healthslips.com.au Policy Information

Teachers Health

StarterPak (Basic Plus)

Restricted Insurer

$83.54 / month

(Before Rebate, Discount & Loading)

Available in NT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading or an insurer discount. Check with your insurer for details.

This policy covers: Only one person.

Restricted insurer: Membership of this insurer is restricted to education union members and their families

Policy ID: NTF/J5/DAOM10

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Joint reconstructions
Kidney and bladder
Male reproductive system
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

This policy does not include cover for

Assisted reproductive services
Dialysis for chronic kidney failure
Heart and vascular system
Insulin pumps
Joint replacements
Lung and chest
Miscarriage and termination of pregnancy
Pregnancy and birth

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: No excess

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Includes accident cover. If your doctor or specialist participates in our Access Gap Cover scheme, you may be able to reduce or eliminate your out-of-pocket medical costs. In addition, through Teachers Healthcare Services eligible members can connect with dedicated care coordinators to support them with hospital treatment, or managing their physical and/or mental health.

Extras Cover

We’ve partnered with a network of optical and dental providers Australia-wide to give members greater access to high quality treatment and exclusive discounts, including 'no gap' offers. See https://www.teachershealth.com.au/members/find-a-provider/member-wellbeing-network/.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $38
  • Subsequent visit: $38
Chinese medicine 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $38
  • Subsequent visit: $38
Chiropractic 2

$400 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

sub-limits apply

  • Initial visit: $40
  • Subsequent visit: $40
Exercise physiology 2

$400 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: $40
  • Subsequent visit: $40
General dental* 2

$500 per policy

  • Fluoride treatment: $27
  • Scale & clean: $70
  • Periodic oral examination: $40
Health management / Healthy lifestyle 6

$150 per policy

sub-limits apply

  • Health management: $150
Major dental* 12

$500 per policy

  • Surgical tooth extraction: $0
  • Full crown veneered: $0
Non PBS pharmaceuticals 2

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $60
Optical 6

$180 per policy

  • Multi-focal lenses & frames: $180
  • Single vision lenses & frames: $180
Osteopathy 2

$400 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

sub-limits apply

  • Initial visit: $40
  • Subsequent visit: $40
Physiotherapy 2

$400 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

sub-limits apply

  • Initial visit: $40
  • Subsequent visit: $40
Psychology 2

$300 per policy

sub-limits apply

  • Initial visit: $72
  • Subsequent visit: $72
Remedial massage 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $38
  • Subsequent visit: $38
Vaccinations 2

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $60

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $38}

{Subsequent visit: $38}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $38}

{Subsequent visit: $38}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Fluoride treatment: $27}

{Scale & clean: $70}

{Periodic oral examination: $40}

Health management / Healthy lifestyle

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$150 per policy}

{sub-limits apply}

Examples of maximum benefits

{Health management: $150}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Surgical tooth extraction: $0}

{Full crown veneered: $0}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $60}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$180 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $180}

{Single vision lenses & frames: $180}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $72}

{Subsequent visit: $72}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $38}

{Subsequent visit: $38}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $60}

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Dietetics/dietary advice
Endodontic
Eye therapy (orthoptics)
Hearing aids
Home nursing
Occupational therapy
Orthodontic
Orthotics (podiatric orthoses)
Podiatry
Speech therapy

Ambulance cover

In NT this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Non-emergency: Transport with a waiting period of 1 day, or 1 day for pre-existing conditions, limited to $3,000 per person per year.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

For further information about this policy see: https://www.teachershealth.com.au/health-insurance/our-products/emergency-ambulance/

Insurer Details

Teachers Health

StarterPak (Basic Plus)

Restricted Insurer

$83.54 / month

(Before Rebate, Discount & Loading)

Available in NT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/NTF/J5/DAOM10

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