Frequently Asked Questions

	Who is eligible for Peoplecare cover?
	How do I make a claim on Peoplecare?
	Where can I get a Peoplecare claim form?
	Someone covered by my Peoplecare membership is being admitted to hospital. What happens with Peoplecare?

	When can I make a claim on Peoplecare ?
	Is there a time limit to make a claim?
	Can my De facto be covered by Peoplecare ?
	Does Peoplecare cover me if I am traveling overseas?

	I need a Statement for my Tax Return
	What Providers Are Recognised?
	How much can I claim from Peoplecare
	I'm having a baby. What do I need to know?

	Will I have to serve waiting periods?
	Over what period do limits apply?
	Is Peoplecare the same as other health funds?
	Is my Privacy protected?

	Who is eligible for Peoplecare cover?
	From 1 December 2006, Peoplecare is an open health fund and any permanent resident of Australia with a Medicare card may join.

How do I make a claim on Peoplecare ?

Complete a claim form with the supporting documentation

Send your completed claim form to Peoplecare and attach the supporting documentation for the services you are claiming.

You should read the section on Making a Claim

	Where can I get a Peoplecare claim form?
	A claim form can be downloaded, or you can contact us and we will send you one.

	Someone covered by my Peoplecare membership is being admitted to hospital. What happens with Peoplecare?
	You should read the section on Making a Claim in particular the Hospital and the Medical Gap sections. You may wish to talk to the doctor/s and or anesthetist/s that will be treating you and ask them if they will be charging above the Medicare schedule fee and if they are - by how much.

	When can I make a claim on Peoplecare?
	You can claim whenever you have incurred an expense which is covered by Peoplecare Health Insurance.

	Is there a time limit to make a claim?
	You must submit a claim within 2 years of receiving the service. A service provided more than 2 (two) years ago cannot be claimed.

	Can my De facto be covered by Peoplecare?
	De factos can be covered as dependants in a family membership.

Does Peoplecare cover me if I am traveling overseas?

No benefits are payable for services provided outside the Commonwealth of Australia.

Members or their families going overseas are strongly advised to obtain appropriate travel insurance, in case of inadmissible or higher hospital and medical expenses being incurred outside Australia. Peoplecare provides comprehensive QBE Travel Insurance policies at significantly discounted rates.

Refer to our travel insurance section of this website for more information or to purchase a travel insurance policy on-line.

Medicare benefits are not claimable for services provided in countries other than Australia, special reciprocal arrangements do however, apply with some countries.

	I need a Statement for my Tax Return
	Peoplecare is required to send out the annual Tax statements by 15th July each year. Please ensure your address details are correct with the fund even if you have resigned from the fund during the financial year.

	What Providers are Recognised?
	The Fund pays benefits for Natural Therapy only where the provider is recognised by the fund. Please contact us for details on recognised providers.

	How much can I claim from Peoplecare?
	This depends on the type of service provided. You should read the sections on Making a Claim. Please note: Dental services are fixed benefits based on ADA item numbers. Accurate benefits may be obtained by contacting us with full item details.

I'm having a baby. What do I need to know?

Benefits for Obstetrics related conditions are paid from the Hospital table (except Ante-Natal Classes). Childbirth benefits are subject to 12 months waiting period.

Peoplecare will pay all of the agreed Hospital costs subject to any excess you may have. Benefits are also paid for Inpatient Medical Services - You will be covered up to the Schedule Fee except where the Doctor enters into an agreement with the fund. In these cases you may still be out-of-pocket, however the amount may be considerably less. You should approach your Doctor regarding these arrangements.

You may contact the fund to see if your Doctor has entered into an agreement, however he/she may choose not to use this system for your procedure.

Will I have to serve waiting periods?

Waiting periods can apply.

If you have transferred across from another fund, served waiting periods with that fund and take up an equivalent or lower level of cover with Peoplecare, you will not have to serve waiting periods.

If you are a new member or transferring from another fund with a lower level of cover than what you are applying for, you may have to serve waiting periods.

See the section waiting periods, and contact the Fund if you have any queries in this regard.

Over what period do limits apply?

Limits apply each financial year, 1st July through 30th June.

Some ancillary services have different limit anniversaries. Services which this applies to are: Orthodontics, Orthotics, Hearing Aids, Laser Eye Surgery and Surgical Equipment.

	Is Peoplecare the same as other Health Funds?
	Peoplecare is a Registered Health Fund with the Department of Health the same as all the other funds which operate in the community.