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Controversy Corner: Have You Been Misled?

12.10.2016

By Ron Loftus

 

I am constantly amazed at the outright deceitfulness of some of the large health funds. Recently a large health fund who I would like to name but refrain from doing only because a number of AMC patients are currently members of that fund, deliberately misled its members by writing to them blaming the government for their lack of providing a rebate on bio-identical hormones.  I can only hope that by highlighting their deceptive and untruthful methods, that some may seek to change to more reliable health funds.

Several patients have been refused any form of rebate against their bio-identical hormones based on a dubious and certainly misleading ruling by this particular health fund. When presenting their pharmaceutical receipt, they were refused a rebate and sent an official statement from the fund stating:

“At (name omitted), under Pharmacy Ancillary or Pharmacy Extras cover, we pay benefits on selected prescription medicines.

 

This medicine you have submitted a claim for is known as a compounded medicine. It is a medicine prepared by a trained pharmacist, for a specific use, rather than being prepared in batches by a manufacturer”.

 

They go on to state that whilst the individual ingredients are recognised by the government, that the final product is not. I find this not only to be incorrect, but misleading in that it alludes to compounded medication.

All over Australia in most major hospitals as well as thousands of pharmacies, medication is compounded by pharmacies for patients specifically as prescribed by doctors for their particular needs. These pharmacies are not only government approved but are under strict guidelines and regulations by the Pharmacy Board and the medications produced are acceptable to the government. If this was not the case, then they would not be able to be produced.

 

What this fund really should have said, is that it only rebates on selected medications that are mass produced in set doses by the large pharmaceutical companies. I might also suggest that a closer look at the funding sources for these funds might be able to be traced back to some of these large pharmaceutical companies. Why is it that most reputable funds and certainly the private and smaller ones are happy to rebate their patients on compounded medications and other ancillary services but this particular fund is not? Might it be that they have sweet heart agreements with certain big pharmaceutical groups? Is it because they have been led astray by certain ‘experts’ who have constantly attempted to downplay the benefits of BHRT who at the same time receive funding from the big pharmaceutical companies who produce the traditional synthetic HRT products many of which have had proven health related complications?

I recommend that if you are in a fund that does not cover you for extras such as your bio-identical hormones, look around for a fund that will and allow you to transfer over with no waiting period. There are some really good ones out there. Check this link: https://membersown.com.au/?gclid=CKzk_qTprtICFQoQvQodE8MKsA to compare health funds and watch this short video: https://www.youtube.com/watch?v=TPmV2qvNqWE.