Do you or someone in your family work in the education sector? Compare cover from Members Own health fund: Teachers Health.
Established in 1954 by the NSW Teachers Federation, this industry-based fund now offers a range of affordable health insurance products exclusively to those who are a current or former member of an education union and their relatives and immediate family members.
Compare your cover options and find out more about the benefits of being with a Members Own fund like Teachers Health.
Why get cover from Teachers Health?
Teachers Health offers health insurance designed to suit everyone, from the budget conscious to those who want the highest level of cover available. Currently you can choose from:
- Hospital cover. Teachers Health offers three levels of hospital insurance which are Top Hospital, Mid Hospital and Basic Hospital.
- Extras cover. Teachers Health offers three types of extras insurance which are Top Extras, Essential Extras and Emergency Ambulance Cover.
- Combined cover. The StarterPak hospital and extras policy is designed specifically for young people, offering cover for vital services at an affordable price. Additionally, you are free to mix and match any hospital and extras cover to tailor a policy that suits your insurance needs and price point.
Now that you have a general idea of what is offered by Teachers Health, you may want to know more about what each policy offers. Simply select the type of health insurance you are interested in to view the features and services included.
Teachers Health hospital cover options
- Top Hospital. This comprehensive product is designed to offer complete peace of mind. It covers an extensive range of procedures including pregnancy, heart procedures, joint replacements (including hip and knee), hospital accommodation and theatre expenses. Members get their choice of Agreement Private Hospital and can choose an excess of $0, $300 or $500.
- Mid Hospital. This mid-level cover option provides cover for all services covered by Medicare that are not restricted. Members get their choice of private hospital, a choice of either $300 or $500 excess and cover for shared and private room accommodation, theatre fees, intensive care fees and their choice of doctor.
- Basic Hospital. Basic Hospital is an entry-level health insurance option that covers a range of treatments in private hospitals, and offers your choice of doctor in a public hospital. Designed for young and healthy applicants, it covers essentials like hernias, tonsil removal, appendicitis, and knee and shoulder reconstructions in private hospitals.
Teachers Health extras cover options
- Top Extras. Enjoy generous benefit limits for a wide range of treatments including major dental, optical, psychology, chiropractic, physio, speech therapy, and occupational therapy.
- Essential Extras. This offers affordable cover for a mid-level range of services, including general and preventative dental, physio, optical, podiatry and naturopathy.
Teachers Health hospital and extras option
- StarterPak. Designed for young people and offering a range of essential benefits, this policy excludes a range of treatments and services that members are unlikely to need. It offers cover for your choice of Agreement Private Hospital and choice of doctor, as well as procedures like hernias, knee reconstructions, appendix removal and tonsil removal.
Teachers Health ambulance options
- Emergency Ambulance. While all Teachers Health hospital cover options include Emergency Ambulance cover, this can also be taken out on its own to cover air ambulance and emergency ambulance transport when you are ill or involved in an accident.
What excess options are available?
When you are admitted to hospital, the excess is the amount you will have to pay to contribute towards the cost of your private health insurance claim. Choosing a higher excess will result in your premium rate being reduced.
Depending on the hospital cover option you choose from Teachers Health, you can take advantage of a choice of excesses:
- Top Hospital cover lets you choose an excess between $0, $300 or $500 per calendar year.
- Mid Hospital cover offers a choice between $300 or $500 per calendar year.
- Basic Hospital cover offers an excess limit of $300 per calendar year.
What additional benefits does Teachers Health offer its member?
Members of Teachers Health are also able to take advantage of the following extra benefits:
- Free access to health support programs. These include HealthMeasures, an online tool to help you develop a tailored diet, exercise and healthy lifestyle program.
- Access to Teachers Health Centres. Teachers Health runs specialist centres where members can access discounted optical and dental services.
- Other discounts. Members can also access discounts from health funds including Voice Care for Teachers, AOK Health and Jenny Craig.
- Discounted travel insurance. A range of travel insurance products are available for fund members at discounted rates.
How many members does Teachers Health service?
Teachers Health provides health insurance cover to more than 290,000 people across the Australian education community. Its health insurance market share is 2.2%.
Is Teachers Health nonprofit?
Does Teachers Health get many complaints?
Teachers Health (including UniHealth) accounts for:
- 2.2% of the Australian health insurance market
- 2.2% of all complaints about benefit payments
- 1.2% of all complaints about service
- 0.9% of all complaints that require investigation
Source: Private Health Insurance Ombudsman, State of the Health Fund Report 2016
How many hospital agreements does Teachers Health have in my state and in total?
The benefit your health fund pays for hospital services is influenced by two key factors:
- The level of hospital cover you have
- Whether your health fund has an agreement with the hospital where you receive treatment
The table below features a breakdown of the hospital agreements Teachers Health has in your state or territory. You can compare these figures with the industry maximum for all Australian health funds.
|Private hospital agreements||Day hospital agreements|
|NSW||97 (industry maximum: 101)||90 (industry maximum: 96)|
|ACT||6 (industry maximum: 7)||7 (industry maximum: 9)|
|VIC||78 (industry maximum: 84)||75 (industry maximum: 75)|
|QLD||53 (industry maximum: 57)||45 (industry maximum: 51)|
|SA||26 (industry maximum: 29)||25 (industry maximum: 27)|
|WA||21 (industry maximum: 23)||23 (industry maximum: 26)|
|TAS||6 (industry maximum: 8)||3 (industry maximum: 5)|
|NT||2 (industry maximum: 2)||1 (industry maximum: 1)|
How much does cover from Teachers Health cost?
Everyone is different, so the cost of cover varies from person to person. However, the following may affect how much you'll pay for cover:
- The level of cover you choose. Top tier policies will cost more than ones that only offer a basic level of cover.
- Standalone or combined cover. Hospital or extras only policies will generally be more affordable than a combined hospital and extras policy.
- If you opt for an excess. The excess amount you choose will influence the cost of your premiums.
- Your age when you take out cover. Taking out cover before your 31st birthday will avoid the Lifetime Health Cover loading.
- Your income level. This can affect your eligibility for a private health insurance rebate.
- If you are a single parent. Single parent pricing is available on some Teachers Health products.
Paying your Teachers Health premiums
You can pay your Teachers Health premiums in the following ways:
- BPAY. Contact your financial institution and quote the health fund’s BPAY reference number (54072) and your BPAY member reference number.
- Phone. Credit card payments can be made over the phone by calling 1300 728 588, or (02) 9255 9539 if calling from a mobile phone or from overseas.
- Credit Card. Credit card payments can also be made via Teachers Health online member services.
- Direct debit. You can also set up a direct debit from your nominated bank account for premiums to be deducted automatically.
Premiums can be paid fortnightly, monthly, quarterly, half-yearly or yearly.
Steps for submitting a claim with Teachers Health?
If you need to make an extras claim with Teachers Health, you can do so in the following ways:
- On the spot. You can swipe your Teachers Health membership card on the spot using the HICAPS system to claim instantly.
- Via mobile app. The Teachers Health mobile app is available for Apple and Android devices and allows you to take a photo of your official receipt to submit your claim.
- Online. You can claim for the following extras through the Teachers Health online members area: Acupuncture, chiropractic, complementary therapies, remedial massage, general dental, optical, physiotherapy and podiatry.
- By mail. You can download a claim form from the Teachers Health website, complete it, and send it along with your invoice or receipt to Teachers Health, GPO Box 9812, Sydney NSW 2001.
- In person. You can submit your completed claim form and invoice or receipt in person at a Member Care Centre located at a Teachers Health Centre.
- Via email. You can also submit completed claim forms via email to firstname.lastname@example.org
As for bills from your doctor or specialist, if the doctor or specialist participates in Teachers Health’s Access Gap Cover program then they will send the bill directly to your health fund. If they do not participate in the program, you will need to take the bill to Medicare to be processed before Teachers Health can pay any benefits.
Get the Teachers Health claims app
What isn't covered by your Teachers Health policy?
- Hospital procedures that Medicare does not pay a benefit for
- If the claim is more than two years old
- The practitioner is not recognised by Teachers Health
- Hospital or general treatment received overseas
- Hospital expenses such as telephone charges or TV hire
- Pharmaceuticals not covered by your hospital, except as covered by extras pharmaceuticals
- Ambulance transport between hospitals
- Ambulance transport for a patient requiring day treatment
- Non-government approved surgically implanted prostheses
- Ambulance transport to and from a nursing home
- If the services are claimable as damages from a third party
- For services received free of charge
- Any period during which your membership is suspended
- Have not served a relevant waiting period
- If no official receipt can be provided
- If the claimant was treated by a relative
- For services that were not provided face-to-face
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