Looking for a members own fund? TUH Health Insurance offers value for money and a range of cover options
Despite the many benefits offered by Medicare, it doesn’t cover all the costs associated with looking after your health. This is why it makes sense to take out private health insurance, which covers a much wider range of medical expenses and also gives you access to a wealth of health care options.
TUH is a members own health fund that aims to offer value for money private health cover. Whether you’re looking for standalone hospital or extras cover or a combined policy, TUH has cover options to suit a wide range of budgets and insurance needs.
Who can join?
If you’d like to join TUH, you must be at least 18 years of age and you must also make sure that you meet the following eligibility criteria:
- You must be a current or former member of a union
- You must be the family member of someone who is eligible to join TUH. This includes a dependent child, adult child (and their partner), parent, grandchild, sibling, partner or former partner.
TUH Health Insurance levels of cover
TUH offers a selection of packaged covers, hospital covers and extras covers to its members. Packaged covers include:
- Ultimate Choice. This top-level package aims to offer comprehensive cover and complete peace of mind. It includes top hospital cover with nil excess payable, covering you for treatment as a private patient in a long list of contracted hospitals for any treatments you require that are eligible for Medicare benefits. It also includes TUH’s highest level of extras cover, including major dental, optical and physio and limits that increase each year on some benefits.
- Easy Choice. This insurance option offers top hospital cover but with an excess of $300 for all in-patient hospital services. This allows you to enjoy private patient cover but keep the cost of your premiums down, and it is paired with selected extras cover including acupuncture, osteopathy, natural therapies, chiropractic, major dental, optical, physio and more.
- Active Choice. An Active Choice policy offers intermediate level hospital cover, which covers you for a private room in a private hospital for things like intensive care, theatre fees, coronary care, surgically implanted prostheses and more. However, some treatments such as joint replacements only receive restricted cover. A $250 excess is payable per adult and extras covered include acupuncture, osteopathy, chiropractic, major dental and optical.
- Young Choice. Designed to offer cost-effective cover to young people who don’t need a high level of protection, Young Choice combines basic hospital and extras cover. A $250 excess applies and you are covered for a private room or shared overnight accommodation. Restrictions apply on some treatments, for example psychiatric services, while extras cover includes dental, optical, physio, chiro and acupuncture.
TUH Hospital and Extras
Hospital covers offered by TUH include:
- Total Care Hospital. This policy offers a high level of hospital cover in the event of an accident, if you are pregnant or if you undergo a planned procedure. You can choose from a $0, $300 or $500 excess to suit your budget, and you are covered for private hospital accommodation and treatment for any procedures that are medically necessary and for which a Medicare benefit is payable.
- Budget Hospital. This entry-level hospital cover is designed to offer essential protection at an affordable price. Perfect for people who are young and healthy, this policy covers you in the event of an accident and gives you your choice of doctor or specialist. However, a range of treatments, such as pregnancy services and hip replacements, are excluded from cover.
Extras covers offered by TUH include:
- Comprehensive Extras. TUH Comprehensive Extras offers the highest level of extras cover available from the health fund. It covers acupuncture, audiology, chiropractic, major dental, orthodontics, dietetics, hearing aids, home nursing, health appliances, midwife services, natural therapies, occupational therapy, optical, orthotics, osteopathy, pharmaceutical, physio, podiatry, psychology, remote travel and accommodation, and speech therapy.
- Family Extras. As the name suggests, this option is tailored to families and provides cover for all the general treatments included in a Comprehensive Extras policy. It’s designed to offer cover for you, your spouse and your dependent children.
- Healthy Options (60%) Extras. This cover option allows you to claim 60% of the cost of a wide range of general treatments including major dental, optical, physio, acupuncture, chiropractic, natural therapies, osteopathy, podiatry, psychology and remedial massage.
- Mid Range Extras. Mid Rage Extras cover aims to combine a range of benefits with an affordable price. It includes cover for alternative therapies, chiropractic, major dental, optical, dietetics and more.
- Basic Extras. This entry-level policy provides essential cover for a limited range of general treatments. These include dental, optical, chiropractic, homeopathy, massage therapy and physiotherapy.
What am I not covered for?
Your TUH Health Insurance claim will not be paid if:
- It is for a treatment from a provider not recognised by TUH for benefit purposes
- It is for services which were rendered two years or more prior to the date you lodge your claim
- It is for products and services obtained overseas
- It is for services which were not provided face to face
- It is for treatment by a provider who is also your family member
- It is for hospital treatment which is not medically necessary or which is not eligible for Medicare benefits
- It is for cosmetic surgery
- It is for outpatient treatment
- It is for charges above the Medicare Benefits Schedule fee
- It is for personal sundries
- It is for experimental procedures or therapies
- It is for certain high-cost medications
- It is for robotic surgery
- It is for medical devices not included in hospital theatre fee charges.
Do I have to pay an excess?
The excess is the amount you elect to pay towards the cost of your hospital treatment and it results in cheaper health cover premiums for you. Some hospital cover policies do not require you to pay any excess, while others like Total Care Hospital Cover allow you to choose your excess amount. It’s important to note that the hospital excess only applies to adults, not to your dependents.
SAVE ON YOUR TUH POLICY
How to save on Your TUH Health Insurance policy
- Pay via direct debit or credit card. A 2.5% discount and 1.5% discount apply to premiums made by direct debit and credit card respectively.
- Sign up before you turn 31. This will allow you to avoid a premium loading under the government’s Lifetime Health Cover scheme.
- TUH Eyecare Centre. TUH members receive a 30% discount on products and services purchased from the TUH Eyecare Centre.
- Other discounts. TUH members can also access discounts on purchases such as accommodation and travel insurance.
How do I make a claim?
Many providers will offer on-the-spot electronic claiming. In other circumstances, you can lodge a claim in the following ways:
- Online, through TUH’s Member Services Online portal.
- On your smartphone, using the TUH app for Apple and Android phones.
- Via email. Download and fill out an electronic claim form and then email it to email@example.com
- Manual claim. Download a claim form, fill it out and then post it back to TUH or drop it off at the TUH Health Care Centre.
Get the TUH claims app
FAQs about TUH
QUESTION: Does a cooling-off period apply?
ANSWER: Yes, a 30-day cooling-off period applies if you change your mind and do not wish to take out cover.
QUESTION: Is extended dependent cover available?
ANSWER: Yes. If you’re a single parent or a family with non-student children, you can purchase extended dependent cover up until they reach 25 years of age. However, they will need to earn less than $50,000 a year.
QUESTION: My husband is a member of a union - am I eligible to join TUH?
ANSWER: Yes, the spouses of current and former union members are eligible to join TUH.
QUESTION: Does my private health insurance cover me overseas?
ANSWER: No, private health cover does not cover the cost of any medical or hospital treatment that you receive overseas.
QUESTION: Can I suspend my cover when I travel overseas?
ANSWER: Yes, you can suspend your health insurance cover for up to two months if you are planning an overseas holiday and therefore won’t need private health cover during that time.
QUESTION: How can I pay my premiums?
ANSWER: TUH allows you to pay your health cover premiums via direct debit, credit card and BPAY either online, in person or over the phone.
QUESTION: What waiting periods apply?
ANSWER: Most treatments and services will be available after a two-month waiting period. However, some treatments, such as major dental and outpatient midwife services, attract a longer waiting period.
QUESTION: What if I’m injured in an accident after I sign up for cover?
ANSWER: TUH offers its members immediate cover for accidents.
QUESTION: What is Strive For Health?
ANSWER: This is TUH’s range of health management programs designed to help its members improve their overall health and wellbeing. These include a counselling support line, home care services, mental health support, disease management programs and weight loss initiatives.
QUESTION: Where can I find the TUH smartphone app to help me claim?
ANSWER: This app is available from Apple’s App Store and the Google Play Store.
How to choose the right cover
With a 97% member satisfaction rate, TUH offers a wide range of competitive health cover options. However, choosing the right cover for you and your family can be a difficult decision. You’ll need to closely examine your health needs and your budget, as well as whether you want standalone hospital or extras cover or a combined policy to provide complete protection. Make sure to read the policy documents closely and ensure you’re aware of what is and isn’t covered before you make your choice.
How does TUH calculate benefit amounts?
The amount of benefit you receive when you lodge a claim with TUH will be determined by the type of medical treatment you underwent. As a general rule of thumb, the more serious your condition and the more complex the required treatment the higher your eligible benefit will be.
Compiled using data from the Australian Medical Association's 2016 Private Health Insurance Report Card, this chart shows what TUH will pay for claims on 22 medical services, and includes Medicare's (MBS) benefit amounts for comparison.
Due to TUH being a member of the Australian Health Service Association (AHSA), they are included under that organisations title in the chart:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genetalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health