H E A L T H
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S
OCTOBER 2007 EDITION
FREECALL: 1800 808 690 • Wollongong: (02) 4224 4333 • Fax: (02) 4224 4300 • Email: [email protected] • Web: www.peoplecare.com.au
On the
move!
Many members will already know about our move to new
premises in Victoria Square, Wollongong. Our move took
place in June 2007 with no interruption to member service
and we are now settled in our new office. This property
will be a significant asset to the fund in the future and will
provide us with the additional space we need to operate
the fund efficiently for the benefit of all members.
We’d love to see any members next time you’re in the area,
so please drop in and visit. There’s plenty of undercover
secure parking for your convenience, which you can
access from Young Street.
Smith St.
P
In 2006 we also changed our postal address and our old
Port Kembla PO Box address will be decommissioned later
in 2007, so please take this opportunity to update your fund
contact details. A handy fridge magnet is enclosed with all
of the new details.
New Victoria
Square Office
Cnr Victoria and Young Streets,
Wollongong NSW 2500
Locked Bag 33, Wollongong NSW 2500
1800 808 690
[email protected]
www.peoplecare.com.au
Annual Report 2007
Peoplecare welcomes recent changes to the Corporations Act 2007 which mean
that the fund will no longer be required to distribute hard copy Annual Reports
to members unless specifically requested. This will save the fund a significant
amount of money in printing and distribution each year, which is a positive
development and aligns with our aim to streamline administrative processes as
much as possible.
This year’s Annual Report is currently in production and an electronic version will
be available on our website from the end of October 2007 at:
www.peoplecare.com.au/Corporate/AnnualReport.shtml
If you would prefer a hard copy all you need to do is contact us on 1800 808 690
or email [email protected].
Lysaght Peoplecare Limited. A registered private health insurer. ABN: 95 087 648 753
N
Young
St.
St.
ia St.
Victor
Belmore
Address:
Postal: Phone:
Email: Web:
(Member Parking - Underground)
Old Office
Market
St.
Member Satisfaction
Survey 2007
In the last issue, we published details of our
Member Satisfaction Survey results for 2007 and
Peoplecare has been going through the member
feedback in detail so that we can identify ways
to improve our products and services.
One of the most popular requests was for preventative
health information and in our last issue we started off
our Health Files series with educational articles about
Diabetes and Weight Maintenance which we hope
you found informative and useful. The Health Files
series continues in this issue with articles on Physical
Activity for Women and Physical Activity for Men.
Peoplecare is currently developing a new health
section on our website and this will be launched later
in 2007 with our electronic Health Files Library.
Many members also suggested articles for inclusion
in our newsletter including information to assist in
understanding how their Peoplecare health fund
membership works. This edition will include two
informative articles about what you need to do if one
of your family is hospitalised and who contributes to
the cost of your medical and hospital bills. We hope
you find these articles useful.
You also asked for more competitions and prizes,
so we’re pleased to continue our Family & Friends
campaign and introduce the Win Your Dream Holiday
promotion on the Competitions and Prizes page.
Who pays?
Hospital
claims within
waiting periods
Peoplecare hospital products cover you for
accidents immediately. There is a 12 month
wait for any pre-existing conditions requiring
hospitalisation. All other conditions have a 2
month waiting period.
If you need to go to hospital within your 12 months
waiting period, the fund takes the following steps:
Peoplecare sends you two forms to be
completed by your doctor and your specialist.
The forms ask for more details about the
condition to help us determine whether signs
or symptoms of the condition were present in
the 6 months prior to joining.
You return the completed forms to Peoplecare.
Peoplecare, along with an independent
medical arbiter, reviews this information
within 5 working days and determines if the
condition is pre-existing. If the condition is
not considered pre-exisiting you are covered
after you have served your 2 month waiting
period. If the condition is pre-existing, you
won’t be covered until you have served your
12 month waiting period.
Health insurance can be confusing, especially when you’re trying to work out
who pays for which medical bill. Use our handy tables to find out who pays for
what. For further information, please see our full information brochure as this is
intended as a guide only.
Medicare
Peoplecare
Hospital
Cover
Peoplecare
Ancillary
(extras) Cover
You
Out of hospital
Doctors’ fees (including GPs, specialists, radiology, pathology etc.)
See Page 9
of brochure
In hospital
Doctors’ fees (including GPs, specialists, radiology, pathology etc.)
See Page 9
of brochure
Public hospital charges
• Public Patient
Public hospital charges
• Private Patient
See Page 9
of brochure
Private hospital charges
See Page 9
of brochure
Dental
Set Benefits
Apply
Optical appliances (glasses, contact lenses)
Set Benefits
Apply
Other services (like physiotherapy, chiropractic, psychology,
osteopathy, podiatry
See Pages
12-19 of
brochure
Set Benefits
Apply
What to do
if I have to
go to hospital?
Going to hospital can be a stressful time and
the last thing anyone needs is more confusion.
Follow our easy steps below to help navigate
the maze.
Step 1.
At the doctors…
Step 2.
Contact the fund…
Ask your doctor if they will participate in the Access Gap
Scheme, which means you will have reduced out of
pocket expenses, and you will know exactly what your
medical fees will be.
We will let you know what your level of cover is, along with:
Ask your doctor about the procedures they’ll be
performing and ask them for the Medicare Benefits
Schedule (MBS) item numbers for each. This will help us
to confirm your coverage.
Discuss Informed Financial Consent (IFC) with your
doctor. This means they will outline all fees and explain
what is claimable from Medicare, what is claimable from
the fund and what will be your out of pocket expenses
(‘The Gap’).
• What your coverage will be for the procedures you’re having
• What your excess is (if any)
• Whether your hospital is an agreement hospital and
what benefits you can expect to receive
• We’ll send you a handy Hospital Pack with useful
information to help you navigate your way through
the health system
If in doubt at any time, just call us on 1800 808 690 and
we’ll be happy to guide you through the process.
Step 3.
At the hospital…
Step 4.
After hospital…
Before your admission, the hospital will contact the fund
to confirm your coverage.
When you’re home from hospital, you may receive medical
bills from your doctors, including surgeons, assisting
doctors, anaesthetists, pathologists and radiologists.
The hospital will ask you to pay your excess up front,
often before the day of the procedure or when you are
admitted into hospital.
You will also pay the hospital direct for any extras you
receive in hospital (like take home items and TV) before
you’re discharged from hospital. Your hospital may be
able to provide you with a list of additional charges
beforehand.
The hospital will bill the fund automatically for your
accommodation, theatre and prostheses. We send you
a benefits statement which outlines what we’ve paid
on your behalf and you don’t need to take any further
action with this unless you notice a discrepancy, in
which case please contact us on 1800 808 690.
If your doctor is participating in the Access Gap scheme,
they will forward their accounts directly to the fund for
automatic payment. We send you a benefits statement
which outlines what we’ve paid on your behalf and you
don’t need to take any further action with this.
Most of the time, you should submit your medical
accounts straight to Medicare. You can fill in a 2 Way
Form at Medicare, which means they’ll pay your
Medicare benefit and then forward the statements to the
fund for payment of your fund benefit.
The exceptions to this are any medical accounts that
include a statement asking you to submit to your health
fund. You can send these directly to Peoplecare with a
completed claim form.
If in doubt, please call our Member Service Team on 1800 808 690.
Competitions & Prizes!
Family & Friends
As a member, you already know about Peoplecare’s high quality health insurance and great value for
money. Now that we’re an open fund, why not share the good news with a friend or family member?
Take up this great offer and encourage family and friends to join. The new member can join online at www.peoplecare.com.au and enter your membership number when requested, or join by telephone on
1800 808 700. All they need to do is mention your membership details at the time of joining.
If your friend or family member joins Peoplecare before 31 December 2007, you and the new member
will both receive a distinctive Sports Bag or Back Pack and an entry into the draw to win a fantastic iPod Video 30GB*
valued at $399.
This promotion is authorised under NSW Permit # LTPS/07/22997 and ACT Permit # TP 07/02829. For full Terms & Conditions, please visit www.peoplecare.com.au/Members/NominateFamilyFriends.shtml
Win Your Dream Holiday!
All Peoplecare members and anyone who purchases our QBE Travel Insurance between
1 June 2007 and 30 November 2007 will go into the draw to win a $2,000 travel voucher
towards the dream holiday of your choice.
All you need to do is...
Existing members:
Just maintain your current membership and you will automatically go into the draw. If you
purchase our QBE Travel Insurance during this period, you will receive an extra draw entry,
doubling your chances of winning!
Prospective members:
All you need to do is purchase one of our QBE Travel Insurance policies between
1 June 2007 and 30 November 2007 to go into the prize draw. If you join Peoplecare between 1 June
2007 and 30 November 2007, you will receive an additional entry into the prize draw.
Phone: 1800 808 700
Email: [email protected]
www.peoplecare.com.au
This promotion is authorised under NSW Permit Number LTPS/07/20075, ACT Permit Number TP 07/02183 & SA
Permit No T07/1744. For full Terms & Conditions, please see our website at www.peoplecare.com.au/Documents/
DreamHoliday.pdf
Winners of Family & Friends and Online services promotions
The Family & Friends Campaign for January to June 2007 was drawn on 2 July 2007. We are pleased to announce that the winner was member Mr
Peter Sawyer of Warilla in NSW. Our congratulations go to Peter, who was delighted with his win. The campaign is on again for the period July to
December 2007.
The campaign to encourage members to provide their email address and sign up for online services was a great success with 6,851 members
going into the draw to win a MIO GPS Car Navigation System. The winner was drawn on 2 July 2007 and Mr Tim Young of Castle Hill, NSW is the lucky
recipient of the prize. Congratulations to Tim and we hope you enjoy the GPS.
Dental Reasonability
Guidelines &
Tooth ID
Peoplecare has been working with dentists to adopt the
Australian Dental Association’s guidelines in how dentists
complete their accounts for payment by the fund. These
guidelines say that dentists should include information about
the date of service, the patient’s name, the procedures
performed (each one has an item number) and the charge for
each item, along with other information about the treatment.
In particular, dentists are asked to include Tooth ID, which is a
code identifying which teeth the dentist has treated. The fund
then applies reasonability guidelines to ensure that billing is
accurate. For example, if a claim was submitted for a filling in a
tooth which had already been extracted on a previous claim,
this would highlight an issue with the billing. Another example is
item 011 (comprehensive oral examination), which can only be
claimed once per visit, as it would not be reasonable to charge
two examinations in one session.
Many health funds use this approach to ensure billing is
accurate and reasonable in order to protect all members from
oversights or inaccuracies. These types of claims drive up the
cost of claims and ultimately, all members foot the bill through
increased premiums. In general, it is only a small minority of
claims that come under question and Peoplecare is keen to
work with dentists and the Australian Dental Association to
streamline processes to make it as easy as possible for both
members and dentists.
H E A L T H
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FREECALL: 1800 808 690 • Wollongong: (02) 4224 4333 • Fax: (02) 4224 4300 • Email: [email protected] • Web: www.peoplecare.com.au
Physical Activity - Women
Many women find it hard to find
the time to exercise. This may be
because they can’t fit physical
activity into their daily routine due
to the demands of parenting or
work. Sometimes lack of money or
motivation are barriers to women
being active. However, there are lots
of ways you can build exercise into
your weekly schedule.
Many Australian women are not
active enough.
Generally speaking, when
compared to Australian men,
Australian women are less inclined
to exercise and less likely to engage
in enough exercise to achieve
health benefits. About 39 per cent
of Victorian women aren’t active
enough and more than 12 per cent
are completely inactive.
Lack of exercise is a significant
risk factor for a range of medical
conditions including cardiovascular
disease, diabetes and high blood
pressure. Sedentary women are also
at an increased risk of developing
osteoporosis in later life.
Reasons why women exercise
Women who do exercise regularly
say they do so to:
Don’t think you’ve left it too late
to start. Studies show that older
people can achieve significant
health benefits after just two to
three months of regular exercise. As
an added bonus, if you start being
regularly active, your body will
continue to benefit from exercise
well into your 80s.
product of a busy lifestyle. Working
mothers are often tired.
If you have a medical condition,
are overweight, over 40 years of
age or haven’t exercised regularly
for a long time, see your doctor for
medical advice before increasing
your physical activity levels.
• Lack of money – women on low
incomes are less likely to exercise
regularly. This may be because
they think that any worthwhile
physical activity requires expensive
equipment and expensive clothes (it
doesn’t).
Physical activity barriers
Common exercise barriers for
Australian women include:
• Lack of time – today’s woman
typically juggles child-rearing,
household duties and paid work.
With so much to do every day, many
women find it difficult to squeeze in
time for themselves.
• Health problems – older
women are more likely to have
a chronic health condition (for
example, arthritis) that limits their
participation in some forms of
exercise.
• Gender stereotyping – women
who believe that child rearing and
domestic chores are ‘women’s work’
are less likely to take time to exercise
– perhaps because they feel guilty
taking time out for themselves.
Tips to overcome the exercise barriers
Suggestions include:
• Lack of motivation – some women
say they don’t feel motivated
without a training partner. Others
think that, to be useful, exercise must
be painful, sweaty and gruelling
(which isn’t true).
• Improve their physical fitness
• Have fun
• Manage their weight
• Parenting demands – studies show
that the more children a woman
has, the less likely she is to exercise
regularly.
It is never too late to take up exercise!
• Lack of energy – fatigue is a by-
Lack of time – try to share child
rearing and household chores with
your partner or friends. Perhaps
your family can help, or maybe
paid childcare is an option. Talk to
the people close to you about the
possibilities.
Lack of motivation – find a training
partner; you could ask family or
friends. You could also contact your
local council or community centre
H E A L T H
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FREECALL: 1800 808 690 • Wollongong: (02) 4224 4333 • Fax: (02) 4224 4300 • Email: [email protected] • Web: www.peoplecare.com.au
for information on exercise clubs in
your area. For example, you could
join a local walking group. Don’t just
think of gyms and jogging; you might
find dancing or roller-skating fun.
Parenting demands – talk to your
partner (or your friends) about how
you can fit more physical activity
into your life. Ask friends if they are
interested in swapping babysitting.
Try exercise DVDs – so you can
exercise whenever you have the
chance. Three 10-minute bouts
of physical activity over the day
has the same health benefits as a
continuous 30-minute session.
Lack of energy – a fit body has more
energy to burn than a sedentary
body. Regular exercise gives you
the energy to better cope with the
demands of daily life. If you keep this
in mind, it may help you push past
the tiredness during your first few of
weeks of regular exercise.
Health problems – talk to your doctor
about appropriate forms of exercise.
In most cases, physical limitations
don’t rule out all activities. For
example, exercise in water (such as
aqua-aerobics) is possible for many
people with arthritis.
Lack of money – exercise doesn’t
require expensive clothes or a
gym membership. One of the most
beneficial forms of exercise is also
free – brisk walking. Most community
centres offer a range of physical
activity classes and childcare at
modest prices.
Gender stereotyping – think about
your beliefs about women’s roles.
It may be that sexism is one of
your barriers. (For example, the old
saying, ‘Horses sweat, men perspire
and women gently glow’ illustrates
the stereotype that exercise isn’t
appropriate for women.)
Making the changes
Regular exercise is more likely if you
plan ahead. Suggestions include:
1. Identify your barriers, such as lack
of money or motivation. Think about
a range of possible solutions.
2. Consider the personal beliefs
that may be holding you back: for
example, guilt about taking time out.
Challenge those beliefs. Remember
that a happy mum makes a happy
family, and exercise is an effective
treatment for stress and depression.
If you can’t make the time to
exercise for yourself, do it for your
family.
3. Find a support group – perhaps
your partner, extended family,
friends or paid childcare.
4. Find something you like to do.
You’re more likely to stick with it if you
choose an activity you enjoy than if
you do it because it’s ‘good for you’.
Incidental exercise
A few minor changes to your daily
lifestyle can also increase your physical
activity level. Suggestions include:
• For short trips, walk instead of
taking the car.
• Housework counts as physical
activity. Play some music and treat
chores such as vacuuming as an
aerobic workout.
• Passionate sex burns kilojoules
and improves cardiovascular fitness.
Suggest to your partner that you
have more ‘workouts’ together.
• Get the whole family active on
the weekends. The range of free
activities is only limited by your
imagination but could include
bushwalking, cycling around the
neighbourhood, swimming at the
beach or playing backyard cricket.
Where to get help
5. Check with your doctor that your
chosen exercise is suitable and safe
for you.
• Your doctor
• Local community centre
• ‘Go for your life’ Infoline
Tel. 1300 739 899
6. Look through your diary for
the week and make exercise
‘appointments’ with yourself.
Things to remember
7. Set achievable goals. Don’t
fall victim to the ‘all or nothing’
mentality. If you can only find
the time for one or two exercise
sessions per week at the moment,
congratulate yourself on this
achievement. Every little bit helps
and some exercise is significantly
better than no exercise at all.
• About 39 per cent of Victorian
women aren’t active enough
and more than 12 per cent are
completely sedentary.
• Common exercise barriers include
lack of time, lack of motivation, low
income and parenting demands.
If you have a medical condition, are
overweight, over 40 years of age or
haven’t exercised regularly for a long
time, see your doctor for a check-up.
This information was provided by the
Better Health Channel, a Victorian
Government (Australia) website.
Material on the Better Health Channel
is regularly updated. For the latest
version of this information please visit:
www.betterhealth.vic.gov.au
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FREECALL: 1800 808 690 • Wollongong: (02) 4224 4333 • Fax: (02) 4224 4300 • Email: [email protected] • Web: www.peoplecare.com.au
Physical Activity - Men
Regular physical activity is a
low priority to at least one third
of Australian men. Those aged
between 30 and 50 years are often
not very physically active because
they are busy with work and family
commitments. Lack of physical
activity is linked to a range of health
problems including obesity, heart
disease and some forms of cancer.
However, it’s not difficult to include
regular physical activity as part of
your lifestyle.
If you have a medical condition,
are overweight, are over 40 years of
age or haven’t exercised regularly
for a long time, see your doctor for
a check-up, advice and support
before increasing your physical
activity levels.
Physical activity barriers
Some of the more common reasons
why some men don’t exercise
include:
• Lack of time – men aged between
30 and 50 are typically busy with
work and family commitments. When
leisure time is limited, it’s natural
to choose enjoyable activities – if
men don’t view physical activity as
enjoyable, they won’t do it.
• Lack of interest – some men
believe in the ‘no pain, no gain’
misconception, and think that only
gruelling and uncomfortable forms
of physical activity are worthwhile.
However, physical activity doesn’t
have to be particularly vigorous. Any
activity that works the major muscle
groups, such as walking, gardening
and even washing the car, is usually
demanding enough to offer health
benefits.
• Lack of motivation – some men
view health as a low priority.
Unfortunately, the motivation to
become more active may only
come from a health scare.
• Lack of physical ability – health
issues that make activity and
movement uncomfortable such
as obesity, back pain or persistent
fatigue are a common barrier to
regular participation in physical
activity.
• Limited access to physical activity
options – gym fees, sport club
memberships and some types
of exercise equipment can be
expensive. The local neighbourhood
may have limited recreational
venues, such as parks. In other
cases, outdoor exercise is avoided
because the neighbourhood isn’t
considered safe.
• Weather – extremes of hot
and cold weather can sap the
motivation to undertake physical
activity outdoors.
How to overcome the exercise
barriers
Suggestions include:
• Lack of time – 30 minutes
of exercise per day is the
recommended minimum. For busy
men, finding a spare half-hour can
be tricky. Research suggests that
you can break up your 30 minutes of
exercise into two 15-minute blocks,
or even three 10-minute blocks,
as long as the total energy used
is about the same. Incorporate
physical activity into family time; for
example, you could throw a frisbee
in the park or take your kids to the
local swimming pool. Walk for 10
minutes during your lunch break.
Some workplaces offer exercise
equipment or physical activity
programs during lunch breaks. If you
have been inactive for a long time,
you can start by increasing your
‘incidental’ physical activity (see
following).
• Lack of interest – physical activity
doesn’t have to be difficult. Forget
about the ‘no pain, no gain’ myth
and explore activities that seem fun
and appealing.
Continued >>
H E A L T H
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FREECALL: 1800 808 690 • Wollongong: (02) 4224 4333 • Fax: (02) 4224 4300 • Email: [email protected] • Web: www.peoplecare.com.au
• Lack of motivation – join a physical
activity group or find an exercise
buddy. You’re less inclined to skip a
session if to do so would mean letting
down a friend or family member. If
you can’t find a buddy and find the
activity boring, choose an alternative
like riding a stationary bike so you
can watch television or read a book
at the same time. You can give
your physical activity a purpose; for
example, it can be a way to get
somewhere, or an errand like walking
to get the newspaper.
2. Learn more about the benefits of
physical activity and the multitude of
options available. The Better Health
Channel has lots of information on
these topics.
• Lack of physical ability – find
an activity that doesn’t make you
feel uncomfortable. For example,
swimming and other forms of water
activity are an excellent option if
your mobility is limited. Consult with
your doctor for further suggestions.
If fatigue is a problem, consider the
fact that regular physical activity
actually boosts energy levels.
5. Set reasonable goals for yourself.
Decide how you are going to monitor
your progress.
• Limited access to physical activity
options – choose activities that don’t
require facilities or equipment, such
as walking. If you feel unsafe walking
alone through your neighbourhood,
join a walking group. Contact your
local government for further options
or to express concerns about barriers
to regular activity in your area.
Incidental exercise
• Weather – choose indoor activities,
such as cycling on a stationary
bike or performing aerobics videos.
Explore activities that depend on
specific weather conditions: for
example, swimming in summer or
skiing in winter.
Making the changes
You are more likely to incorporate
physical activity into your day if you
plan ahead.
Suggestions include:
1. Think about the factors that
discourage you from being active.
3. Decide which types of physical
activity appeal to you.
4. Look through your diary and
identify possible timeslots for physical
activity but also try to reduce the
amount of time you are inactive
throughout the day.
6. See your doctor for a check-up,
advice, support and referral.
7. Update your physical activity goals
on a regular basis and document the
benefits to your quality of life.
You can incorporate physical activity
into your daily lifestyle by making a
few small changes, such as:
1. Walk or cycle to the local shops
instead of taking the car.
2. Get off the bus (or train) at an
earlier stop and walk the rest of the
way.
3. Wash your car yourself.
4. Take the stairs instead of the lift.
5. Don’t forget that having sex is a
form of exercise too.
Where to get help
1. Your doctor
2. Kinect Australia Tel. 1300 885 602
website: www.vicfit.com.au
3. ‘Go for your life’ Infoline service Tel.
1300 739 899
Things to remember
Physical activity is not just structured
exercise and it doesn’t have to be
gruelling. Any activity that works
the major muscle groups, such
as walking, gardening and even
washing the car, is usually demanding
enough to offer health benefits.
You are more likely to maintain
adequate levels of physical activity if
you plan ahead.
If you have a medical condition, are
overweight, are over 40 years of age,
have been inactive for a long time, or
just don’t know where to start, consult
your doctor for a check-up and to
discuss your options before increasing
your level of physical activity.
This information was provided by the
Better Health Channel, a Victorian
Government (Australia) website.
Material on the Better Health
Channel is regularly updated.
For the latest version of this
information please visit:
www.betterhealth.vic.gov.au