Health cover designed especially for Territorians, offering your choice of healthcare providers and a wide range of Extras options.
Territory Health Fund is health insurance designed for people living in the Northern Territory. Formerly the Mount Isa Mines Employees Health Society and now operated by Queensland Country Health Fund, THF has been providing value for money health cover to more than 23,000 families across the Top End for over 40 years.
Unlike many other health funds, they allow you to choose your own health care providers without affecting the benefits paid and they have a strong track record of value for members, having increased benefits and added new ones every year over the last 7 years and kept premium increases below the industry average for the past decade.
What cover do they provide?
Territory Health Fund provides a range of Hospital and Extras cover options including;
Hospital
- Intermediate Hospital – lower cost mid-level hospital cover for fit and healthy people just wanting basic cover. This level includes all the necessities such as accommodation in a private or public hospital, theatre fees, intensive care, emergency ambulance and a range of surgical procedures, but with certain hospital services reduced or excluded
- Top Hospital – this is THF’s highest level of hospital cover designed for those with families, which includes comprehensive cover for public or private hospital accommodation, theatre fees, intensive care, emergency ambulance and many surgical procedures, plus a choice of excess levels towards in-patient treatments.
Extras
- Young Extras – a standalone product that can be bought separately by those wanting basic cover for general dental, optical, physio and a small range of other therapies.
- Select Extras – ideal for singles, couples and families with young children who only want cover for the most popular services, including general and major dental, optical, physio, chiro and podiatry.
- Essential Extras – includes benefits for a comprehensive range of services including dental, optical, physio and chiro, covering all the therapies in Premium Extras with lower benefit amounts.
- Premium Extras - top extras cover providing benefits for a comprehensive range of therapies including dental, optical, physio and chiro, with higher benefit amounts than Essential Extras and generous annual limits.
Conditions, waiting periods and excess
There is a waiting period of 2 months for palliative care, psychiatric, rehabilitation services and all other hospital treatments not involving pre-existing conditions (apart from accidental injury). There is a 12 month waiting period for pregnancy and assisted reproductive services and pre-existing medical conditions.
Members have a choice of paying a $250 or $500 excess on same day or overnight hospital admissions, which is payable once per person per membership year.
A benefit will only be paid in the following circumstances;
- The service is provided in Australia
- The service is medically necessary
- The service or treatment is provided by a recognised practitioner
- The service is one for which Medicare also provides a benefit entitlement
- The benefit cannot be claimed from another source (i.e. worker’s compensation).
How do I make a claim?
There are several ways to make a claim with THF and all of them are easy;
- On-the-spot - if your healthcare provider has a HICAPS or CSC HealthPoint electronic claiming facility, you can just pay the difference on-the-spot.
- Online – simply log into Online Member Services and follow the instructions to lodge a claim. Just enter the details from your receipts, click the submit button and any benefit entitlement will be paid into your nominated bank account normally within two business days.
- Email - simply download and complete the claim form and email a scanned copy along with your receipts and bank account details to info@territoryhealth.com.au.
