Teachers Health Insurance
Looking after 330,000 educators, Teachers Health gives an affordable range of health insurance for education staff.
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Do you, or someone in your family work in the education sector? Not-for-profit Teachers Health fund provides health insurance cover for all price points.
Top 3 features
- Good for teachers, education staff and their families.
- Good for attractive member health benefits.
- Beware if you're not part of an education union.
Who is 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.
The members-owned, not-for-profit fund now looks after over 330,000 teachers, education staff and their families around Australia.
What health insurance options are available?
Teachers Health offers health insurance designed to suit everyone, from the budget conscious to those who want the highest level of cover available.
- Basic Hospital (Basic Plus). An entry-level health insurance option that covers a few treatments in private hospitals, and offers your choice of doctor in a public hospital. Designed for young and healthy applicants, it covers essentials like dental surgery, hernias, appendicitis, and joint reconstructions. This cover has a $300 excess.
- Mid Hospital (Basic Plus). A mid-level option, covering a wide range of services and has no exclusions. Instead, it provides restricted cover for some services, such as heart and vascular and pregnancy and birth. You can choose a $300 or $500 excess for this cover.
- Mid Classic (Silver Plus). Another mid-level option, this policy is designed to give you cover for everyday health needs, but not the expensive big-ticket services. It includes private hospital cover for a wide range of services, including diabetes management, cancer treatment, and more. You can choose a $300 or $500 excess for this cover.
- Top Hospital (Gold). This comprehensive product is designed to offer complete peace of mind. It covers an extensive range of procedures including pregnancy, heart procedures, hospital accommodation and theatre expenses. Members get their choice of Agreement Private Hospital and there's no excess.
|Benefit||Basic Hospital (Basic Plus)||Mid Hospital (Basic Plus)||Mid Classic (Silver Plus)||Top Hospital (Gold)|
|Assisted reproductive services|
|Back, neck and spine|
|Bone, joint and muscle|
|Brain and nervous system|
|Breast surgery (medically necessary)|
|Chemotherapy, radiotherapy and immunotherapy for cancer|
|Diabetes management (excluding insulin pump)|
|Dialysis for chronic kidney failure|
|Ear, nose and throat|
|Eye (not cataracts)|
|Heart and vascular system|
|Hernia and appendix|
|Hospital psychiatric services|
|Implantation of hearing devices|
|Kidney and bladder|
|Lung and chest|
|Male reproductive system|
|Miscarriage and termination of pregnancy|
|Pain management with device|
|Plastic and reconstructive surgery (medically needed)|
|Podiatric surgery (provided by a registered podiatric surgeon - limited benefits)|
|Pregnancy and birth|
|Tonsils, adenoids and grommets|
|Weight loss surgery|
|Private Hospital (Agreement private hospital and same day surgeries)|
|Choice of Agreement private hospital|
|Accommodation – shared and private room (where available)|
|Theatre fees, intensive care fees|
|Labour ward fees|
|Choice of doctor|
|Access Gap Cover|
|Government approved surgically implanted prostheses (some prostheses may have out-of-pocket expenses)|
|Private room (where available)|
|Theatre fees, intensive care fees|
|Labour ward fees|
|Excess (Basic Hospital)|
|Emergency Ambulance Transport|
- Top Extras. Teachers Health fund Top Extras lets you 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, and podiatry.
- 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, joint reconstructions, appendix removal and tonsil removal.
Information on tiersIn line with Private Health Insurance Reforms in place as of 1 April 2019, Teachers Health have aligned their hospital products to be categorised in the Gold/Silver/Bronze/Basic tiers.
Teachers Health have added one new form of cover to their product range, but have discontinued their CoreElect and Public Hospital options.
Members of Teachers Health are also able to take advantage of the following extra benefits:
- Free access to health support programs.
- 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, Jenny Craig, CSIRO Total Wellbeing Diet, Jen4Men, and Great Ideas in Nutrition.
- Discounted travel insurance. A range of travel insurance products are available for fund members at discounted rates.
How to make a claim
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
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