Queensland Country Health Fund Review
Overview
Queensland Country is member owned and is the state’s only regional health fund. The 40-plus year old fund owns 6 retail centres across the state and prides themselves on their affordable and easy to understand policies.
Queensland Country Health has over 50,000 members and is a subsidiary of the member-owned Queensland Country Group.
Queensland Country Health Key Facts
Founded: 1977
For-Profit or Not-For-Profit?: Not-For-Profit
Private Hospital Agreements Nationwide: 279
Day Hospital Agreements Nationwide: 262
Health Deal Represented? No
Headquarters: Townsville, QLD
Queensland Country Health Hospital Cover
Queensland Country has 2 hospital covers. One offers full comprehensive cover and the other is a mid-level policy designed for people who only require the essentials. The 2 hospital covers currently available from Queensland Country are:
- Better Hospital (Silver +)
- Vital Hospital (Bronze +)
Queensland Country Health Extras Cover
Extras Cover takes care of the everyday healthcare service expenses that are not generally covered under Medicare such as dental services, prescription glasses, and physiotherapy. Here is a list of the current extras covers available:
- Premium Extras
- Essentials Extras
- Select Extras
- Young Extras
Queensland Country Health Waiting Periods
Queensland Country recognises the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:
Queensland Country Health Hospital Waiting Periods
- Ambulance services: None
- Accidental Injury: None
- New Conditions: 2 Months
- Pregnancy and birth-related services: 12 months
- Pre-existing conditions: 12 months
- Rehabilitation & Palliative care: 2 months
- Weight Loss Surgery: 12 months
How Do You Claim Extras with Queensland Country Health?
Queensland Country offers several convenient and easy ways to claim on your extras. This can be done in the following ways:
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
Via a mobile app: You can lodge a claim using the by uploading a photo of your receipt to the Queensland Country mobile claiming app.
Online: You can log into their website and lodge your claim by providing the details on your receipt.
In person: You can lodge your claim by visiting any of their 6 retail outlets with your relevant accounts and receipts.
Queensland Country Health Gap Cover
Queensland Country’s gap cover is called the Access Gap Cover. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense. Access Gap can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.
Gap Cover Ratings by State
To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme.
Medical Services with No Gaps — The percentage of claims that were fully refunded.
Medical Services with No or Known Gaps — The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.
The information below outlines the percentages of services covered under no-gap and known-gap.
Queensland Country Health medical services with No Gap: 60.8%
Industry Average: 79.1%
Queensland Country Health medical Services with No or Known Gap: 81.0%
Industry Average: 90.5%
Queensland Country Health medical services with No Gap: 93.2%
Industry Average: 89.5%
Queensland Country Health medical Services with No or Known Gap: 97.4%
Industry Average: 95.7%
Queensland Country Health medical services with No Gap: 91.8%
Industry Average: 86.7%
Queensland Country Health medical Services with No or Known Gap: 97.2%
Industry Average: 95.1%
Queensland Country Health medical services with No Gap: 91.7%
Industry Average: 89.2%
Queensland Country Health medical Services with No or Known Gap: 97.7%
Industry Average: 94.5%
Queensland Country Health medical services with No Gap: 90.8%
Industry Average: 89.5%
Queensland Country Health medical Services with No or Known Gap: 99.1%
Industry Average: 96.6%
Queensland Country Health medical services with No Gap: 85.5%
Industry Average: 84.4%
Queensland Country Health medical Services with No or Known Gap: 94.1%
Industry Average: 96.2%
Queensland Country Health medical services with No Gap: 85.7%
Industry Average: 90.2%
Queensland Country Health medical Services with No or Known Gap: 95.0%
Industry Average: 96.7%
Queensland Country Health medical services with No Gap: 72.5%
Industry Average: 84.2%
Queensland Country Health medical Services with No or Known Gap: 93.8%
Industry Average: 93.8%
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