healthslips.com.au Policy Information

TUH, part of the Teachers Health Group

Silver + Active Choice

Restricted Insurer

$541.50 / month

(Before Rebate, Discount & Loading)

Available in TAS

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

This policy covers: Two adults & dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 31), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: A child of the primary member or their partner who is between the ages of 18 and 20 and does not themselves have a partner.

Restricted insurer: Membership of this insurer is restricted to current or former union members and their families.

Policy ID: QTU/ATV/TEAK2D

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)
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
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
Cataracts
Joint replacements
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: You will have to pay an excess on admission. This is limited to a maximum of $250 per person per year.

Excess payments do not apply to hospital admissions for dependants.

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

Value-added services: home care after hospital, chronic disease management programs, hospital substitute programs (conditions apply). **Accident cover for included service categories only. Reducing your excess is considered to be upgrading your membership. We will charge your previous excess within the first two months of the upgrade, including for adults who are upgrading their level of cover by joining/re-joining as a dependant on a family membership.

Extras Cover

No-gap or agreed discounts at preferred optical, dental, podiatry and physiotherapy providers. See https://tuh.com.au/information/using-your-extras/find-provider.

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

$400 per person

combined limit for acupuncture, chinese medicine, osteopathy, remedial massage & other services

sub-limits apply

  • Initial visit: $34
  • Subsequent visit: $29
Ante-natal/Post-natal classes* 2

$200 per person up to $400 per policy

combined limit for ante-natal/post-natal classes, health management / healthy lifestyle & other services

sub-limits apply

  • Initial visit: 80% of charge
Chinese medicine 2

$400 per person

combined limit for acupuncture, chinese medicine, osteopathy, remedial massage & other services

  • Initial visit: $34
  • Subsequent visit: $29
Chiropractic 2

$300 per person

  • Initial visit: $34
  • Subsequent visit: $29
Dietetics/dietary advice 2

$350 per person

combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy

sub-limits apply

  • Initial visit: $60
  • Subsequent visit: $42
Endodontic* 12

$1,000 per person

combined limit for endodontic, major dental, orthodontic & other services

sub-limits apply

  • Filling of one root canal: $141
Exercise physiology 2

$600 per person

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

  • Initial visit: $25
  • Subsequent visit: $25
General dental 2

$600 per person

  • Fluoride treatment: $24.15
  • Scale & clean: $60.9
  • Surgical tooth extraction: $109
  • Periodic oral examination: $31.5
Health management / Healthy lifestyle* 2

$200 per person up to $400 per policy

combined limit for ante-natal/post-natal classes, health management / healthy lifestyle & other services

sub-limits apply

  • Health management: 80% of charge
Major dental* 12

$1,000 per person

combined limit for endodontic, major dental, orthodontic & other services

sub-limits apply

  • Full crown veneered: $580
Non PBS pharmaceuticals 2

$400 per person

  • Per eligible prescription: $60
Occupational therapy 2

$350 per person

combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy

sub-limits apply

  • Initial visit: $37
  • Subsequent visit: $29
Optical* 6

$210 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic* 12

$1,000 per person

combined limit for endodontic, major dental, orthodontic & other services

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $550
Osteopathy 2

$400 per person

combined limit for acupuncture, chinese medicine, osteopathy, remedial massage & other services

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $30
Physiotherapy* 2

$600 per person

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

  • Initial visit: $42
  • Subsequent visit: $37
Podiatry* 2

$350 per person

combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy

sub-limits apply

  • Initial visit: $36
  • Subsequent visit: $30
Psychology 2

$350 per person

combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy

sub-limits apply

  • Initial visit: $75
  • Subsequent visit: $60
Remedial massage 2

$400 per person

combined limit for acupuncture, chinese medicine, osteopathy, remedial massage & other services

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $35
Speech therapy 2

$350 per person

combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy

sub-limits apply

  • Initial visit: $52
  • Subsequent visit: $27

Acupuncture*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $34}

{Subsequent visit: $29}

Ante-natal/Post-natal classes*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for ante-natal/post-natal classes, health management / healthy lifestyle & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 80% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

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

Examples of maximum benefits

{Initial visit: $34}

{Subsequent visit: $29}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: $34}

{Subsequent visit: $29}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $42}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, major dental, orthodontic & other services}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $141}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for exercise physiology, physiotherapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Fluoride treatment: $24.15}

{Scale & clean: $60.9}

{Surgical tooth extraction: $109}

{Periodic oral examination: $31.5}

Health management / Healthy lifestyle*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for ante-natal/post-natal classes, health management / healthy lifestyle & other services}

{sub-limits apply}

Examples of maximum benefits

{Health management: 80% of charge}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, major dental, orthodontic & other services}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $580}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

Examples of maximum benefits

{Per eligible prescription: $60}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $29}

Optical*

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$210 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, major dental, orthodontic & other services}

{sub-limits apply}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $550}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for exercise physiology, physiotherapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $37}

Podiatry*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $36}

{Subsequent visit: $30}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $60}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for dietetics/dietary advice, occupational therapy, podiatry, psychology & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $52}

{Subsequent visit: $27}

Also covers: Anti snore device $300 sub-limit included in major dental overall limit. Group Physiotherapy & Ante/post-natal Physiotherapy $17 per consult up to sub-limits. Group Psychology $30 per consult and Counselling $35 per initial consult, $28 per subsequent consult, up to $250 sub-limit. Chiropractic x-ray (one per year) $50, Osteopathic x-ray (one per year) $50 included in sub-limits. Myotherapy $35 per consult included in remedial massage sub-limit. Biogait Analysis (one per year) $30 included with the $250 Podiatry sub limit. Speech Therapy group consult $12 included in Speech Therapy sub-limit. Occupational Therapy group consult $17.50 included in Occupational Therapy sub-limit. *Health Management overall limit includes Health Screenings 80% of charge up to $90 sub-limit , Wellbeing Programs 80% up to $110 sub-limit, Weight Loss and Fitness Programs 80% up to $120 sub-limit and Ante/post Natal Classes 80% up to $160 sub-limit. Active Health Bonus $20/person $40/Membership (conditions apply). Remote travel and accommodation is provided as a fixed benefit of 15 cents per kilometre for trips exceeding 100 kilometres one way (or 200 kilometres return) calculated directly from the home address (conditions apply).

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

Audiology
Blood glucose monitors
Eye therapy (orthoptics)
Hearing aids
Home nursing
Orthotics (podiatric orthoses)
Vaccinations

Other features of this general treatment cover: Online and mobile access, claims via smart phone app. Some major dental sub-limits increase with year of membership

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover: Tasmanian residents are covered under the State scheme within Tasmania & all States & Territories except SA & Qld. Tasmanian residents who have COMBINED HOSPITAL AND EXTRAS COVER are entitled to full cover for emergency road ambulance services required whilst travelling in Qld or SA only. No annual limit will apply to emergency road ambulance services. This benefit is not available for stand-alone extras cover. Benefits may be payable for state-owned air ambulance transportation services where charges are not payable under the State scheme ($6,000 per person per annum limit applies).

For further information about this policy see: https://tuh.com.au/information/glossary/ambulance

Insurer Details

TUH, part of the Teachers Health Group

Silver + Active Choice

Restricted Insurer

$541.50 / month

(Before Rebate, Discount & Loading)

Available in TAS

TUH, part of the Teachers Health Group

https://tuh.com.au/

enquiries@tuh.com.au

1300 360 701

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/QTU/ATV/TEAK2D

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