Teachers Health gives you a choice between Top Extras and Essential Extras for educators.
If you, or someone in your immediate family, works in the teaching community, Teachers Health is designed just for you. They keep Extras cover simple with two options to cover dental, physio, optical, and other services.
Top 3 features
- Good for teachers and their families.
- Good for attractive health member benefits
- Beware if you're looking for wide-ranging cover of major dental services.
What Teachers Health Extras Only policies are available?
Teachers Health's two Extras Only policies are Essential Extras and Top Extras.
- Essential Extras. This offers affordable cover for a mid-level range of services, including general and preventative dental, physio, optical, podiatry and naturopathy.
- Top Extras. Teachers Health fund Top Extras includes wide-ranging benefits a range of treatments including dental, optical, psychology, chiropractic, physio, speech therapy, and occupational therapy.
Rather than reimbursing you only a percentage, Teachers Health offers generous flat sum reimbursements for covered health extras, with a handful of minor exceptions. This makes it easier for you to get use out of your cover without needing to pay anything out of pocket.
|Extras||Essential Extras yearly limit||Top Extras yearly limit|
|Natural Therapies including;|
|Chiropractic and Osteopathy|
|Hypnotherapy consultation or session|
|Medical appliances - CPAP machine purchase|
|Medical appliances - CPAP accessories purchase|
|Artificial aids including;|
|Emergency ambulance transport|
Other benefits of Teachers Health Extras Cover
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 do the costs work?
Benefit limits are per calendar year, from January 1 to December 31. Once a benefit limit is reached over the course of a calendar year it will not be refreshed until January 1 of the following calendar year.
Benefits are limited to one service per patient, per provider, per day, so you won't be covered for multiple visits to the same provider on one day.
There are some out of pocket expenses that you have to pay for Extras, which is the difference between what the provider charges and the benefit we pay.
Waiting periods and limitations
There are limits to the amount you can claim, both per year and per treatment. Waiting periods also apply as follows:
- 26 months. Orthodontics
- 12 months. Medical appliances, health aids, hearing aids, major dental
- 6 months. Optical, healthy lifestyle benefits
- 2 months. Non-PBS pharmaceuticals, therapies, general dental and everything else not otherwise specified
- 1 day. Emergency ambulance cover
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.