It is a rare occasion when I can say I am lost for words, but a recent message from my health fund left me speechless ... well for a short time at least.
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I'd sent my fund a receipt of payments made for a gym membership with the intent of making a claim. I have done this before and have been reimbursed.
The response about a day later was:
"Thank you for your recent claim for gym membership/exercise program. Unfortunately we can't pay you for this claim because your policy only covers gym memberships and exercise programs that are designed to address or improve a medical condition. They also need to be endorsed by a medical doctor."
My first thought was "what form of exercise isn't intended to improve a medical condition, or potential medical condition?"
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Let's face it, I'm a woman in my early fifties - there are a multitude of reasons why I should be exercising to improve my medical condition or at least my health to avoid a medical condition.
If we have to come up with a few health improvement options for a 50-something female then managing hormonal changes, middle-age spread, avoiding diabetes, promoting heart health, and staving off the potential for osteoporosis quickly spring to mind.
According to the Australian Medical Association (AMA) an estimate in 2011-12 put the cost of obesity to the health system at $8.6billion. Meanwhile diabetes Australia estimates Type 2 diabetes costs about $6 billion a year.
According to Osteoperosis Australia the low bone density condition affects 66 per cent of adults over 50, carried a economic cost burden of $2.745b in 2012 and is expected to reach $3.84b by 2022. Weight-bearing exercise is one of the recommended preventative measures for the condition.
All are solid arguments for the need for exercise to improve, or better still avoid, a medical condition for anyone, of any age.
It seems ludicrous that a health fund, to which people pay significant amounts of money to ensure extra cover (and still usually have to meet the cost of a hefty gap), should require extra documentation from a doctor to prove the need for exercise to improve a medical condition.
Why wait until there is a medical condition? Doesn't that defeat the purpose of promoting good health and reducing the overall burden on the health system?
It seems the fees go up, the payment gap gets wider and the expectations of the paying customer become more ridiculous. Surely prevention is the best medicine and far more cost effective for any health fund.
