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