Mobile App and Online Member Service login process

Queensland Country Care Navigation Pty Ltd is an independent subsidiary of Queensland Country Health Fund Pty Ltd.  Queensland Country Health Fund will share hospital claim data with Queensland Country Care Navigation to help their Care Coordinators identify Health Fund Members who might benefit from some extra support.

Queensland Country Bank assists Queensland Country Health Fund to providing  face to face service across Queensland. The Bank provides a full range of financial services, from savings to loans, insurance and other financial products and services.

Your card will arrive within 10 days of the date of your application, even if your policy doesn't start right away.

Each of our cover options has different levels of cover depending on who is included in the policy.

Here is a summary of who is covered under each policy type.

^Dependents aged up to 21 and including 31 who aren’t full-time students,  apprentices or trainees and do not have a partner can be covered under Extended Family Cover, which attracts an additional cost.

If you’re heading out of the country for more than four weeks, but less than two years, have a chat to us about whether or not you’re eligible to apply for a suspension to your membership.

Suspending your membership means you’ll be able to put your payments on hold while you’re out of the country. We’ll still recognise you as a Member and honour all of the waiting periods you’ve served, and once you come back you can pick up right where you left off.

When travelling overseas and applying to suspend your policy the only information you will now be required to submit to us with your suspension application is a copy of your travel itinerary. This itinerary should specify your departure date and your intended return date to Australia. What this change will also allow us to do is automatically reactivate your policy upon your return to Australia without you doing anything further. That’s right no more boarding passes or passport copies for you to have to organise on your return home!

Now we also know money can be tight after a return from an overseas holiday so to ensure your policy reactivation can automatically take effect on your return date to Australia, we will now require you to be paid a minimum of one month in advance from the date of your policy suspension. This way you can come home and not have to immediately find the money to kick-start your health cover. A minimum period of 6 months must be served between reactivation and suspension for overseas travel.

While your membership is suspended, you won’t be able to make any claims, but once your payments recommence, you’ll be good to go!

Whether your trip is a short one or a long one, your health insurance won't cover you for injury, treatment or surgery while you're overseas, so don’t forget to approach your preferred insurer about travel insurance to cover you while you’re away. Travel insurance will cover any medical expenses that may crop up during your travels.

To find out more about suspending your membership, contact us when you’re making your travel plans.

Your Membership Year is the anniversary date of when you first joined Queensland Country.

Your yearly limits and excesses are calculated from this date, and reset each year on that date.

So, if you first signed up with us on October 25, your limits and excess will reset each year on October 25.

We're a little different from some other health funds. Your yearly limits reset each year on your anniversary date - the date you first joined our health fund.

This applies to benefit limits and excesses.

If your payments aren't up to date, we won't be able to pay any claims for treatments or services.

Please note that it is the policy holder’s responsibility to make sure that payment amounts are correct and are paid in advance, to avoid any claims being rejected due to having an unfinancial status.

If you're experiencing financial difficulty, please contact us on 1800 813 415 to discuss your options.

Yes. If you'd like to change the way you pay your premiums or the frequency, call us on 1800 813 415 to update your payment method.

You can choose to pay weekly, fortnightly, monthly, six monthly or yearly, as long as you're paid up in advance if you switch your payment frequency. There’s no hidden fees for paying more or less frequently – the overall premium price will be exactly the same, regardless of weekly or yearly payments. If you switch to paying quarterly, six monthly or yearly, we’ll send you a reminder notice as a courtesy.

You can pay by credit card, direct debit or BPAY.

Credit card

You can make an immediate payment by credit card through our Mobile App or Online Member Service Portal.  Alternative you can call 1800 813 415 and speak to one of our friendly staff to arrange payment over the phone. 

We also have EFTPOS machines for immediate payment located at Aitkenvale in Townsville, Mount Isa, Ayr, Earlville in Cairns and Caneland Central Mackay.

Direct debit

Direct debit facilities are available if you'd prefer to have your payment amount automatically deducted from an account or credit card. If you’d like to set up a direct debit, you can do this via our Mobile App or Online Member Services or you can contact our friendly team who can update your membership. 

BPAY

The BPAY biller code and your reference number appears on all statements. If you don’t receive regular statements (for example, if you pay weekly, fortnightly or monthly), just give us a call or email and we’ll be happy to supply you with our biller code and your reference number. You can also set up recurring BPAY payments so you never have to worry about missing a payment – just ask your financial institution.

Online Member Services (OMS) our online self-service portal which gives you control over your policy, allowing you to update your details, view your benefits and make payments by credit card.

If you don't have access yet, you can register and login straight away.

Online Member Services (OMS) gives you control over your policy. Normally, you’d need to call us to make changes to your details or policy, but with OMS, you simply need to login (or register) to access everything you need.

Here's what you can do in OMS:

• Update your personal details
• Make a credit card payment
• Access tax statements
• View your claims history
• View your limits and remaining benefits
• Update payment details

Login or register.

The best way to add or remove a person from your membership is to give us a call. If you're adding a person, they may need to serve waiting periods for benefits, depending on their previous health insurance history.

We'll make sure you continue to have the best level of cover for your needs if you make any changes to your policy.

Singles and Couples (also previously known as Smart Start) (Basic+), Top Hospital (Gold), Comprehensive Hospital (Gold), Intermediate Hospital (Basic+), Value Hospital (Basic+) and Public Hospital (Basic+) Covers are no longer sold as a new product. If you've already got one of these policies there's no change, and we'll still honour all of the conditions, inclusions and benefits you enjoy on the policy.

However, if you're on a different level of cover and wanted to change to this one, or already hold it and wanted to recommend it to a friend, this policy type is no longer available.

If you're on one of our lower or medium levels of cover, you can choose to upgrade at any time by contacting us on 1800 813 415.

Upgrading could include:

• Increasing the level of cover - for example, going from Vital Hospital (Bronze+) to Better Hospital (Silver+)
• Adding a new cover - for example, adding extras cover
• Reducing your excess - that is, going from $500 excess to $250

If you're upgrading, you may need to serve waiting periods on the upgraded portion of your cover. While you're waiting, we'll still honour the benefits of your previous cover. Conditions also apply to hospitalisation if you're changing your excess.

If things are a bit tight financially, or if you want to change to a level of cover that's more practical, you can choose to downgrade your cover.

Downgrading may include:

• Reducing the level of cover - for example, going from Better Hospital (Silver+) to Vital Hospital (Bronze+) Cover
• Removing a current cover - for example, dropping extras cover
• Increasing your excess - going from a $250 to $500 excess

If you choose to downgrade, you won't need to serve additional waiting periods, and your new excess applies to inpatient hospital services immediately.

In the unfortunate case that you and your partner have separated, there are a few options available.

We can separate your policy where one partner, usually the primary policy holder, keeps the same Member number but we change it to a single policy or single parent policy. We then create a new policy for the other partner, and they can keep the same level of cover (even if it's a closed product). Your dependents can be covered under one policy or both, but please be aware that it's fraudulent to claim for the same treatment under both policies. One service can only have benefits paid from one policy and funds will be recovered if it is found that a service has already received benefit entitlements elsewhere.

If the separation is amicable, some people choose to stay on the same policy, especially where there are dependents involved.

It's best to give us a call on 1800 813 415 to discuss your policy.

We hope you won't, but if you change your mind about taking out cover with Queensland Country Health Fund and haven’t made any claims, we’ll allow you to cancel your policy and receive a full refund of any premiums paid within 30 days of the start date of your policy.

We have a number of flexible payment options, so you can choose the option that best suits you. You can choose to pay weekly, fortnightly, monthly, six monthly or yearly, whichever suits you. There’s no hidden fees for paying more or less frequently – the overall premium price will be exactly the same, regardless of weekly or yearly payments. If you prefer to pay quarterly, six monthly or yearly, we’ll even send you a reminder notice as a courtesy.

You can choose to pay by credit card, direct debit or BPAY.

Credit card

You can make an immediate payment by credit card through our Mobile App or Online Member Service Portal.  Alternative you can call 1800 813 415 and speak to one of our friendly staff to arrange payment over the phone. 

We also have EFTPOS machines for immediate payment located at Aitkenvale in Townsville, Mount Isa, Ayr, Earlville in Cairns and Caneland Central Mackay.

Direct debit

Direct debit facilities are available if you'd prefer to have your payment amount automatically deducted from an account or credit card. If you’d like to set up a direct debit, you can do via our Mobile App or Online Member Services or you can contact our friendly team who can update your membership. 

BPAY

The BPAY biller code and your reference number appears on all statements. If you don’t receive regular statements (for example, if you pay weekly, fortnightly or monthly), just give us a call or email and we’ll be happy to supply you with our biller code and your reference number. You can also set up recurring BPAY payments so you never have to worry about missing a payment – just ask your financial institution.

All contributions are payable in advance. If you don't pay your contributions within two months (63 days) of the contribution due date, this may result in cancellation of both your membership and your entitlement to benefits.

Your adult children can be covered on your family policy up to and including 31 years of age if they are:

• studying full-time at a school, college or university; or

• working as an apprentice; or

• trainee; and

• do not have a partner (i.e. spouse or other person living with him/her in a genuine domestic relationship)

If your adult children don’t meet the above criteria, that’s ok – we still offer a cover option called Extended Family/Extended Single Parent cover.

Extended Family cover keeps your adult children on the same policy (as long as they’re not married or in a de facto relationship) from the age of 21 up to and including 31 years of age. The premium for an Extended Family/Extended Single Parent cover is higher than our standard family or single parent family policy, however it is a more economic option for your adult children compared to them taking out their own cover at the same level.

Our Extended Family/Extended Single Parent cover is available across all of our hospital products with the exception of our Public Hospital (closed) cover or extras only cover.

We can appreciate that private health insurance is an added cost, but it's worth it for the cover you and your family will receive. Here are some of the things you should know about why private health insurance is for you.

• You can choose your own doctor
• You can choose your own hospital
• You get to have more choice over when you're treated
• You may pay less tax if you're a higher income earner
• You can lock in your Lifetime Health Cover age, if you're over 31 and haven't had private health insurance before
• You don't have the long waiting periods you get in the public hospital system
• Peace of mind for you and your family.

Your health insurance is "portable" by law - this means if you switch from another Australian registered health fund to Queensland Country, you won't have to re-serve the waiting periods you've already served at your current fund. 

You just have to make sure you join us within 63 days of leaving your old fund and we'll recognise your waiting periods, or partial waiting periods.

The only time this doesn't apply, and you may have to serve waiting periods, is if you've chosen to take out a level of higher cover than your previous policy. This includes changing to a lower excess or changing to a higher hospital or extras cover.

When you upgrade, you'll still be entitled to the same level of benefits of your previous cover, until your waiting periods are up.

If you're transferring from another health fund, we'll need a transfer certificate to complete the switch. 

A transfer certificate confirms your health insurance history and your Lifetime Health Cover status. We need this to make sure you get continuity of cover and apply the appropriate waiting periods, and we need it before we can pay any benefits.

We usually request the transfer certificate on your behalf (with your permission, of course) but if your fund sends it to you instead of us, you'll need to forward it us.

We hope you won't, but if you change your mind about taking out cover with Queensland Country Health Fund and haven’t made any claims, we’ll allow you to cancel your policy and receive a full refund of any premiums paid within 30 days of the commencement of the policy.

It is important to Queensland Country Health Fund to protect and keep a Client’s personal information, including their health information, securely. To achieve this we are committed to complying with the requirements of the Privacy Act (Cth 1988) the Australian Privacy Principles (APPs) and the APRHA Board Code of Conduct for Registered Health Practitioners when we collect, hold and manage a Client’s personal information, that is, information that allows others to identify an individual.

View our Privacy Policy.

The Australian Government Rebate on private health insurance is a financial incentive introduced by the Federal Government to help Australians afford private health insurance.

The rebate scheme provides you with a rebate on your premium (based on the age of the oldest person covered by your policy), which you can take either as an ongoing reduction of your premium (essentially like a discount), or you can receive part or all of the rebate as a lump sump at tax time.

Find out more about the Australian Government Rebate on private health insurance.

The Medicare Levy Surcharge (MLS) applies to higher income earners that don't hold hospital cover. The surcharge is designed to encourage people to take out hospital cover and reduce the demand on the public health care system.

If you don't have a hospital cover and have an income above the ATO's threshold, you may pay between 1% and 1.5% of your income as the Medicare Levy Surcharge. This is in addition to the standard 2% Medicare levy.

All of our hospital covers exempt you from paying the surcharge.

Find out more about the Medicare Levy Surcharge, including details on the income thresholds and surcharge percentages.

There are a couple of ways you can claim on services.

For most Extras services you can claim at the time of your treatment by swiping your Membership card in the provider's HICAPS machine.

You can also submit claims for many Extras services through the Mobile App.

For hospital services or larger Extras claims, you'll need to complete a claims form, which can be emailed to info@queenslandcountry.health.

HICAPS is a service available to many providers of Extras services. It looks just like an eftpos machine, and you can swipe your Membership Card to instantly claim the amount that's covered on that service. It deducts that amount from the total cost of the treatment, and then you only have to pay the difference.

You can claim on-the-spot using HICAPS for a range of treatments, like:

• Dentists, endodontists, periodontists, dental prosthetists, advanced dental technicians, prosthodontists, paediatric dentists
• Dispensing optometrists, optical dispensers
• Physiotherapists
• Chiropractors
• Osteopaths
• Podiatrists
• Occupational therapists
• Psychologists
• Massage therapy

To find out if your provider has HICAPS, you can search for them on www.hicaps.com.au.

Online Claiming through Online Member Services is currently not available. We are in the process of updating our Online Member Service portal. Claiming can still be completed online via the Mobile App.

In most cases, when you're discharged from hospital, your account will be settled directly by Queensland Country Health Fund.

Before going into hospital, you'll need to pay the excess that applies to your policy. If your hospital stay was subject to any waiting periods, or if you had any personal expenses, like telephone calls, then you'll be responsible for those expenses. The hospital will usually require settlement for these when you're discharged.

Benefits are the payments you get back when claiming for hospital and extras services.

There are a couple of different payment options available for receiving benefits.

Deducted from the cost of treatment on the day

If your medical practitioner has HICAPS, your claim is processed on the spot, and any benefit amount is immediately deducted from the cost of your treatment, so you’ll only have to pay any difference.

Paid into your bank account

Your benefit can be paid directly into your nominated financial institution account. All you need to do is provide us with your account details on your application or claim form (including account name, BSB and account number), and we’ll pay the benefits directly to your account, usually within two business days of the claim being processed.

Benefits are payable when:

• The treatment or service is covered by your level of cover, all conditions are met and the waiting period for that service has been served
• A service or treatment is medically necessary, clinically relevant and is a treatment recognised by us
• The service or treatment is delivered in Australia by a recognised practitioner or therapist
• No benefits are payable from another source (e.g. compensation payment or Government benefit).

We calculate the benefit based on the cost of the treatment or aid, taking into account any allowances or discounts that are you may get from the provider. None of the benefits we pay will be higher than the actual charge of the service or appliance.

Limits are the maximum amount we'll pay on certain services in a single Membership Year.

To make cover affordable, limits apply to Extras cover. Limits are in place to set the number of times you can claim on a particular service, or combination of services, and to set monetary limits on total claims within any one Membership Year.

Some services also attract a sub-limit. This is the maximum amount we'll pay on a single type of service. For example, Premium Extras has an overall limit of $1,400 per person per Membership Year, but diagnostic dental has a sub-limit of $600. This means you can claim up to $600 on check-ups at the dentist, and the remaining $800 can be used on other types of dental services.

When you make a claim, the amount we pay for that service (your benefit) is deducted from your cover's benefit limits.

Most of our limits are per person, per Membership Year (unless stated otherwise). Unused benefits can't be transferred to anyone else on your policy.

The Access Gap Scheme is designed to reduce your out-of-pocket expenses when you receive a service in a hospital as an inpatient.

Under the Access Gap Scheme, participating medical practitioners can decide to accept up to the Queensland Country Health Fund fee as full settlement of the account. If this was the case it would mean that you wouldn’t have to make any additional payments to the doctor/surgeon for that particular service.

Alternatively your doctor can accept the Queensland Country Health Fund fee as part of the payment for their services. In these circumstances the doctor/s will inform you of any gap or shortfall that you will have to pay. This is called the known gap.

In a situation where your doctor chooses not to participate at all in Access Gap, you will only receive the applicable Medicare Benefits Schedule fee for your inpatient services. This will result in high out- of- pocket expenses for doctor’s services.

Medical specialist search

An excess is the amount you pay up front if you go to hospital or day surgery. The higher the excess, the less you pay for your regular premiums. The excess applies to all Members covered and is applied to the full cost of hospitalisation, including dependent children (*excluding exempt children as provided below) in both public and private hospitals and day surgery facilities.

In addition to your agreed excess, you may have other out-of-pocket costs associated with your hospital treatment.

The calculation of the excess amount will apply to hospitalisations in the order they are processed by Queensland Country. If the excess contribution on your first visit is less than your chosen excess option, and you’re admitted to hospital again in the same Membership Year you will be required to pay the remainder of your excess obligation.

The most you’ll have to pay each Membership Year for your excess payment is outlined below:

Once the excess has been paid, the rest of the hospital accommodation charges will be sent to us, so you can enjoy the full benefits of your private hospital cover. Of course your medical costs will be determined by your doctors’ participation with our gap scheme. See Access Gap section for more information or use the Medical Costs Finder tool to find and understand costs for medical specialist services across Australia.

 *With all of our hospital covers you won't be charged an excess if your dependent aged 21 years or under is admitted to hospital for medical treatment.

A pre-existing ailment, illness or condition is one where signs or symptoms of the condition were present at any time during the six months prior to applying for membership of Queensland Country Health Fund or an upgrade of your existing cover. This determination is made by an external medical examiner appointed by Queensland Country. You may have a pre-existing condition, ailment or illness without even being aware of it.

If a pre-existing condition is deemed present, you will need to serve a 12 month waiting period before claiming benefits for this treatment. It isn’t necessary for the signs or symptoms of your condition to have been diagnosed by a doctor at the time of joining or upgrading your cover.

The 12 month waiting period for pre-existing ailments will be applied to all hospital (or hospital substitute) treatments for which we pay benefits. There are a couple of exceptions; a two month waiting period applies to the following services:

• Approved rehabilitation treatment
• Palliative care

A 12 month waiting period also applies to obstetrics (pregnancy) related services. Surgery for assisted fertility programs such as IVF or GIFT, sterilisation or vasectomy and surgical dental extractions also attract a 12 month waiting period.

The 12 month waiting period for the treatment of a pre-existing ailment can also apply to Extras services.

Out-of-pocket expenses are the additional costs once all Medicare and private health insurance benefits have been expended. Usually, out-of-pocket expenses apply when you’re not fully covered for a particular treatment or service, or when a set benefit limit applies. Discovering you’ll be out of pocket can be a tough pill to swallow, especially after being discharged from hospital, or once your treatment is complete.

It’s your right to know if there are any out-of-pocket expenses that you might incur as part of your treatment, to avoid any surprises later. Knowing the cost of your medical treatment upfront is called Informed Financial Consent, and the Government has introduced a checklist, providing you with the questions you need to ask before going into hospital.

We recommend contacting us before going into hospital so that we can discuss what your policy provides cover for, and if any out-of-pocket expenses will apply. We’ll also supply you with a copy of the checklist. By talking to us before going into hospital, you’ll have the total picture and can avoid any unwanted surprises later.

Hospital cover protects you and your family if you need to go to hospital, by covering most of the major expenses that come with hospital treatment.

Having hospital cover means you don't need to be concerned about public hospital waiting periods, as well as giving you access to your choice of hospital and your choice of doctor in most cases.

With all hospital covers, you won’t be charged an excess if your dependent up to and including the age of 21 years is admitted to hospital for medical treatment.

Our Better Hospital (Silver+) and Vital Hospital (Bronze+) Covers have one or more services that are excluded.

If a service is marked as "excluded", it means you won't be covered in a public or private hospital and we won't pay any benefits on that service. 

If you're upgrading, don't forget that you'll need to serve a 12 month waiting period on those excluded or restricted services before you can claim.

Our Better Hospital (Silver+) & Vital Hospital (Bronze+) Covers have one or more services that are restricted.

If a service is covered as a "restricted" benefit, it means you'll be covered with your choice of doctor for shared ward accommodation in a public hospital only. If you go into a private hospital for a restricted service, you'll likely end up with large out-of-pocket expenses.

Restricted benefits are amounts set by the Government, and generally aren't enough to cover the accommodation costs in a private hospital, and no benefits are paid towards the costs of theatre charges in private hospital.

Waiting periods may also apply to all restricted services.

If you think you'll need full cover for a restricted service, you should check the appropriate product brochure to determine your benefit entitlements for specific hospital treatments or services.

 If you're upgrading, don't forget that you'll need to serve a 12 month waiting period on those excluded or restricted services before you can claim.

When you go to hospital, your doctor, surgeon and anaesthetist all charge for their services separately to your hospital accommodation costs. Their fees are known as medical expense. These medical expenses are assessed against the Medicare Benefits Schedule (MBS) fees, which are set by the government. If you're admitted to hospital as a private patient, Medicare will pay 75% of the MBS fee for your medical expenses. We then pay the remaining 25% of the MBS fee.

However, some doctors charge more than the MBS fee, which can mean big out-of-pocket expenses for you. Our private hospital cover can help reduce or avoid these extra expenses through our Access Gap agreement.

Waiting periods are exactly what their name suggests; the length of time a policy holder needs to wait before being able to make claims on services.

They apply when you join any health fund for the very first time, or when you upgrade to a higher level of cover.

Waiting periods are designed to keep health cover fair for everyone, by protecting the fund and Members against people who join intentionally to make big claims, and then cancel their membership.

If you're transferring from another fund and take out an equivalent level of cover, or if you've previously been covered by your parents' membership, we recognise that you've already served the waiting periods, so you can claim straight away. If you upgrade to a higher level of cover when you switch, you'll only need to serve the waiting period on the increased benefits.

Our table below outlines the waiting periods that apply to hospital and extras:

^ Two month waiting periods apply for most other items or services. Cover for an accident is immediate provided it is not recoverable from another source such as Workers Compensation, third party or other liability provision. Sporting accidents sustained by sportspeople in activities relating to their fulltime employment as a sporting professional, including training and competition have a two month waiting period.

Hearing aids are covered on our Better Hospital (Silver+) product. A benefit amount is provided to use over a period of three (3) Membership years based on the date on which the purchase of a hearing aid/s is made. The benefit limit is applied based on your length of membership with Queensland Country Health Fund.

• Up to 10 years - $1,000
• 10-15 years - $1,500
• 15 years + - $2,000

Benefits for the cost of hearing aids are per person up to the approriate benefit level.

Singles and Couples (also previously known as Smart Start) (Basic+), Top Hospital (Gold), Comprehensive Hospital (Gold), Intermediate Hospital (Basic+), Value Hospital (Basic+) and Public Hospital (Basic+) Covers are no longer sold as a new product. If you've already got one of these policies there's no change, and we'll still honour all of the conditions, inclusions and benefits you enjoy on the policy.

However, if you're on a different level of cover and wanted to change to this one, or already hold it and wanted to recommend it to a friend, this policy type is no longer available.

If you're on one of our lower or medium levels of cover, you can choose to upgrade at any time by contacting us on 1800 813 415.

Upgrading could include:

• Increasing the level of cover - for example, going from Vital Hospital (Bronze+) to Better Hospital (Silver+)
• Adding a new cover - for example, adding extras cover
• Reducing your excess - that is, going from $500 excess to $250

If you're upgrading, you may need to serve waiting periods on the upgraded portion of your cover. While you're waiting, we'll still honour the benefits of your previous cover. Conditions also apply to hospitalisation if you're changing your excess.

If things are a bit tight financially, or if you want to change to a level of cover that's more practical, you can choose to downgrade your cover.

Downgrading may include:

• Reducing the level of cover - for example, going from Better Hospital (Silver+) to Vital Hospital (Bronze+) Cover
• Removing a current cover - for example, dropping extras cover
• Increasing your excess - going from a $250 to $500 excess

If you choose to downgrade, you won't need to serve additional waiting periods, and your new excess applies to inpatient hospital services immediately.

Out-of-pocket expenses are the additional costs you'll pay for a treatment or service, once all of the Medicare and private health insurance benefits have been expended. Usually, out-of-pocket expenses apply when you’re not fully covered for a particular treatment or service, or when a set benefit limit applies. For example, say you picked a pair of $700 Prada glasses, and your policy covers $210 per Membership Year, your out-of-pocket expenses will be $490 for that pair of glasses.

For extras services, we publish many of the benefits payable for the services covered by your policy here on our website, but you can also contact us to find out how much we'll cover.

To find out how much is payable on dental services, we recommend getting a quote from your dentist first and the item number that applies to each service so we can accurately let you know how much will be covered.

Extras cover pays benefits on a number of private health services, like dental, optical, podiatry, physio etc that aren't covered by Medicare.

We offer four levels of Extras cover. Premium and Essential Extras pay benefits on the biggest range of treatments and therapies, while Select Extras and Young Extras are more tailored to services you might use most frequently.

Ancillary cover is another term for Extras cover.

Waiting periods are exactly what their name suggests; the length of time a policy holder needs to wait before being able to make claims on services.

They apply when you join any health fund for the very first time, or when you upgrade to a higher level of cover.

Waiting periods are designed to keep health cover fair for everyone, by protecting the fund and Members against people who join intentionally to make big claims, and then cancel their membership.

If you're transferring from another fund and take out an equivalent level of cover, or if you've previously been covered by your parents' membership, we recognise that you've already served the waiting periods, so you can claim straight away. If you upgrade to a higher level of cover when you switch, you'll only need to serve the waiting period on the increased benefits.

Our table below outlines the waiting periods that apply to hospital and extras:

^ Two month waiting periods apply for most other items or services. Cover for an accident is immediate provided it is not recoverable from another source such as Workers Compensation, third party or other liability provision. Sporting accidents sustained by sportspeople in activities relating to their fulltime employment as a sporting professional, including training and competition have a two month waiting period.

Hearing aids are covered on our Better Hospital (Silver+) product. A benefit amount is provided to use over a period of three (3) Membership years based on the date on which the purchase of a hearing aid/s is made. The benefit limit is applied based on your length of membership with Queensland Country Health Fund.

• Up to 10 years - $1,000
• 10-15 years - $1,500
• 15 years + - $2,000

Benefits for the cost of hearing aids are per person up to the approriate benefit level.

Singles and Couples (also previously known as Smart Start) (Basic+), Top Hospital (Gold), Comprehensive Hospital (Gold), Intermediate Hospital (Basic+), Value Hospital (Basic+) and Public Hospital (Basic+) Covers are no longer sold as a new product. If you've already got one of these policies there's no change, and we'll still honour all of the conditions, inclusions and benefits you enjoy on the policy.

However, if you're on a different level of cover and wanted to change to this one, or already hold it and wanted to recommend it to a friend, this policy type is no longer available.

If you're on one of our lower or medium levels of cover, you can choose to upgrade at any time by contacting us on 1800 813 415.

Upgrading could include:

• Increasing the level of cover - for example, going from Vital Hospital (Bronze+) to Better Hospital (Silver+)
• Adding a new cover - for example, adding extras cover
• Reducing your excess - that is, going from $500 excess to $250

If you're upgrading, you may need to serve waiting periods on the upgraded portion of your cover. While you're waiting, we'll still honour the benefits of your previous cover. Conditions also apply to hospitalisation if you're changing your excess.

If things are a bit tight financially, or if you want to change to a level of cover that's more practical, you can choose to downgrade your cover.

Downgrading may include:

• Reducing the level of cover - for example, going from Better Hospital (Silver+) to Vital Hospital (Bronze+) Cover
• Removing a current cover - for example, dropping extras cover
• Increasing your excess - going from a $250 to $500 excess

If you choose to downgrade, you won't need to serve additional waiting periods, and your new excess applies to inpatient hospital services immediately.

It's easy to get in touch with us. Call us on 1800 813 415 or email us on info@queenslandcountry.health

Our phone number is 1800 813 415.

Our contact centre is open from 8am to 5.30pm on Monday, Tuesday, Thursday and Friday, and from 9am to 5pm on Wednesday.

If you'd rather sit down and talk about your health insurance needs or your policy with someone in person, we have retail centres inside our Queensland Country Bank branches at Aitkenvale in Townsville, Caneland Shopping Centre in Mackay, Mount Isa, Earlville in Cairns and Ayr.

You can also visit any Queensland Country Bank branch for assistance from staff.

Find a location here.

If any of your details have changed, like your phone number, email or address, you can update them through Online Member Services.

You can also call us on 1800 813 415, or visit any of our branches.

Based on Queensland Country Health Fund hospital claims, a Care Coordinator has identified that you might benefit from Care Navigation, due to a recent discharge from hospital or that you are living with a chronic disease.

A Care Navigation Care Coordinator will work with you to design a tailored health management plan based on your goals and your support needs. Our aim is to support you to stay safe and well at home for as long as possible.

Queensland Country Health Fund will share hospital claim data with Queensland Country Care Navigation to help their Care Coordinators identify Health Fund Members who might benefit from some extra support.

Queensland Country Care Navigation Pty Ltd ABN 92 610 024 916 is a related entity of Queensland Country Health Fund ABN 11 126 884 786

Queensland Country Health Fund offers Care Navigation to Health Fund Members with Better Hospital (Silver+) at no additional cost. Third party service providers may charge a fee for services but we will let you know and obtain your agreement before we arrange any services for you.

Yes. Participation in Care Navigation is voluntary. Health Fund Members can opt in and out of the service at any time.

No. Care Navigation is a service offered to support you to improve your health and wellbeing and remain safe and well in your home. Your participation is voluntary, now and in the future as long as you are a current Member of Queensland Country Health Fund.

If we recommend a third-party service provider, we will let you know about any fees and any contract obligations before we arrange the service for you.

Your Care Coordinator will schedule ongoing telephone appointments with you at a time that is most convenient to you. Telephone assessments generally take half an hour, however as the service is individualised this can vary. Your Care Coordinator can be flexible in the length of your appointments.

Yes. All information provided to Care Navigation is kept in compliance with the Australian Privacy Principles. If a referral to another support service is recommended, your consent to share information is required. Details about your participation in Care Navigation are not shared with Queensland Country Health Fund, except for details required to make a claim as a registered provider to the service provider.

Care Navigation aims to work in partnership with your existing health professionals - not replace them. Many Members participate in multiple services or programs simultaneously. For example, GP, Specialist, physiotherapists and community rehab.

Queensland Country Care Navigation will always endeavour to advise Clients about their rights and the way the service operates. Part of the process of providing this information to Clients is providing access to our Charter of Client Rights.

Download the Queensland Country Care Navigation Charter of Client Rights.

It is important to Queensland Country Care Navigation to protect and keep a Client’s personal information, including their health information, securely. To achieve this we are committed to complying with the requirements of the Privacy Act (Cth 1988) the Australian Privacy Principles (APPs) and the APRHA Board Code of Conduct for Registered Health Practitioners when we collect, hold and manage a Client’s personal information, that is, information that allows others to identify an individual.

View Our Privacy Policy.

Our Care Coordinators are based in Care Navigation’s head office in Townsville, North Queensland. Find out how you can contact the team.

An excess is the amount you pay up front if you go to hospital or day surgery. The higher the excess, the less you pay for your regular premiums. The excess applies to all Members covered and is applied to the full cost of hospitalisation, including dependent children (*excluding exempt children as provided below) in both public and private hospitals and day surgery facilities.

In addition to your agreed excess, you may have other out-of-pocket costs associated with your hospital treatment.

The calculation of the excess amount will apply to hospitalisations in the order they are processed by Queensland Country. If the excess contribution on your first visit is less than your chosen excess option, and you’re admitted to hospital again in the same Membership Year you will be required to pay the remainder of your excess obligation.

The most you’ll have to pay each Membership Year for your excess payment is outlined below:

Once the excess has been paid, the rest of the hospital accommodation charges will be sent to us, so you can enjoy the full benefits of your private hospital cover. Of course your medical costs will be determined by your doctors’ participation with our gap scheme. See Access Gap section for more information or use the Medical Costs Finder tool to find and understand costs for medical specialist services across Australia.

 *With all of our hospital covers you won't be charged an excess if your dependent aged 21 years or under is admitted to hospital for medical treatment.

While the approved premium increase rate shared publically represents the average premium increase per fund, this is not indicative of what every consumer may experience. Some products may offer either a lower or a higher increase.  We inform Members in writing of the exact premium increase for their particular policy directly and take into account the policy specific premium and rebate to provide this exact amount.

Premium increases occur as a direct result of increases to the cost of hospital charges, treatment fees and utilisation of the services. 

Even though our increase may be slightly above some funds, it’s important to note that if our base premium (without Australian Government Rebate or Lifetime Health Cover Loading if applicable) is lower, the overall dollar increase for our product may still be lower despite a slightly higher increase.

From 1 April 2014, the rebate contribution from the Australian Government has been calculated based on a Rebate Adjustment Factor. The Rebate Adjustment Factor is determined using a formula which considers growth in the Consumer Price Index (CPI) and the industry weighted average premium increase. 

There has been no adjustment to the rebate since 1 July 2024 and there will be no adjustment effective 1 April 2025.

The Australian Government Rebate on private health insurance provides a financial incentive to assist Australians in affording private health cover. Rebate eligibility is based on a Member/s age and assessable income and the rebate amount will be indexed by CPI (Consumer Price Index) each year. The rebate is available for Australian residents that hold a green or blue Medicare card, and is applicable on both hospital and extras products.

You can choose to claim the rebate automatically through reduced premiums, or claim it back on completion of your annual tax return.

We work closely with the Government and our peak industry body Members Health to reduce costs and provide greater benefits for the policyholders of 25 health funds like our own who are ‘putting Members’ health before profit’.

Yes, Members have the option of pre-paying their premiums to take their paid-to-date up to two years in advance, and if this payment is received through our Contact Centre by 31 March 2023, the premium payable will be based on your current premium rather than the increased premium effective from 1 April 2023.

Payments can also be accepted through Online Member Services or through the Mobile App.

It might be time for a cover review. We have a selection of cover options to suit different needs and budgets. To make sure you are covered for what matters most, you can review our cover options online , or you can get in touch with our friendly team on 1800 813 415 to make sure you’re on the right cover for you.

We also offer a generous pre-payment option allowing you to lock in your current premium up to two years in advance. Payments can be accepted through Online Member Services, the Mobile App, or by calling 1800 813 415.

You to contact us using any of the following options:

• Email – Email us at info@queenslandcountry.health
• Online –Complete our online contact form and we’ll get back to you either by email or phone.
• Phone: Call us on 1800 813 415
• Social media – Send us a private message on Facebook Messenger

Yes, with the easing on Oral Health Services restrictions to Level 1 effective from Friday 8th May 2020, our Dental practices in Mackay, Mt Isa and Townsville are able to provide a full range of services including scale and cleans.

Level 1 restrictions mean you will notice some differences in our practices:

• We have removed all magazines, books and children’s toys from the waiting rooms
• You will be asked a number of questions about your general health and if you are unwell we may not be able to see you
• Social distancing measures will continue to be in place in our waiting rooms
• You will be asked to use alcohol based hand sanitiser while you are in the practice
• You will be given an antibacterial mouthrinse to use before any treatment is carried out.

We would like to assure our members that claims are operating as normal, and this includes in-hospital procedures as covered by their policy.  We encourage members to speak directly with their doctor and chosen hospital to confirm if their surgery will still be going ahead.

You can claim:

• Via our Queensland Country Health Fund Mobile App
• By completing a manual claim form attaching your receipt/s.  You can hand this to our friendly staff at your local Queensland Country branch or return by post.

Members who held an active Hospital and/or Extras policy between 1 July 2021 and 31 May 2023 are eligible to receive a return.  To qualify for the payment, you must have be financial at the time we process the payment. 

The amount Members receive will depend on the level of cover held, their standard contribution amount and number of days they held an active Membership during the period 1 July 2022  to 31 May 2023. 

Your return will be credited to the primary nominated bank account for your membership.  This is the same account that your benefit payments are received into whenever you make a claim. 

Our team looked at our entire membership base and their standard contribution amount for the level of cover that was held during this period. 

We then factored in how many days the policy was active during the period 1 July 2022 - 31 May 2023 and distributed the entire giveback amount of $3 million as a percentage across the membership base.  Our team believed this was the fairest way to calculate how much our Members were going to receive.

Queensland Country will commence processing Member’s payments on 19 June.  If you do not receive your payment by mid July and believe you are eligible based on the information provided, please contact our team on 1800 813 415 or via email at info@queenslandcountry.health.   

QCHF is joining HBF as part of an acquisition that is occurring.

HBF and Queensland Country Health Fund are both purpose-driven organisations with a long history of delivering for members in the moments that matter.

HBF is very similar to Queensland Country Health Fund, a purpose-driven Australian health fund that puts members’ interests at the heart of everything they do. With over 80 years of experience in the health insurance industry and around one million members - you can rest assured we are in the care of a well-resourced fund committed to being there for members in the moments that matter.

If you’ve not heard of HBF before:

• HBF have been in business since 1941. That’s over 80 years’ experience supporting their members’ health and wellbeing needs.
• HBF have had some of the lowest premium increases of all the major funds over the longer term.
• HBF is currently the most trusted private health insurer in Australia, according to the Roy Morgan Net Trust Survey 2022

Our sale to HBF is great news for Members, as it brings the benefits of being with a not-for-profit fund that has scale.

In the next 12 months, there will be no changes to your cover or the way you currently interact with QCHF.

As we work to become one organisation, we’ll be putting our Members’ interests first and believe that for most of you, any changes that arise from this process will be positive.

Rest assured you will remain on the same QCHF cover you are on now. HBF will communicate with you to make sure you’re kept up to date on any changes in the future.

We intend to have our normal premium increase on April 1, 2023, and we will notify you about its impact on your policy and any associated increase in benefits. Until then your premiums will remain the same. HBF will make sure you’re kept up to date on any changes in the future.

Any current discount that applies to your policy will continue. Any changes to policies or premiums in the future will be communicated in the usual way.

There will be no changes to your service at this stage. HBF will communicate with you to make sure you’re kept up to date on any changes in the future.

Our sale to HBF is great news for Members, as it brings the benefits of being with a not-for-profit fund that has scale.

Rest assured you will remain on the same cover you are on now. HBF will communicate with you to make sure you’re kept up to date on any changes in the future.

While you didn’t choose HBF for your health cover, there are a lot of similarities between HBF and Queensland Country Health Fund. We are both purpose driven organisations who put their members at the heart of everything we do.

There will be no changes to your health cover in the short term, and no changes in the way the way you interact with Queensland Country Health Fund. HBF’s dedication to our Members also means that we will continue to be committed to providing the service and support you’re used to. However, if you have any concerns, we can review your cover to ensure it’s still meeting your needs.

If you have any issues you can continue to call, email, or visit a branch and someone will be able to help you.

HBF will make sure you’re kept up to date on any changes that may occur in the future.

There will be no changes to the way you interact with Queensland Country Health Fund. You can continue to call, email, or visit a branch to make a change to your policy.

If there are any changes, HBF will communicate with you regularly and make sure you’re kept up to date on what you need to do.

What if I don’t want my personal information shared between Queensland Country Health Fund and HBF?

HBF have purchased Queensland Country Health Fund. As an Australian operated organisation, HBF are required to adhere to strict privacy laws. You can rest assured that your personal information will continue to be handled in accordance with the Privacy Act, ensuring a high standard of privacy, security and respect is maintained.

HBF may send out a new privacy collection statement in the future. In the meantime you can view their privacy policy here.

You can continue to claim as normal. There will be no changes to the way you use your health cover or interact with Queensland Country Health Fund. If there are any changes, HBF will communicate with you regularly and make sure you’re kept up to date on what you need to do

While there is no obligation to change your cover, anyone can purchase an HBF product. If you would like to see which product might suit your needs, you can visit the [Product Recommendation Tool] on the HBF website.

Once you’re an HBF member, you will be able to access all the additional benefits of an HBF membership.

While there will be changes to the way that Queensland Country Health Fund team Members work, the primary aim is to ensure minimal disruption to Members. You can continue to contact Queensland Country Health Fund and claim as normal. Any changes to how you manage your policy or contact your us will be communicated to you by HBF.

You can continue to call the current contact numbers. If there are any changes, HBF will communicate with you regularly and make sure you’re kept up to date on what you need to do.

Yes, you can continue to make changes to your health cover, including switching products. HBF will communicate any changes to you directly and make sure you’re kept up to date with any key changes to your policy.

While there is no obligation to change your cover, anyone can purchase an HBF product. If you would like to see which product might suit your needs, you can visit the Product Recommendation Tool on the HBF website.

Once you’re an HBF member, you will be able to access all the benefits of an HBF membership.

Yes, you can continue to access or contact Queensland Country Health Fund the way you normally do. HBF will make sure you’re kept up to date with any key changes.

Yes, you can continue to access or contact Queensland Country Health Fund the way you normally do. HBF will make sure you’re kept up to date with any key changes.