healthslips.com.au Policy Information

TUH, part of the Teachers Health Group

Gold Ultimate Choice

Restricted Insurer Corporate Policy

$811.28 / month

(Before Rebate, Discount & Loading)

Available in VIC

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: 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.

Corporate policy: This is a corporate policy only available to new members who qualify under TUH's Fund Rules.

Policy ID: QTU/ULTC/VEFE2D

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
Assisted reproductive services
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)
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
Joint replacements
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)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

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
  • 9 months for pregnancy and birth (obstetrics)
  • 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

Superior health cover you and your family deserve. Excellent range of value-added services: home care after hospital, chronic disease management programs, hospital substitute programs (conditions apply).

For further information about this policy see: https://tuh.com.au/package/gold-ultimate-choice

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

$450 per person

combined limit for acupuncture & chinese medicine

  • Initial visit: $45
  • Subsequent visit: $40
Ante-natal/Post-natal classes 2

$300 per person up to $600 per policy

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

sub-limits apply

  • Initial visit: 80% of charge
  • Subsequent visit: 80% of charge
Audiology 2

$200 per person

  • Initial visit: $75
  • Subsequent visit: $70
Blood glucose monitors* 12

$690 per person

sub-limits apply

  • Per monitor: 85% of charge
Chinese medicine 2

$450 per person

combined limit for acupuncture & chinese medicine

  • Initial visit: $45
  • Subsequent visit: $40
Chiropractic 2

$450 per person

  • Initial visit: $44
  • Subsequent visit: $35
Dietetics/dietary advice 2

$450 per person

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

$3,800 per person

combined limit for endodontic, major dental & other services

sub-limits apply

  • Filling of one root canal: $195
Exercise physiology 2

$750 per person

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $35
Eye therapy (orthoptics) 2

$450 per person

  • Initial visit: $42
  • Subsequent visit: $42
General dental 2

No annual limit

  • Fluoride treatment: $32.55
  • Scale & clean: $80.85
  • Surgical tooth extraction: $156
  • Periodic oral examination: $44.1
Health management / Healthy lifestyle 2

$300 per person up to $600 per policy

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

sub-limits apply

  • Health management: 80% of charge
Hearing aids 12

$2200 limit overall $1100 per ear $800 sub-limit on repair. Limits apply over 3-year period from date of first supply.

  • Hearing aid: $1100
Home nursing 2

$600 per person

  • Initial visit: $80
  • Subsequent visit: $80
Major dental* 12

$3,800 per person

combined limit for endodontic, major dental & other services

sub-limits apply

  • Full crown veneered: $800
Non PBS pharmaceuticals 2

$600 per person

  • Per eligible prescription: $60
Occupational therapy 2

$450 per person

  • Initial visit: $59
  • Subsequent visit: $45
Optical* 6

$270 per person

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

$1,000 per person

$2,800 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $1000
Orthotics (podiatric orthoses) 12

$450 per person

sub-limits apply

  • Orthotics supply & fit: 85% of charge
Osteopathy 2

$400 per person

  • Initial visit: $49
  • Subsequent visit: $42
Physiotherapy* 2

$750 per person

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: $62
  • Subsequent visit: $52
Podiatry 2

$450 per person

  • Initial visit: $42
  • Subsequent visit: $39
Psychology 2

$450 per person

  • Initial visit: $95
  • Subsequent visit: $83
Remedial massage 2

$450 per person up to $900 per policy

  • Initial visit: $45
  • Subsequent visit: $45
Speech therapy 2

$450 per person

  • Initial visit: $77
  • Subsequent visit: $47

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

{combined limit for acupuncture & chinese medicine}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $40}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 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}

{Subsequent visit: 80% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $70}

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$690 per person}

{sub-limits apply}

Examples of maximum benefits

{Per monitor: 85% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

{combined limit for acupuncture & chinese medicine}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $40}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $44}

{Subsequent visit: $35}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $42}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,800 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $195}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $42}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $32.55}

{Scale & clean: $80.85}

{Surgical tooth extraction: $156}

{Periodic oral examination: $44.1}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 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}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2200 limit overall $1100 per ear $800 sub-limit on repair. Limits apply over 3-year period from date of first supply.}

Examples of maximum benefits

{Hearing aid: $1100}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $80}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,800 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $800}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per eligible prescription: $60}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $59}

{Subsequent visit: $45}

Optical*

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$270 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}

{$2,800 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $1000}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: 85% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

Examples of maximum benefits

{Initial visit: $49}

{Subsequent visit: $42}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $62}

{Subsequent visit: $52}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $39}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $95}

{Subsequent visit: $83}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person up to $900 per policy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Initial visit: $77}

{Subsequent visit: $47}

Other services: Anti snore device $500 sub-limit included in Major Dental overall limit. Hydrotherapy $25 per consult included in Physiotherapy limit. Group Physiotherapy $25 per consult up to $300 sub-limit. Ante/post natal Physiotherapy $17 per consult up to $140 limit. Chiropractic x-ray (one per year) $63 included in Chiropractic limit. Group Psychology $42 per consult ,Psychometric assessments $116 and Counselling $45 per initial consult, $41 per subsequent consult included within the $450 Psychology limit. Osteopathic x-ray (one per year) $63 included in Osteopathy limit. Myotherapy $45 per consult included in Remedial Massage limit. Outpatient Podiatric Surgery 85% and Biogait Analysis $37 (one per year) included in $450 Podiatry limit. Orthotic Repairs 85% up to $100 sub-limit. Group Speech Therapy $21 per consult and Paediatric Assessment (one per year) $100 up to $450 Speech Therapy limit. Group Occupational Therapy $28.50 per consult and Paediatric Assessment (one per year) $71 up to $450 Occupational Therapy limit. Health Management overall limit includes $120 sub-limit Health Screenings, $150 sub-limit on Health Management Programs, $160 sub-limit on Healthy Lifestyle Programs and $225 sub-limit on Ante/post-natal classes. *Blood Glucose Monitors $550 sub-limit included in Health Devices/Appliances overall $690 limit. All services in Health Devices/Appliances limit payable at 85% of cost including CPAP etc machines, $100 sub-limit on accessories/repair, $200 sub-limit on other appliances, $300 sub-limit on compression garments, and $120 sub-limit on Health Aids. $1,500 limit on Non-surgically implanted prostheses e.g. breast prostheses and wigs, payable at 85% of cost. Lactation nursing $50 daily included in $600 Home Nursing limit. Home Nursing benefits apply daily. Travel and Accommodation $55 per night and up to $110 travel up to $110 limit (conditions apply). Active Health Bonus $125/person $250/membership (conditions apply).

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

Vaccinations

Other features of this general treatment cover: Online and mobile access, claims via smart phone app. Most extras annual limits increase with years of membership.

For further information about this policy see: https://tuh.com.au/package/gold-ultimate-choice

Ambulance cover

In VIC this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Non-emergency: Unlimited transport with a waiting period of 1 day, or 1 day for pre-existing conditions.

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

Other features of this ambulance cover: Members who have COMBINED HOSPITAL AND EXTRAS COVER are entitled to emergency ambulance services benefits. No annual limit will apply to emergency road ambulance services. State-owned air ambulance transportation services are covered up to $6,000 per person per annum. From 1 Jan 2022 members who have eligible stand-alone extras cover may claim the cost of a third-party ambulance subscription fee from the Health Program benefit category (sub-limits apply).

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

Insurer Details

TUH, part of the Teachers Health Group

Gold Ultimate Choice

Restricted Insurer Corporate Policy

$811.28 / month

(Before Rebate, Discount & Loading)

Available in VIC

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/ULTC/VEFE2D

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