
Q. How can I tell if my healthcare provider offers electronic claiming?
- A. All you have to do is log on to www.hicaps.com.au and search for your provider.
Q. Does Queensland Country Health Fund offer an Access Gap Cover scheme?
- A. Yes. Queensland Country Health Fund’s Access Gap Cover initiative allows you to minimise or even eliminate your out-of-pocket expenses.
Q. How can I pay my Queensland Country Health Fund premiums?
- A. You can pay your premiums using the following options: credit card, direct debit, BPAY, or through a BillPaying account (for Queensland Country Credit Union members).
Q. What is the waiting period that applies for most benefits?
- A. You will have to serve a two-month waiting period before you can access most hospital and extras benefits as part of your Queensland Country Health Fund membership. However, some procedures, for example treatments related to pre-existing conditions, will require you to first serve a 12-month waiting period.
Q. Can I apply online?
- A. Yes, you can apply for membership online through the health fund’s website. You’ll need to provide information including your Medicare card number, your previous health cover details, the details of everyone who will be covered under the policy and your bank account or credit card information.
Speak to an adviser about getting private health insurance
Queensland Country Health Fund offers a wealth of cover options and benefits to its members, so compare its services with those of other health funds around the country. This will ensure that you find the health insurance fund that meets all of your needs.