F E B R UARY 2016
LIVING
HEALTHY
LAUR A GE ITZ
NE TB AL L CL INI CS
ARE YOU
HAVING
TOO MUCH
PROTEIN?
5 WAYS TO STAY
MOTIVATED DU RIN G
SU MM ER
C O N T E N TS
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FRO M TH E GE NE RA L MA NAGE R.
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LAU RA GE ITZ NE TBA LL CL INI CS
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NAVIG ATI ON ...... ..... ..... ..... ..... ..... ..... .....
QU EE NS LAN D CO UN TRY ’S CA RE
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MOTIVATE D DU RIN G SU MM ER . .....
Y
STA
TO
YS
WA
5
:
LLY
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RE
LAU
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T IN PU BLI C HO SP ITA L.... ..... ..... .....
ELE CT ING TO BE A PR IVATE PAT IEN
..... ..... ..... ..... 9
L CE LEB RAT ES 1 YEA R... ..... ..... .....
NTA
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EE
QU
..... 10
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ING
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ON LIN E CL
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PR OB LEM ...... ..... ..... ..... ..... ..... ..... .....
INC ON TIN EN CE : AN INC RE AS ING
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BE NE FIT IN FO CU S: DIE TIT IAN ......
..... ..... ..... ..... ..... ..... ..... ....1 3
..... ..... ..... .14
G TO O MU CH PR OT EIN ?.... ..... ..... .....
LAU RE N JAM ES : AR E YO U HAVIN
16
S... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... .....
ATE
S-Y
LAW
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DE
HT:
LIG
OT
STA FF IN SP
..... ..... ....1 7
ING ...... ..... ..... ..... ..... ..... ..... ..... ..... ..... .....
BE NE FITS IN FO CU S: HE ALT HY LIV
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PB S ME DIC INE LIST CH AN GE S ......
..... ..... ..... ..... .18
FR OM TH E
GENERAL
MANAGER
The private health insurance industry
continues to be a topic of public debate
as the Federal Government announces
a private health insurance review which
will focus on the value of private health
insurance for consumers and its long
term sustainability.
The Government is consulting widely through
surveys for consumers as well as industry forums and
submissions and seems intent on achieving some
reform which we are very supportive of. The Health
Minister has advised that the review will focus on:
ø O
pportunities to amend unnecessary and inefficient
regulation which adds costs for the consumer; and
ø R
eforms which would enhance the inherent value
proposition of the product to the consumer
Almost half of all Australians are covered by private
hospital cover while more than 55 percent have some
form of extras cover. Private health insurers paid
$17.2 billion in benefits in 2014 and are on track to
exceed that figure in 2015. More than 40 percent of
all procedures occurred in one of Australia’s private
hospitals where patients receive timely quality treatment.
Clearly, private health insurance is an important pillar
in the health system and meaningful reform can further
improve the value of private health insurance and
alleviate cost pressures on the public system.
Currently health insurance premium increases
are outstripping inflation which is being driven
by increases to hospital and medical costs along
with increasing utilisation of medical services by
all consumers but particularly for people over age
65. There are some Government regulations that
contribute to healthcare cost increases and positive
reform to policy could have a positive effect on future
premiums. There is also more that health funds can do
to manage premium increases to maintain affordability.
Queensland Country is launching a Care Navigation
service which has been established to assist in
providing Members with access to some health
services following discharge from a hospital for those
Members in most need of assistance. Not all Members
have good support at home following a procedure and
we will work with these Members to ensure they have
the support to make a good recovery which should
reduce the need to be readmitted to hospital.
Queensland Country is a member of the HIRMAA
Industry Association (hirmaa.com.au) and through this
association we are contributing to a submission to
Government to hopefully achieve positive reform for
the industry.
Aaron Newman | General Manager
[email protected]
3
L AU R A G E IT Z
N E T B A L L C L IN IC S
I N M I D-NOVE M B E R QU E E N S LAN D
COU NTRY B RAN D AM BASSADOR
AN D AUSTRALIAN N ETBALL CAPTAI N,
LAU RA G E ITZ R ETU R N E D TO NORTH
QU E E N S LAN D HOSTI NG TH E
QU E E N S LAN D COU NTRY H EALTH FU N D
LAU RA G E ITZ N ETBALL CLI N ICS I N
Towns ville Junior Comp winner s
MACKAY, TOWN SVI LLE, CAI R N S AN D FOR
TH E FI R ST TI M E MOU NT I SA.
In each city, over 70 aspiring netball stars joined Laura and
her Queensland Firebird team mate Romelda Aiken in junior
and senior clinics to learn and hone key netball skills and
techniques. The 30 excited winners of Queensland Country
Health Fund’s meet Laura Geitz competition enjoyed a meet
and greet with Laura discussing a few tips and tricks as well
as a few World Cup stories.
Rising netball stars of the future who attended each of the
clinics enjoyed lots of laughs with Laura and took home
some great new skills.
4
Macka y Senior Comp winner s
5
WE LCOM E TO QU E E N S LAN D COU NTRY
CARE NAVIGATION
Queensland Country Health Fund takes our Members’ health and wellbeing seriously. Our aim is to
be the most valued health fund in Queensland.
To support our Members, especially those living with a chronic illness or a recent discharge from hospital we
launched Queensland Country Care Navigation in January. Care Navigation’s Care Coordinators work with
eligible health fund Members to understand and better manage their health.
The service’s Care Coordinators are experienced Australian Registered Nurses who work in partnership with the
health fund Member and their existing health professionals to help identify opportunities or contacts in their local
area that might help them better manage their health.
HOW DOE S IT WOR K?
Care Navigation’s Care Coordinators review Queensland Country Health Fund’s hospital claims data and identify
Members who may benefit from extra support. After a discussion with the Member and with their consent, the
Care Coordinator will work with the Member’s existing health professionals to devise a personalised care plan.
The aim is to help the Member find supportive in-home services in addition to improving their access to local
community programs, support groups and health professionals.
For more information visit www.carenavigation.com.au
M E E T K IN D E E L AW T Y
CA R E N AV IG AT IO N
M A N AG E R
Guiding you to
better health
Kindee is a Registered Nurse with more than 15 years’ experience
working in different areas of health in North Queensland. She has
worked in Cardiac, Medical, Surgical, Emergency and Community
Nursing, to name a few areas. Kindee has also been in charge
of wards, teams and most recently a rural hospital. Outside of
work Kindee loves spending time with her family; including going
camping, fishing or building Lego with them.
Kindee says she might also have a small addiction to coffee.
6
Kindee Lawty, Care Navigation Manager
5 WAYS TO
STAY MOTIVATED
DURING SUMMER
By Lau ren Kel ly
Per son al Tra ini ng
IT’S HOT. YOU’R E FE E LI NG LAZY AN D THAT AI RCON I S J UST TOO
D E LIG HTFU L TO CON S I D E R EXCE SS IVE BOD I LY MOVE M E NT. J UST LI KE
TH E COLD E R MONTH S, SU M M E R I S ALSO A S EASON THAT CAN M E SS
WITH OU R MOTIVATION. SO HOW DO WE STAY ON TRACK?
#1 - Get Active in
the Morning
Don’t wait for later in the day to
exercise. When you’re tired, ready
for a nanna nap or sporting a
post-dinner food baby that would
make Kim Kardashian West proud
get it out of the way first thing! Go
for a walk, run, swim in the cooler
hours of the morning. Involve
friends and family members for
extra motivation. Remember,
exercise will increase energy
levels, thus increasing motivation
to continue exercising.
#2 - Plan Ahead
Summer is the season of fresh
salads, stone fruit, cold meats and
seafood! Have plenty available
for quick easy meals and snacks
and plan ahead when you can. Eat
every couple of hours to maintain
energy levels throughout your day,
try to eat as close to nature as
possible and always start your day
with a big, healthy breakfast.
#3 - Get Outside
The body is happier when it’s
warm and moving. Enjoy the
Australian outdoors - eat al fresco,
enjoy a picnic with the family, play
backyard cricket, go swimming or
hit the beach. And remember to
Slip, Slop, Slap, stay well hydrated
and avoid the midday sun if
possible.
#5 - Enjoy time off
Include 1-2 rest days per week.
Enjoy dessert, a cheeky chocolate
or a decadent meal every now and
then, just not every day and all the
time. A 90/10 rule –
healthy/indulgent is a sensible one
to follow. It is always nice to have
something to look forward to.
#4 - Beat the Heat
The heat makes us tired, so along
with exercising in the cooler parts
of the day make sure you get a
good night’s sleep, aim to eat a
balanced, healthy diet and drink
plenty of water. 1.5 litres is a good
goal, with 2 litres to be consumed
when its hot or you’ve been
exercising.
7
E LE CT IN G TO B E A
A
IN
T
N
IE
T
A
P
E
T
A
IV
R
P
P U B L IC H O S P ITA L
OU R M E M B E R S PR I MAR I LY HOLD H EALTH I N SU RANCE SO THAT TH EY
CAN ACCE SS HOS PITAL AN D M E D ICAL S E RVICE S I N PR IVATE HOS PITALS
I N A TI M E LY AN D AFFOR DAB LE MAN N E R.
That being said, Members also have the option to
be treated in a public hospital as a private patient.
Over the past few years we have seen the number of
Members being treated as private patients in public
hospitals increase significantly and from feedback
provided by Members, this appears to have been at
the instigation of hospital staff.
The National Health Reform Agreement states that
people can choose to be a private patient in a public
hospital and that the public hospitals can charge for
these private patients at a fee set by each state.
Under the National Health Reform Agreement, health
providers must follow business rules listed in the
agreement. Some of these include:
ØØ The election by eligible patients to receive admitted
public hospital services as a public or private patient
will be exercised in writing before, at the time of, or
as soon as possible after admission
ØØ Private patients have a choice of doctor and all
patients will make an election based on informed
financial consent
ØØ An eligible patient presenting at a public hospital
emergency department will be treated as a public
patient, before any clinical decision to admit. On
admission, the patient will be given the choice to
8
elect to be a public or private patient in accordance
with the National Standards for Public Hospital
Admitted Patient Election processes
ØØ Hospital employees will not direct a patient
towards a particular choice
These rules support the concept that health fund
Members have the choice to be treated as a public or
private patient in a public hospital.
We have received feedback from a number of
Members that they were unaware that signing a
patient election form meant that they were being
treated as a private patient and that Queensland
Country would incur the cost of the hospital
admission. We’d like to highlight that it should be a
conscious decision to be treated as a private patient
in a public hospital.
HAPPY BIRTHDAY
QUEENSLAND
COUNTRY DENTAL!
I N JAN UARY, QU E E N S LAN D COU NTRY D E NTAL CE LE B RATE D
ITS 1ST B I RTH DAY.
Since opening its doors in 2015, the Townsville based practice has been extremely popular amongst our Members,
with the team treating over 6,000 Members. With such popularity the dental team has grown significantly and will
expand even more in 2016. Members enjoy the service the team provide as well as the benefit they receive. Some
of the services the practice offers includes:
ØØComprehensive examinations for the whole family
ØØMouthguards for adults and children
ØØDigital x-rays and photographs
ØØHygienist treatment
ØØPreventive treatments such as scale and clean
ØØFull range of restorative treatments.
Dr Sarah Wilkinson and her team are looking forward to seeing even more Members in 2016.
To make an appointment with the Queensland Country Dental team contact them
on 1800 4 QCDENTAL or www.qldcountryhealth.com.au/dental
Don’t forget Members with Premium
Extras cover are able to access high
quality dental care with no or low out of
pocket expenses on preventive treatments
including check-ups, mouthguards and
scale and clean.
9
ONLINE CLAIMING
YOU CAN NOW MAKE CLAI M S ON LI N E! WITH SO MANY OF US LIVI NG VE RY
B USY LI FE STYLE S WE HAVE MAD E CLAI M I NG FOR CE RTAI N S E RVICE TYPE S
EVE N EAS I E R FOR OU R M E M B E R S.
To claim online, you will need to have been with Queensland Country Health Fund for more than 3 months and
registered with our Online Membership Services (OMS). You can register for this service via the home page of our
website under “Register”. If you need help to do this, just send us an email or give us a call. Once you are registered
for OMS simply follow the step by step guide below to claim online.
1.
2.
3.
4.
Log onto Online Member Services at
www.qldcountryhealth.com.au/members/online-member-services
Hover over “Claims” and
select “Online Claiming”
Read the terms and
conditions, then select
“Next”. Confirm the bank
account details are correct
and Select “Next”
Complete the “Add Claim
Lines” section with the
service details.
NOTE: The service date cannot be
older than 3 months prior to the date
of lodging this claim. To add another
service click on “Add New Service”. If
you have finished adding all services
click on “Next”
5.
6.
Review the details of the
claim/s you have entered.
Confirm your claim by
ticking the Declaration
boxes and then clicking
“Next”
Now click on "Submit"
Next
If there is an error you will see a RED MESSAGE under “claim line assessing”. This means that this particular claim has not been processed and you need to
contact the Health Fund for further information. If the word APPROVED appears in green, your claim has been processed and payment will be made within 2
business days. You will also at this stage be provided with the claim result, benefit limit remaining after this claim has been paid and your claim number.
TE R M S AN D CON D ITION S DO APPLY FOR ON LI N E CLAI M I NG S E RVICE.
YOU CAN FI N D TH E S E ON OU R WE B S ITE WWW.QLDCOU NTRYH EALTH.COM.AU
10
Laura Geitz
Australian Netball Captain.
PASS +
SCORE!
REFER A FRIEND TO QUEENSLAND COUNTRY HEALTH
FUND AND IF THEY JOIN AND PURCHASE AN ELIGIBLE
POLICY BEFORE 31 MARCH 2016, WE’LL REWARD YOU
WITH A $150 GIFT CARD!*
Don’t forget to tell your friend when joining to provide us with your name and
contact details so we can send you your reward.
*Offer valid from 15 February 2016 to 31 March 2016 and is subject to all financial obligations under the policy being met. Excludes all
Public Hospital and Young Extras only covers. Offer is available with the corporate discount offer but is not available with any other offer.
The referring person must be an existing Queensland Country Health Fund policy holder. Terms and Conditions apply and are available at
qldcountryhealth.com.au. Queensland Country Health Fund Ltd ABN 18 085 048 237.
11
E
C
N
E
N
I
T
N
O
C
IN
G
N
I
S
A
E
R
C
N
I
AN
P R O B LE M
Dr Michael Gillman
St Andrews War Memorial Hospital, Spring
Hill Brisbane
OVE R 4.8 M I LLION AUSTRALIAN S HAVE B LAD D E R OR BOWE L I NCONTI N E NCE
(OR BOTH) AN D B ECAUS E OF TH E E M BAR RASS I NG NATU R E OF TH I S
PROB LE M, MANY SU FFE R I N S I LE NCE. D E LOITTE ACCE SS ECONOM ICS
E STI MATE D THAT TH E COST OF I NCONTI N E NCE TO TH E H EALTH SYSTE M I S
EXPECTE D TO R I S E TO $450 M I LLION BY 2020.
Incontinence is the involuntary or accidental loss of
urine or faeces. It can range from a small volume leak to
complete loss of control of the bladder or bowel or both.
Faecal incontinence is usually caused by weak pelvic
floor muscles or sphincters from either childbirth, as a
result of surgery or radiation therapy or by lower bowel
problems such as chronic constipation or diarrhoea.
Many sufferers of this condition have tried a range
of different management options for both urinary
and faecal incontinence which begin with lifestyle
interventions, pelvic floor exercises and bladder
training. Unfortunately some people have found these
treatments unsuccessful and now rely on incontinence
aids such as pads, catheters and bedding protection.
12
The Australian Centre for Bladder and Bowel
Incontinence at St Andrew’s Hospital in Brisbane
has brought together a range of Medical Specialists
to offer newer treatment options such as Botulinum
Toxin injections into the bladder and sacral nerve
neuromodulation. These procedures are generally
highly effective in treating incontinence.
The newer methods of treatment are now offering
these people a real possibility of a life without
reliance on incontinence products. All of these newer
treatment options have rebates available through
Medicare and Private Health Insurance for eligible
patients.
B E N E FIT I N FOCUS
DIETITIAN
A dietitian is defined as someone that provides expert nutrition
advice for people of all ages and prescribes dietary treatments
for many conditions such as diabetes, food allergies, cancers,
gastro-intestinal diseases, and obesity.
QU E E N S LAN D COU NTRY H EALTH FU N D PAYS G E N E ROUS
B E N E FITS FOR D I ETITIAN S VI S ITS.
DIETITIAN
Initial
Subsequent
WAITING
PERIOD
PREMIUM
EXTRAS
ESSENTIAL
EXTRAS
YOUNG
EXTRAS
$1400 overall benefit
per person per
membership year for
all therapy services
$900 overall benefit
per person per
membership year for
all therapy services
(benefits per
membership year)
$300 per therapy
$500 per person
Up to $1000 per
policy
$75
$48
$55
$40
$26
$35
2 months
UPDATING YOUR DETAILS
Don’t forget to update all your contact details with us!
To receive communication from us via SMS alert and by email ensure all your details are up to date
in our system.
You can now receive communication from us via SMS alerts and by email. However this requires all
your contact details to be up to date on our system.
You can update your details as well as all Members’ contact details over the age of 16 on your policy
by giving us a call on 1800 813 415, emailing us at [email protected] or using Online Member
Services (OMS) via our website www.qldcountryhealth.com.au
13
ARE YOU HAVING
TOO MUCH
PROTEIN?
MANY OF THE DIETS TRENDING
AT THE MOMENT RECOMMEND AN
INTAKE OF PROTEIN RICH FOODS
SUCH AS MEAT, FISH & SEAFOOD,
CHICKEN & POULTRY, DAIRY
PRODUCTS, EGGS, TOFU & TEMPEH,
LEGUMES & BEANS, NUTS AND
By Lauren James
EatSmart Nutrition
SEEDS. FROM PALEO TO VEGAN,
FROM ATKINS TO DUKAN AND
CSIRO TO FLEXARIAN, HOW MUCH
IS TOO MUCH?
For the general public, doing low to moderate intensity
exercise such as walking you require 0.75 to 1.0 gram
of protein per kilo of body weight per day. So, for a
60kg female this would be 45 to 60 grams of protein
per day. In food terms, this would be a serve of dairy at
breakfast, a serving of ham on a sandwich at lunch and
a small piece of meat or chicken at dinner. Those of a
higher weight would require more protein than those
with a small frame as more nutrients are required to
supply a greater mass of tissue.
Protein is a nutrient our body requires for good
health, functioning and recovery. A protein
molecule is made up of amino acids, which have
a plethora of actions within the body including
being the building blocks of hair follicles, skin cells,
muscle tissue and blood cells. Whether you are
a couch potato, someone who just likes to keep
active (or maybe not likes, but commits to keeping
active!) or a weekend warrior or elite athlete.
protein containing foods are required daily for
optimal health. But how much is enough? And can
you have too much?
14
For a moderate exerciser who might do 40-60 minutes
of exercise at least 3 days per week, with some
of this exercise including resistance training, it is
recommended that you have 1.2-1.6 grams of protein
per kilo of body weight. For an 80kg male, this would
be 96 – 128g per day. This would be the equivalent of
2 eggs at breakfast, a latte, a tub of yoghurt and a small
handful of nuts, meat or chicken on a sandwich at lunch
and a serve of meat, chicken or fish at dinner.
WHETHE R YOU ARE A COUCH POTATO, SOMEON E WHO JUST LIKES
TO KEEP ACTIVE (OR MAYBE NOT LIKES, BUT COMMITS TO
KEEPING ACTIVE!) OR A WEEKEN D WARRIOR
OR EVEN AN ELITE ATHLETE; PROTEIN CONTAIN ING FOODS
ARE REQUIRE D DAILY FOR OPTIMAL HEALTH.
For those preferring endurance activity such as running or cycling at least 3 days per week, it is recommended
you consume 1.2 to 1.7g per kilo of body weight per day. This may surprise some people that endurance activity
requires about the same amount of protein as a more strength based trainer. The muscle recovery is quite similar
from both types of training.
Adolescents who are growing rapidly may require up to 2 grams per kilo. Those who are recovering from a
serious illness or treatment regime such as those currently undergoing cancer treatment may require higher
levels of protein. People with kidney conditions
may require a lower protein intake. Interestingly,
THE TABLE BELOW OUTLINES THE FOOD
females require 15% less protein than males. This
is due to males’ higher level of muscle mass.
PORTIONS TO ACHIEVE 10 G PROTEIN:
In the protein table below you can see it is very
easy to achieve the required amount of protein per
day, even if you are a consistent exerciser.
So what happens to any additional protein you may
eat? Any unused food, whether it is from protein,
carbs or fat will be stored in the fat cells for later
use as a fuel. So more is not better in this case!
There is a risk of some people not consuming
adequate protein, particularly those following a
vegetarian or vegan diet. This is likely due to not
consuming enough serves of protein rich foods
like beans or tofu. This may lead to inadequate
recovery, sore muscles and fatigue.
Striking the right balance in your protein intake
may be difficult as protein rich foods are often
very satisfying. Eating additional protein will help
manage your appetite. This needs to be weighed
up against your individual requirements to ensure
the additional protein foods you are consuming are
not contributing to an increase in storage of fuel in
the fat cells.
To find out what your protein requirements are,
speak with an expert Accredited Practicing
Dietitian.
TYPE OF PROTEIN
SOURCE
AMOUNT
REQUIRED TO
PROVIDE 10G
PROTEIN
Small eggs
2
Milk
250mL/1 cup
Cheese
40g/2 slices
Yoghurt
200g/1 tub
Beef, lamb or pork
35g cooked weight
Chicken
40g cooked weight
Fish or seafood
50g cooked weight
Wholemeal bread
4 slices
Cooked pasta or rice
2 cups
Lentils or beans, legumes
1 cup
Baked beans
1.5 cups
Tofu or soy meat
100g
Soy milk
300mL
Nuts & seeds
50g
Protein powder
Varies, approx 1 tblsp
Protein bar
1 small or ½ large
15
STAFF IN SPOTLIGHT
DELVENE LAWS-YATES
Senior Membership Officer, Delvene Laws-Yates has been with
Queensland Country Health Fund for over 4 years. Delvene’s role involves
all things Membership including staff membership training, streamlining
process to achieve quick and easy results for our Members and ensuring all
staff deliver a fantastic Member experience every single time. Delvene truly
loves what she does!
Like most people, Delvene loves to spend time with her husband, dogs,
family and friends. She absolutely adores her niece and nephew. Delvene’s
other love is travel. She is always planning her next holiday. Her favourite
place she has visited so far has been Paris. She has been lucky enough
to visit three times and agrees it is true what they say Paris is always
a good idea, especially in the rain!
Se ni or Mem be rs hi p O ff ice r
Di d yo u kn ow ?
H O M E AWAY FR O M H O M E
Queensland Country Health
Fund Accommodation Units
d, it is often
l and remote areas of Queenslan
iona
reg
in
live
ers
hold
icy
pol
As the majority of our
al treatment. This can mean
or Brisbane for essential medic
ille
nsv
Tow
to
el
trav
to
ple
peo
necessary for
the patient.
for family members accompanying
high accommodation expenses
ng a complex of 2 bedroom,
issue for policy holders by providi
this
sed
res
add
has
ry
unt
Co
Queensland
y from the Mater Hospital in
rtments just a stone’s throw awa
apa
d
ishe
furn
and
ined
nta
-co
fully self
al rates for our
units are available at concession
se
The
e.
ban
Bris
in
l
pita
Hos
Townsville and the Wesley
d.
associated with a medical nee
policy holders, exclusively for use
and
Australia to provide this benefit
We are the only health fund in
it is easy to book online.
k your stay visit
For more information or to boo
ccommodation
www.qldcountryhealth.com.au/a
or call 1800 813 415.
16
B E N E FIT I N FOCUS
HEALTHY LIVING
As well as helping you to get well we want to help you stay well. Therefore we have introduced
benefits to encourage you to live a healthy lifestyle. We will pay up to $150* per person per
Membership year to assist you to:
ø P
articipate in your choice of weight
ø C
onsultation fees for metabolic dietitians and nutritionist
management programs
when providing assistance with weight management
ø P
articipate in quit smoking programs
ø B
owel screening tests and bone density tests. No
ø P
articipate in other approved health management
programs** including:
doctors referral will be required
ø P
SA Test (one per year, we will cover a second yearly
test not covered by Medicare)
ø g
ym membership
ø personal Training programs
ø H
ave your skin checked for skin cancers through
mole mapping
ø C
onsultation fees for diabetes educator
TYPE OF SERVICE
Healthy Living
WAITING
PERIOD
PREMIUM
EXTRAS
ESSENTIAL
EXTRAS
YOUNG
EXTRAS
2 months
$150 per person
per membership
year
$125 per person
per membership
year
$125 per person
per membership
year
* Benefit payable under Premium Extras
** To comply with private health insurance legislation you must have been referred by your health care professional to
participate in health management program to address, improve or prevent a specific health or medical condition. A Health
Management Program Benefit Approval Form available on our website must accompany claim for these benefits.
17
PBS MEDICINE
LIST CHANGES
AR E YOU PR E PAR E D?
DO YOU TAKE PANADOL OSTEO
AS PART OF YOUR PAIN
MANAGEMENT PLAN?
HAVE YOU TYPICALLY ACCESSED
THIS MEDICINE THROUGH THE
GOVERNMENT’S SUBSIDISED
PHARMACEUTICAL BENEFITS
SCHEME?
Well there are some significant changes which may hit
your hip pocket and your pain management plan pretty
hard if you aren’t prepared.
Members are urged to take the time to find out more
about how recent changes to the Pharmaceutical
Benefits Scheme (PBS), will impact on their regular
care plans.
From January 1 this year, a number of common
medicines were delisted from the PBS and patients
and carers across the state have been caught out on
prescriptions that are no longer subject to discount
and in some cases are significantly more expensive.
PBS-subsidised medicines are available to all
Australian residents who hold a current Medicare
card and are more commonly used by concessional
patients to access medicines at a discounted price.
Experts have warned the biggest changes included
the delisting of a number of first line therapy
medicines such as aspirin and paracetamol and the
subsequent 50% price increase on Panadol Osteo.
One in five Australians lives with chronic pain
including adolescents and children.
18
Matt Calanna
General Manager, Calanna Pharmacy
This prevalence rises to one in three people over the
age of 65.
Forward planning is the best approach and people are
encouraged to also consider alternatives in their pain
management planning.
In Australia, a number of common medicines can be
bought over the counter while also being listed on the
PBS so that they can be prescribed at a discount and
also count toward a person’s safety net.
Once a person reaches their allocated safety net
threshold of spend on these medicines they are
then entitled to receive them for free or at a heavily
discounted rate.
Some of the more familiar medicine brands
facing delisting include Astrix (aspirin), Panamax
(paracetamol; 500 mg tablet, 100 ml liquid,
200 ml liquid) and Panadol Osteo (paracetamol;
665 mg modified release tablets), as well as Chlorsig
eye drops (0.5%) and ointment (1%) and Dulcolax
suppositories (10 mg).
The changes are part of the Federal Government’s
PBS Access and Sustainability Package.
The government has estimated that removing these
changes will save taxpayers around half a billion
dollars over the next five years.
TO P T IP S
F O R PAT IE N TS
A N D CA R E R S
1. KNOW YOU R ACTIVE I NG R E D I E NT
3. KE E P A M E D ICI N E S LI ST
Active ingredients are what make your medicines
work. Some products may have more than one active
ingredient in them. If you are taking more than one
type of medicine, check the active ingredients to make
sure you are not doubling up on a dose.
Consider preparing an up-to-date list of all your
medicines that shows important information, such as
the active ingredients and the brand names. Take this
list to your pharmacist and use it to identify suitable
products that you can take if your usual medicine
brand is not available.
Knowing the active ingredient means that if the brand
of medicine you would normally take is not available,
it is easier to find other products that are suitable for
you to use.
2. KNOW YOU R DOS E
Some medicines might have the same active
ingredient but in different strengths. If you are buying
these medicines over the counter, it is important to
know how much active ingredient is in each tablet and
how many tablets you need to take to manage your
health condition. This information is also important
when you need to take more than one product that
may contain the same active ingredient – for example,
cold and flu medicines contain paracetamol as do
pain relief medicines.
4. TALK TO A PROFE SS IONAL
Your local pharmacist or health care professional
can help you manage these changes by helping you
understand what impact they will have and how best
to continue your care affordably.
(Courtesy of NPS Medicine Wise)
http://www.nps.org.au/publications/consumer/medicinewise-living/2015/some-otc-medicines-lose-pbs-subsidy
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