newsletter-issue 10 how stuff works 1010

8/12/2019 Newsletter-Issue 10 How Stuff Works 1010

1/15

How stuffworksGETTING THE BEST FROM

YOUR HEALTH COVER CAN

BE AS SIMPLE AS KNOWING

WHERE TO LOOK AND WHEN

TO ASK.

Issue 02 October 10


2/15

FROM THE CEO

Health insurance is complicated, probablymuch more so than any other type ofinsurance. Our job is make sure thatyou have access to the information andassistance you need when you havequestions thats what this issue is all about.

HOW YOUR COVER WORKS

Getting the best from your health cover canbe as simple as k nowing where to look. Find(almost) everything you need to know aboutwhat youre covered for, how much youll getback, how your cover works and how to findyour way through the healthcare system with

these handy resources.

HOW AMBULANCE COVER WORKS

Fortunately, this is not a topic many of usknow too much about, but its importantto know youll be covered if you ever needit. Find out the facts and check your levelof cover.

HOW OUR HEALTH ANDWELLBEING PROGRAMS WORK

If you have hospital cover with rt, youreeligible to use these two great programs:one designed to help you improve yourhealth and wellbeing a nd the other tohelp you get well in the comfort of yourown home.

CONFUSED ABOUT THESE?

Heres a couple of topics that can tendto trip people up: find out more about whyyoure not covered for purchases you makeoverseas, and how to make the most of yourorthodontic entitlements.

HOW CLAIMS WORK

Making claims is what its really all about,find out more about how, when and whereyou should be making claims.

HOW OUR ONLINE CENTRE WORKS

Have you registered yet to use our onlinemember centre? With instant access to

make changes to your membership, anda new service that makes it possible for youto view your claims history and track claims,its handy to know about.

ITS THAT TIME OF YEAR AGAIN

It wont be long before our minds turn to theend of another year and Christmas holidaytravels. Find out what you need to do if youhave adult children on your cover and whyyou should leave your health cover behindif youre travelling this summer.

Contents

02

04

05

08

11

12

24

16

Editor Simone TregeagleDesignTeam Scope, scopedesign.com.auThe health information provided inbe well

is intended to be informative only andshould be carefully evaluated for its source,accuracy, completeness and relevance foryour purposes. It is not a replacement forprofessional medical evaluation, advice,diagnosis or treatment by a healthcareprofessional. You should always obtainappropriate professional advice relevant toyour particular circumstances.

railway + transport health fund ltd (abn 93 087 648 744)

is a registered health benefits organisation.

HOWGOVERNMENTINCENTIVESWORK

Rebate, LifetimeHealth Cover,Medicare Levy all your questionsanswered whatthey are, how theyaffect you and whatyou need to knowabout them.

18

04

05

12

Getting to know your health cover is an almostimpossible task! Unlike car or house insurance,which cover you for relatively few things, your healthcover potentially pays benefits for hundreds ofdifferent products, services and treatments youllnever know them all off by heart. What you can doto make sure you get the best from your cover ismake sure that you know where to look for answersand when to ask questions. In this issue we tacklesome of the trickier topics that can confuse people,and introduce you to the resources available to helpyou get to know your cover better.

be well1


3/15

fromtheCEOThe first thing you might notice aboutthis issue ofbe well, is that theres anew face welcoming you from the CEOpage. Im Michael Prior, a memberof the rt board of directors and amcurrently acting in the role of CEO.Glenn Campbell, who served as CEOsince 2006, and who led the organisationthrough a period of significant change,growth and reinvigoration resigned hisposition in August. At the time of writing,the board is recruiting for the role and Iexpect that by time the next issue ofbe wellcomes around, well beintroducing our new CEO to you.

In this issue we continue in our efforts tohelp you better understand your healthcover. The fact is that health insuranceis complicated, probably much more sothan any other type of insurance, and ourview is that its probably impossible to everfeel like you really understand your coverwell. The best we can do is make surethat you have access to the informationand assistance you need to help youwhen you have questions. One of themost important things you can do whenit comes to using your health cover, is notmake assumptions. Our team is availableto help you check your cover, confirm whatyoure covered for, and they can even tell

you exactly how much you can expect toget back armed with all that information,there will be no nasty surprises.Throughout this issue weve also tackled arange of topics that we find members areoften confused about ambulance cover,orthodontic cover, overseas purchases,and the various government programsthat can either cost you money or saveyou money. As always, if you have anyquestions, please feel free to call or emailour member care team.

Also in this issue youll find someinformation about what to do with yourcover as we approach the end of anotheryear. If you have children finishing theirstudies, it may be time for them to

consider their own health cover options.Your adult children are automaticallyeligible to remain on your family cover untilthe age of 21, after that, we have a coupleof different options available, dependingon whether they are studying or working.If youre not certain about whether yourkids are covered, see our article on page24 or give our team a call.

As you opened this issue ofbe wellyouwill have also found enclosed a noticeof meeting for this years annual generalmeeting (AGM) and information aboutour board member elections. I encourageall members to take the opportunity toparticipate in this process by sending inyour ballot and attending our AGM. Forregular attendees, please note that theAGM will be held at a new venue this year

after our regular venue was unavailable.All the information you need is containedin the notice of meeting, and I hope to seeyou there.

As the year draws to an end, Id like to takethe opportunity to congratulate the r t teamfor seeing the fund named by the FinancialReviews Smart Investormagazine as oneof the nations best value health funds,for the third year running! This is a fantasticendorsement of the great value rt offers itsmembers. The team also recentlyparticipated in the ATA contact centreof the year awards, and while we werenot successful on the night, it is a greatindicator of just how important it is to us tobe delivering exceptional customer service.

And finally, congratulations to our Sydney-based City2Surf team. The staff, theirfamilies and friends braved the infamousheartbreak hill and went the 14kmdistance to raise money for the rt FamiliesFoundation. It was a stunning day anda wonderful achievement for everyonewho participated.

Id like to take this early opportunityto wish you and your family a safe andmerry Christmas, and a healthy andhappy New Year.

Take care andbe well.

Michael PriorDirector and Acting CEO

OUR TEAM IS

AVAILABLE TO

HELP YOU CHECK

YOUR COVER,

CONFIRM WHAT

YOURE COVERED

FOR, AND THEY

CAN EVEN TELLYOU EXACTLY

HOW MUCH YOU

CAN EXPECT TO

GET BACK.

2 be well3


4/15

How your coverworksYoull get the best from your health coverby using it well and making sure youunderstand what youre covered for, or atleast which questions to ask. If you haventalready made use of these great resources,designed to help you get to know your coverbetter, visit our website to have a look,www.rthealthfund.com.au.

COVER GUIDES

These are comprehensive tables that listeverything youre covered for and howmuch you can expect to get back. Take alook at the rt members area of our websiteand click on the page how do you knowwhat youre covered for.

A TO Z OF RT

If youre looking for information abouthow your cover works, this will tell youeverything you need to know. Its all therules, regulations and details. Log in to ouronline member centre where youll find theA to Z in the library section.

BE WELL

The last couple of issues of ourbe well

magazine have been dedicated to helpingyou understand your cover better, and knowhow to get the most from it. Find out moreabout how your health cover works by visitingwww.rthealthfund.com.au/be_well.html.

HOWAMBULANCECOVER WORKS

Callyour rt member caretea

m

on 1300886123, email us

at

[email protected]

orvisit us online at

www.rthealthfund.com.au1

THEA-ZOF

RTHEALTH

FUND

TherearetwotypesofhealthfundsinAustraliaunrestrictedfundsthatanyonecanjoin,andexclusivemembershipfundsthatrequirespecialeligibilitytojoin.rtis

anexclusivemembershiphealthfund.Weexistspecificallytoprovidehealthcovertotransportandelectricityindustryemployeesandtheirfamilies.

Membership eligibilityAny currentorformeremployeesofa railway,

transportorelectricity industry organisationandtheirfamily including partner, kidsandextendedfamily are eligible to join. So, youare able to joinifyouorany memberofyourextendedfamily haseverworkedfora:

governmentorprivately ownedland,sea orairtransportcompany

governmentorprivately ownedelectricitycompany

governmentbody responsible foradministering the transportorelectricity

industries

company thatprovidescontractservicesto any of the above organisations.

Non-residentsofAustralia

Australianresidentswithfull Medicareentitlementsare able to join(providedtheyalso meetourothereligibility requirements,

asdescribedabove). We are unable to providefull coverto anyone who isineligible, oronlypartly eligible, forMedicare. Ifyoure inthissituation, we recommendthatyoulook for

anoverseasvisitor cover(offeredby someAustralianhealthfunds) to make sure thatyouare fully coveredinthe eventthat youneedhospitalisationduring yourstay inAustralia.

Membership typesWe offera choice offourmembershiptypes,depending onwho youwantto cover:

1. Single coversone adult.

2. Couple coverstwo marriedorde factoadults(including same sexcouples).

3. Single ParentFamily coversone adult

andall dependantchildren.

4. Family coverstwo marriedorde factoadults(including same sexcouples) andalldependantchildrenofeitherorboth adults.

Adultchildrencanremaincoveredby yourmembershipupto the age of25. See

page 7 fordetails.

HealthcoverchoicesWe like to keep thingspretty straightforward,so we offera small range ofeasy-to-understandcovers.

Youcanchoose from:PrivateHospital+Extras

(our toplevelofcover)

There are no exclusionswithourPrivateHospital Cover: youre coveredfortreatmentinthe hospital ofyourchoice, withthe doctorofyourchoice. AndourExtrasCovergives

yougenerousrebatesona huge range ofhealthandwellbeing products, servicesandtreatments.

The A-Zofrt healthfund is intended tobethe ultimate guide toyourhealthcoverandhow it works. Weve grouped the contentintosp ecific topic areas that we hope makeit easy foryoutofind what youre looking

for. Ifyoustill have questions orneedclarification, please call ourmembercareteam on1300 886 123. Were here tohelpand wed value yourfeedbackabout howwell were doingwhenit comes toproviding

youwiththe informationyouneedtobetterunderstand yourhealthcover.

Anonline versionofthe A-Zcan be foundatwww.rthealthfund.com.au/atozofrt.html.Youll also finda pdfversionoft hisdocument

available fordownload.

Ifyoure looking fordetailedinformationaboutyourcoverandwhatyou canclaim, youcandownloaddetailedcovertablesfrom ourwebsite. Visit www.rthealthfund.com.au, clickonmemberlogin atthe topofthe screenand

youll findwhatyoure looking forinthe librarywithinthe online membercentre.

Ifyouhave a suggestionorfeedbackaboutthisguide, wedlove to hearfromyou. Please email usat

[email protected].

Contents

Joining 1

Y ou r m em be rs hi p 4

C ov er f or t he k id s 6

Wa it in g pe ri od s 8

Benefits 9

Ma kin gc lai ms 1 1

M ak in g pa ym en ts 1 4

Your hospitalcover 16

Your extrascover 24

Your ambulancecover 27

H e al t h and w el l be i ng p r og ra m s 28

T ra v el l ing o ve r se a s 30

Governmentprograms 32

Fundrulesandpo licies 34

Complaints 35

R eg ul at or y bo di es 3 6

Version2.Effective1April 2010.Fundrulesandpolicies

aresubjecttochangewithoutnotice.If achangewilladverselyaffectyourmembershipand/orbenefits,we

willnotifyyouin writing.Dependingontheissue,thismaybethroughapersonally addressedletter,viaemailorthroughourmember magazine,bewell.

JOINING

THEA-ZOF

RTHEALTH

FUND

101

THEA-ZOF

RTHEALTH

FUND

Remember,becauseyoure

anrthealthfundmemberyour

immediatefamilycanjointoo,

eveniftheydontworkinthe

transportorelectricityindustrie

s

yourmembershipmakesthem

eligible.Sharethegoodnewsan

d

askthemtogiveourteamacall

to

comparecover,1300886123.

4 be well5


5/15

6 be well7

Fortunately, most of us will neversee the inside of an ambulance,so its not something we thinkabout until we find ourselves inthe middle of an often stressfuland confusing situation,wondering if we are covered,and exactly whats included.Ambulance cover isnt only something tothink about if you are a little older or if youhave been unwell. If you break your armskiing, get injured on a family picnic, or just

trip over your four-legged friend and breakyour ankle, its good to k now that yourecovered for the trip to hospital. And itsespecially important if you live in or travelto regional or remote areas where you needto be transported to a city for treatmentafter an accident.

It often comes as a big surprise to peoplethat Medicare doesnt cover the cost ofambulance treatment and transportation.Unless you have ambulance cover, you willbe paying for the service and it can bevery expensive.

Ambulance cover is one of thosedeceptively simple-looking things, whichaint. Theres emergency versus non-emergency cover; ambulance treatment

Thesedetailscanbeconfusing,buttheyareimportant,andnevermoresothanthedayyouneedtouseyourcover.Wewanttohelpyou

makesurethatyouvemadetherightdecisionsforyourselfandyourfamilyifthatdaycomes.Asalways,ifyourenotcertainaboutexactlywhatyouarecoveredfor,pleasecallus,1300886123.

versus ambulance transportation; and theambulance cover that comes with yourhealth cover versus the one you might buyfrom your state ambulance scheme. Letstry to break it down.

Each of rts hospital covers includes coverfor ambulance, and the extent of ambulancecover you have depends entirely on whereyou live.

When youre looking at ambulance cover,check that you understand the differencebetween cover for ambulance attendanceand ambulance transportation. Sometimes

an ambulance will attend, but the personwill not be transported to hospital becausethankfully the emergency has passed, orwasnt as serious as it first seemed. In thiscase, if you are only covered for emergencytransportation, the ambulance service willcharge an attendance fee, but you wontbe able to make a claim. Only residentsof NSW and the ACT are fully covered forambulance attendance and transportationby the cover that comes with our hospitalcovers. If you are a resi dent of another state,we recommend you look into additionalcover offered by your state governmentambulance scheme if youre after somethingmore comprehensive.

If you live in: Then youre covered for:

NSW or ACT Unlimited cover Emergency and non-emergency ambulance attendance and transportation Cover applies no matter where you are in Australia

QLD If youre a Queensland resident, you pay a Community Ambulance Levy through yourelectricity bill. Your rt hospital cover therefore does NOT include cover for ambulance.

For more information visit w ww.ambulance.qld.gov.au.

VIC, SA, WAand NT

$5,000 per person, per year Emergency ambulance transportation (no cover for non-emergency transportation or

ambulance attendance only)

Cover applies no matter where you are in Australia

You can take out a higher level of ambulance cover, which includes non-emergency andambulance attendance, with these state-based organisations:

Victorian Ambulance Service, ww w.ambulance.vic.gov.au

South Australian Ambulance Service, www.saambulance.com.au

St John Ambulance Western Australia, www.stjohnambulance.com.au

St John Ambulance Nor thern Territory, www.stjohnnt.org.au

TAS $5,000 per person, per year Emergency ambulance transportation (no cover for non-emergency transpor tation or

ambulance attendance only)

Cover only applies when Tasmanian residents use the ambulance service while inQueensland or SA (there is no cover for Tasmanian residents while in Tasmania, Victoria,WA, NT, NSW or ACT)

The Tasmanian Ambulance Service provides a free service to all Tasmanian residents,www.dhhs.tas.gov.au.


6/15

Health4life: helping you stopchronic illness from controllingyour life

Chronic illnesses can often have profoundeffects on a persons physical, emotional and

mental wellbeing, making it difficult to carryon with daily routines and relationships.

The positive news is that in many caseschronic illness can be managed and evenprevented by adopting specific behavioursand making lifestyle changes. But this canbe difficult to do al one. We want to helpyou improve your health and enjoy a betterquality of life.

Whats it all about?If a doctor has diagnosed you with a chronicillness and/or multiple risk factors fordeveloping a chronic illness, our health4lifeprogram can help you make the changesyou need to improve your health and yourquality of life.

Chronic illnesses include (but are notlimited to) conditions such as asthma,diabetes, arthritis, depression, cancer andheart disease, and they affect up to 70%of all Australians. While most were onceassociated with getting old er, today theyare becoming more prevalent in all agegroups and affecting men and women alike.Our health4life program is designed to helpour members prevent or manage the effectsof chronic illness in their lives.

Heres how it worksYoull be assigned a case manager whowill work with you throughout the courseof the program. This will be either a six or12-month period, dependi ng on the severityand complexity of your condition.

Through a series of regular phoneconsultations, youll be provided withinformation about your condition andassistance in developing strategies to

help manage it through positive healthbehaviours.

Youll be supported in setting goals andachieving them, with a focus on cleari ngaway the barriers and roadblocks that mayhave prevented you from making a changefor the better in the past. And, youll receiveup-to-date advice, information and referralsto the additional support and servicesavailable to you.

Interested in finding out more?The health4life program is availableabsolutely free to members with anyhospital cover who have served theminimum two-month general serviceswaiting period.

Our health and wellbeing programs are designed to help you takecare of your health in two very different ways. Health4life is designedto give support and assistance to people living with a chronic illness,and hospital at home is about making sure that when youre unwell youhave options available to help you get the best of care without havingto check into a hospital. If you have hospital cover with us, both ofthese programs are available to you at absolutely no extra cost.

How our health

and wellbeingprograms work

THE POSITIVE

NEWS IS THAT

IN MANY CASES

CHRONIC

ILLNESS CAN BE

MANAGED AND

EVEN PREVENTED

BY ADOPTING

SPECIFIC

BEHAVIOURS

AND MAKING

LIFESTYLE

CHANGES.

8 be well9


7/15

DOUBLE-CHECK BEFORE YOUDOUBLE-CLICK

Health insurance legislation in Australia ispretty clear on this one. Were not allowed tocover you for healthcare products, servicesor treatments you purchase overseas.

We recommend you suspend your coverif youre travelling overseas, since youcant use it while youre away (read moreabout suspending your cover on page 24).Similarly, we cant cover you for productsyou purchase where the transaction takesplace overseas, whether youre overseasyourself or sitting in front of your computerat home. If its an approved product, whichyou have cover for, and youre purchasingfrom an Australian company then youreokay. But if the company youre buyingfrom is overseas and you are bringing theproduct into the country, you wont becovered. If youre not 100% sure, give us aquick call before you make your purchase.

Hospital at home: we bring thehospital home to you

Bringing healthcare to people at homemeans theyre more likely to be comfortableand relaxed, which can improve recoverytime and reduce the chances of secondaryinfections or relapse. And its great formorale, as people enjoy a much bet terquality of life in familiar surroundings withfamily and friends nearby. The objective isto bring hospital care to you, so you canconcentrate on your recovery.

Whats it all about?Hospital at home can help you gethome from hospital faster, or avoid ahospitalisation altogether, by providingyou with hospital equivalent treatmentand follow-up care in your own home.The program is available for all kinds oftreatments and post-procedure support. Its

ideal for people undergoing regular medicaltreatments that could easily be provided athome or for those living in regional areaswhere a hospital stay can mean being farfrom home.

Heres how it worksIf your treating doctor agrees that hospitaltreatment at home is right for you, thenin consultation with your doctor and thehospital, well arrange for you to receivethe services you need from registeredpractitioners who specialise in home-basedcare. During the program you might receivehome visits from a range of different healthservice providers, including your doctor,nurses, physiotherapists and so on all the

Confusedaboutthese?

Orthodontic benefits that will give youa reason to smilert provides a fantastic level of orthodontic benets: up to $3,000per person covered by your membership. To get the most fromyour orthodontic benefits its important that you understand howit works, and, especially if youve been an rt member for a whileand claimed for orthodontics before, that theres been a change inrecent years.

Heres how it works: if you have our E xtras Cover (not Fit + Healthy

Extras), each person is covered up to a lifetime limi t of $3,000 fororthodontics. The $3,000 cant be claimed all at once though.You can claim 70% of your invoiced amount, up to a maximum of$1,000 per year, each year for three years. To get the best fromyour cover, ask your orthodontist to work out a payment plan withyou rather than paying everything up front. If they invoice you eachyear for not less than $1,500 (70% of which is your annual limitof $1,000) then youll be able to claim bac k your full orthodonticentitlement. Its important to understand, at least from the pointof view of your health cover, theres no benefit in paying the fullamount up front; no matter how much you actually pay you canonly claim back a maximum of $1,000 per year, and you can onlyreceive your full $3,000 limit by paying in installments. If you payup front youll only be able to make one claim for a maximum of$1,000. You cant use that same upfront payment receipt to claimagain in the second and third years.

same types of practitioners who would havelooked after you in hospital.

The type and frequency of visits you receivewill depend on your condition and will bedetermined by your doctor. Your conditionwill be constantly assessed and, wherenecessary, your recovery or treatment planwill be changed to accommodate your needs.

Interested in finding out more?The hospital at home program is availableabsolutely free to members with hospitalcover who have served the applicablehospital waiting periods. If your doctoragrees that leaving hospital early (oravoiding it altogether) is appropriate for yoursituation, both you and your doctor will needto complete a referral and consent form.

Visit our website for more informationFor enrolment and consent forms visitour website and click on rt members,

health and well being programs,www.rthealthfund.com.au.

This can be a confusing one, ifyoure planning orthodontictreatment, please call our membercare team before you get started soyou understand how to get the bestfrom your cover.

VISIT

www.rthealthf

und.com.au

foreverything

you

needtoknowa

bout

yourhealthcov

er.

THE OBJECTIVE

IS TO BRING

HOSPITAL

CARE TO YOU,

SO YOU CAN

CONCENTRATE

ON YOUR

RECOVERY.

With an increasing number of peoplethese days travelling overseas andbecoming more comfortable withmaking purchases from overseascompanies online, where does yourhealth cover fit in?

10 be well11


8/15

HOW

CLAIMSWORKThis is the nuts and bolts of it all:you pay us money and we pay youmoney. Heres how it works.

What you should know about extrascover claimsFirst, make sure that the product, serviceor treatment you're planning to claim iscovered. If you're not 100% certain, pleasecheck with us. Even if its something youvemade a claim for before, if its been a yearor two, give us a quick call to make surenothings changed. We can let you know

if youre covered as well as exactly howmuch youll be getting back, so there'll beno surprises.

Extras cover benefits are paid where:

the service or treatment is providedin Australia

in the case of product purchases, wherethe transaction takes place in Australia(that means youre not covered for itemsyou purchase in person, online, by phoneor mail order overseas. Theres moreabout this on page 11.)

the provider or practitioner is recognisedby rt

youve served the waiting periods, and the treatment is necessary or appropriate

to the condition.

12 be well13


9/15


10/15

Have you registered to use our online member centre yet? Setting yourself up to accessyour membership online is fast, easy and convenient. It means you can check and changeinformation about your membership anytime you like. Plus, weve recently launched a newonline service so you can chec k on the progress of your claims and see when they arereceived, logged and paid by us.

Howouronlinemembercentreworks

Once youre logged in, heres what you can do: Partner authority check and change

your partner authority status. If itsays not granted, it means yourpartner (if named on the membership)is not currently authorised to makechanges, enquiries or clai ms. You caninstantly change this to granted givingyour partner full authority over themembership. The only thing he or shewont be able to do is cancel or suspendthe membership, only the main membercan do that.

Correspondence download copiesof your benefit statements showingwhat youve claimed and how muchyou got back.

Tax statements download copiesof your tax and lifetime healthcover statements.

Cover details check your membershipdetails, including the name of your cover,whos covered, how much you pay, thedate you joined and the date youre paidup until.

NEW Claims view a history of all theclaims youve made since 1 January2009. You can search by the date, typ eof claim or who made the claim. Plus,check on the progress of your currentclaims, when they were received, wheretheyre up to in the process and whenthey are paid.

Provider search look up which pri vatehospitals have a contract with us (theres498 Australia-wide), which doctorsparticipate in our Access Gap Cover, andfind a registered extras provider.

Contact details check and change youraddress, telephone and email details.

Bank account check and change thedetails of the account you use to payyour contributions by direct debit, or theaccount you want us to pay your claimsbenefits into.

Download forms find all the forms youneed here.

Library download detailed informationabout what youre covered for, copies of

our newsletters, annual report and more. Change password create your own

easy-to-remember password.

VISIT

www.rthealthfund.com.au

tosetupapartner

authorityfor

yourmembership.

Did you know? We have contracts in place with498 private hospitals Australia-wide, so no matterwhere you are in the country, weve got youcovered. Find out if your preferred hospital is onour list by using the hospital search facility in ouronline member centre. Find out how below.

If you havent registered yet, visitwww.rthealthfund.com.au and click onmember login at the very top of the screen.Grab your rt membership number (its on yourmembership card) and follow the prompts toregister. Within a minute or two youll receivean email from us with your password, andyoure ready to go. Its as easy as that.

16 be well17


11/15

government programs you shouldknow at least a little about

The government runs a number ofprograms designed to encourage andsupport people in having private healthcover particularly hospital cover whichhelps to ease some of the pressures onthe public system. Some will save you

money, and some could cost you money,so its worthwhile having at least a basicunderstanding of how they work.

HOWGOVERNMENTINCENTIVES

WORK

CARROTSAND STICKS:

18 be well19


12/15

Federal Government Rebateon Private Health InsuranceYou might have heard of this referred to asthe 30% rebate. Basically, the governmentbelieves that having private health insuranceis good for you so good in fact that itsprepared to pick up some of the tab and helpmake your cover that much more affordable.

if you are under the age of 65, thegovernment will pay 30% of the cost ofyour health cover

if you are aged between 65 and 69,itll pay 35% of the cost

and if you are over 70, itll pay 40%

Everyone who is a Medicare cardholderand a member of a registered private healthfund in Australia is eligible to receive therebate, no matter what their level of incomeor type of membership the rebate appliesto singles, couples, and families and tohospital, extras and ambulance cover. (Notethough, it doesnt apply to ambulance coverprovided by a state government ambulancescheme, only to ambulance cover providedby health funds. Read more aboutambulance cover on page 5.)

There are three different ways you canreceive your rebate, choose whichever suitsyou best:

1. You can take the rebate as a reduction inyour contribution payment we discountthe cost of your health cover by therebate you are entitled to, and you pay thedifference.

2. You can pay 100% of your contributionand then claim your rebate as a refundthrough Medicare.

3. You can pay 100% of your contributionand claim your rebate through yourincome tax return.

Deciding which way to receive your rebate issomething that is best discussed with your

accountant, tax agent or financial adviser.You can change the way you receive yourrebate anytime, so youre not locked i n toany decision you make. You dont needto do anything in particular to receiveyour rebate, you would have completedall the details we needed as part of yourapplication form when you first joined.

If youre interested in knowing more aboutthe rebate, talk to us, or take a look at theCommonwealth Department of Health andAgeing website, www.health.gov.au.

Lifetime Health CoverLifetime Health Cover (LHC) was introducedin the year 2000. The idea is to give peoplean incentive to take out private hospitalcover before the age of 31 (and to maintainit throughout their lifetime) by enabling thosepeople to pay lower contributions than peoplewho take out hospital cover later, or whoallow their cover to lapse for long periods.

Heres how it works: if you join privatehospital cover for the first time before the

1st of July immediately following your 31stbirthday, then youll pay the base rateoffered by the health fund. For every yearyou are over 31 when you join, you add 2%to the base rate contribution. The amountyou have to pay above the base rate iscalled your Lifetime Health Cover Loading.For example, if you take out private hospitalcover for the first time when you are 40youll pay 20% more than someone whotakes it out at 30 (2% loading per year x 10years = 20% loading).

The maximum loading that anyone wouldever have to pay is 70%, and thats if theytook out private hospital cover for the firsttime when they are 65. Anyone born on orbefore 1 July 1934 is exempt from the LHC

Loading; they can join hospital cover atanytime and only pay the base rate, the sameas someone who joins when they are 30.

Your certified age of entry (CAE)This is a flash-sounding term for the age

at which you first take out private hospitalcover. It is used to determine whether or notyou will have to pay an LHC Loading. If youare under the age of 31 when you first takeout hospital cover, your CAE will be 30,whether or not you were actually 30 yearsold at the time you joined. All this numberdoes is tell the various computer systemsthat need to talk to each other that you arenot liable to pay a loading. If you are overthe age of 31 when you first take out privatehospital cover, your CAE will be your actualage at joining.

Absent daysYou can lock in your LHC Loading (or noloading) by maintaining your hospital cover.Throughout your lifetime the governmentallows you to be without private hospitalcover for a total of 1,094 days (three years,less one day) without incurring an LHCLoading. These are called absent days andthey only start to kick in after youve turned31. But take note: even though you may not

incur an LHC Loading during your absentdays, you may need to serve waiting periodsagain when you next take out hospitalcover. If you suspend your rt hospital cover,the period of suspension does not counttoward your number of absent days. Youcan read more about suspending your coveron page 24.

New 10-year loading limitThe government realised that while LifetimeHealth Cover was a good incentive foryounger people, it was a disincentive forolder people, because if you joined afteryou were 31 you would have a l oading forthe rest of your life. In 2007 a new rulecame into effect, which says that your LHCLoading will be removed after youve held

EVERYONE WHO

IS A MEDICARE

CARDHOLDER

AND A MEMBER

OF A REGISTERED

PRIVATE

HEALTH FUND

IN AUSTRALIA

IS ELIGIBLE TO

RECEIVE THE

REBATE.

DONTGET

STUCK

CARRYING

THELOAD!

Ifyourepaying

aLifetimeHea

lth

CoverLoading

onyourhospita

l

cover,youmigh

tbeeligibletoh

ave

itremoved.Th

isyear,people

who

havebeenpayi

ngtheloading

forten

continuousyea

rswillbethefir

stto

havetheirload

ingsremovedun

der

thegovernmen

tsnewten-ye

arrule.

Readmorebelo

w.

Could you afford to keep yourcover withou t the rebate?In July each year, all health funds senda tax statement to anyone who has heldhealth cover with them in the previousfinancial year. The statement shows youexactly how much the government haspaid toward the cost of your health cover.When you see the numbers in black andwhite, its easy to understand what a bigimpact the rebate has on how much youpay, and how much more expensive yourhealth cover would be without it.

As part of its 2009 budget, the governmentintroduced a proposal to means test therebate. Means testing would reduce and,in some cases, completely remove therebate for many members. This proposalwas blocked twice by the Senate prior to

the recent election but that doesnt meanit wont be back for a third time! As amember of a private health fund andsomeone who benefits from the rebate,its important that you are aware of theimpact proposals such as this could haveon your personal or family budget, andeven if youve never done anything like itbefore, pick up the phone or write a l etterto your local member of parliament andtell them you value your rebate. There arearound 11 million people in Australia withprivate health cover, and 11 million voicesare difficult to ignore! For more informationvisit ww w.privatehealth.com.au/rebate.

20 be well21


13/15

hospital cover continuously for ten years.This year, people who have held theirhospital cover since the year 2000 will bethe first to have their LHC Loading removed.If you have an LHC Loading on your rt

hospital cover, we may have written to youto ask you to provide documents from anyfund you were previously a member of inorder to know when your ten years are up.Because the ten-year limit is a relativelyrecent change, health funds have notpreviously collected that information, so ifyou have a loading but youve been withus for less than ten years, well need you toprovide us with the information that tells ushow long youve been paying your l oading.

If you are interested in reading more,take a look at the CommonwealthDepartment of Health and Ageing website,www.health.gov.au.

Medicare Levy SurchargeMost of us pay a Medicare Levy throughour income tax, its 1.5% of our taxableincome and its automatically deductedfrom our pay packets. The Medicare Levy

helps to fund the public health system.People who earn over certain amounts,and who dont have private hospital cover(extras cover doesnt count in this instance),may also have to pay an additional 1% levy,called the Medicare Levy Surcharge (MLS).If you dont have private hospital cover andyou earn more than $70,000 a year as asingle person, or over $140,000 a year as acouple or family, youll probably have to paythe surcharge (the family income thresholdincreases by $1,500 for each dependantchild after the first).

To avoid paying the MLS, you must haveprivate hospital cover, and if you choose acover with an excess it must be a maximumexcess of $500 per year for a si ngle and$1,000 per year for couples and families.All of our hospital covers and excessoptions will exempt you from havi ng to paythe MLS.

If you have dependant children you mustcover them; a person with a family cannotavoid the MLS by taking out cover as a single.

If you are interested in reading more, visitthe Australian Taxation Office website atwww.ato.gov.au.

Theres no getting around it, thesegovernment programs, incentives anddisincentives can be confusing, so if youdlike to speak to a real person who canexplain it all, please give our member careteam a call on 1300 886 123.

IF YOU HAVE A

LOADING BUT

YOUVE BEEN

WITH US FOR

LESS THAN TEN

YEARS, WELL

NEED YOU TO

PROVIDE US WITH

THE INFORMATION

THAT TELLS

US HOW LONG

YOUVE BEEN

PAYING YOUR

LOADING.

22 be well23


14/15

24 be well25

With summer just around the corner its that timeof year when our minds turn to the end of anotherschool year and Christmas travels. In the midstof this years silly season rush, dont forget yourhealth cover.

WEVE GOT YOUR KIDS COVERED

If youve got kids covered under yourmembership aged between 21 and 25, wellbe checking in with you at the beginning of2011 to confirm their student status. Kidsstudying full-time at an approved Australianschool, college or university can remaincovered by your family membership up untilthe age of 25. In February each year wewrite to you to ask you to reconfirm theirstudent status, or to let us know that theyreno longer eligible for student cover. So evenif you have a child whos finishing up his orher studies at the end of this year, you dontneed to do anything yet. Theyll remain fullycovered over the Christmas season, and

youll hear from us in February. If its timefor them to come off your family cover andstart out on their own, well help you allmake that transition in the New Year.

HEADING OVERSEAS THISSUMMER? DONT FORGETTO LEAVE YOUR HEALTHCOVER BEHIND

You can only use your private health coverwhile you are in Australia and for productsand services you purchase here. If yourenot going to be in the country, you cantuse your health cover, so why keep payingfor it? You can suspend your cover i fyoure going overseas for a holiday or forwork, from one month right up to a coupleof years. It means youre not paying forsomething you cant use and you donthave to drop your cover for an extended

period while youre away. There are a fewsimple terms and conditions, such as, youmust suspend your cover before you le avethe country, you can only suspend a wholemembership (not just cover for one ortwo people on the membership), and youmust have been an rt member for at least12 months. Suspending your hospital coverdoes not count toward your number ofabsent days (see page 21 for more aboutthis) but, if you are away for an extendedperiod, it may result in you having to paythe Medicare Levy Surcharge (MLS) (seepage 23). Give our member care team acall when youre planning your overseasbreak, and well talk you through the details.

Itsthattimeofyearagain

call to make a payment 1300 3 04 321 to talk to us1300 886 123

email [email protected]

fax 1300 887 123

mail po box 1100 burwood north nsw 2134

visit 46 burwood road burwood nsw 2134

139 keira street wollongong nsw 2500

2/28 donald street hamilton nsw 2303

1/59a melbourne street south brisbane qld 4101


call to make a payment 1300 3 04 321 to talk to us1300 886 123

email [email protected]

fax 1300 887 123

mail po box 1100 burwood north nsw 2134

visit 46 burwood road burwood nsw 2134

139 keira street wollongong nsw 2500

2/28 donald street hamilton nsw 2303

1/59a melbourne street south brisbane qld 4101


Cut out and keep this card soyou can phone, fax, email orvisit us anytime theres onefor your wallet and one for thefridge or one for you and onefor your partner. To make it niceand easy all our contact detailsare the same, no matter whereyou are in Australia.

Keep intouchwith

this handycontact card

GOTAGREATSTORYYOU

LOVETOTELLYOURMATES?

Ifyourhealthcoverhassavedyoua

fortunewhentheunexpectedhappened,

orifyouvehadanexperiencethatleaves

youinnodoubtthatyoullneverdrop

yourcover,wedlovetoshareit. Send

yourstoryto

[email protected]

or mailtopobox1100

burwoodnorthnsw2134.


15/15

Did you know researchshows that peoplefind health insurance

confusing?No kidding.Its confusing enough with all the rules, regulations,government programs, incentives and penalties.Then most health funds like to roll out dozensof different health covers each one making itsound like you have the top level of cover available wrapped in a mountain of fine print. We preferto keep it simple with a small range of easy-to-understand covers, and no itty-bitty fine print to

confuse you. It seems to be an approach thatworks, too.

The Australian Financial Reviews Smart Investormagazine has named rt among its best valuehealth funds in the country for three years running.(2008 + 2009 + 2010)

newsletter-issue 10 how stuff works 1010

Documents