Teachers Health Fund Review

Teachers Health Fund is Australia’s largest industry-based health fund, providing health insurance to educators across the country. They’re a not-for-profit fund and a member of the Members Own Health Network.

The fund was established in 1954 by the NSW Teachers Federation, with the goal of providing affordable private health insurance to those who work in one of the most important industries: education.

Today, Teachers Health provides insurance for 330,000 teachers and education staff, and their families throughout Australia.

  • Teachers Health is a non-profit health fund for those who work in the education industry.
  • You can purchase hospital, extras, combined, and emergency ambulance cover from Teachers Health.
  • Teachers Health provides several easy ways to make a claim.

You can purchase hospital, extras, combined, and emergency ambulance cover from Teachers Health.

Ahead, we take a deeper look into each coverage option so you can better understand what you’re buying.

Hospital Cover

Teachers Health Fund has four different levels of hospital cover: Basic Hospital, Mid Hospital, Mid Classic, and Top Hospital. These fall into the new national health insurance tiers of Basic Plus, Silver Plus, and Gold categories. Here’s a brief breakdown of what you can expect with the policies.

  • Basic Hospital (Basic Plus)

    The Basic Hospital policy offers you the ability to choose your doctor when you receive treatment in a public hospital. Some services in a private hospital are available as well.

    Basic Hospital falls into the “Basic Plus” category, which means it offers coverage for dental surgery, hernia and appendix, joint reconstruction, tonsils, adenoids, and grommets.

    All other services are restricted through Basic Hospital. There is a $300 excess with this policy.

  • Mid Hospital (Basic Plus)

    Mid Hospital is an option from the Teachers Health Fund that works well for those who want a bit more than the standard Basic policy. This policy offers coverage for a wider range of services, falling just short of the Silver tier.

    You can choose a Mid Hospital policy with a $300 or $500 excess.

  • Mid Classic (Silver Plus)

    Mid Classic is a step up from Mid Hospital and jumps into the Silver tier. You’ll be able to receive treatment for heart and vascular, joint replacements, and pregnancy and birth with this policy.

    Like Mid Hospital, Mid Classic allows you to pick from a $300 or $500 excess.

  • Top Hospital (Gold)

    Top Hospital, as the name suggests, is the most comprehensive policy from Teachers Health Fund.

    This policy covers all gold tier clinical categories, along with all hospital accommodation at any public hospital and all private hospitals that have an agreement with the fund.

Extras Cover

There are two Extras policies from Teachers Health Fund: Essentials Extras and Top Extras.

The two policies cover the same services, but Top Extras has higher annual limits and more benefits.

Those who plan on using their extras policy to its full extent may get better value from Top Extras. Essential Extras, on the other hand, is an affordable way to receive benefits for things like optical and dental.

Combined Cover

There’s only one combined cover option from the Teachers Health Fund: StarterPak. This is a Basic Plus policy that combines the Essential Extras and Basic Hospital products into one package. It is aimed towards young, healthy, active people who only want basic cover.

Emergency Ambulance Cover

Emergency Ambulance is included in all Teachers Health hospital policies, but you can purchase it as standalone cover for a small monthly premium.

The waiting period is only one day, and the Ambulance Cover provides benefits of up to $6,000 a year for singles and $12,000 a year for families. Residents of Queensland and Tasmania are already covered by state services, but residents of other states could face a hefty bill if they aren’t covered.

The Private Health Insurance Ombudsman (PHIO) handles the complaints and review of different health funds in the country. They compile data to show how certain health funds stack up against the rest of the industry.

Here’s a snapshot of how Teachers Health performs in the coverage and complaints departments according to the PHIO.

  • Hospital Related Charges Covered
    Teachers Health: 92.1%
    Industry average: 91.06%
  • Medical Services with No Gaps
    Teachers Health: 89.31%
    Industry average: 86.6%
  • Medicare Services No or Known Gap
    Teachers Health: 97.6%
    Industry average: 94.88%
  • General Treatment Covered
    Teachers Health: 49.78%
    Industry average: 53.52%

Teachers Health Summary Report Card

Teachers Health PHIO Complaints

Source: PrivateHealth.gov.au

Teachers Health offers several ways to make a claim for your hospital or extras policies.

You can:

Teachers Health doesn’t offer member rewards per se, but they offer several support programs for their members including at-home rehabilitation, diabetes management, new family programs, and more.

Members can receive benefits through the Teachers Health Fund ‘Healthy Lifestyle’ program, which includes gym membership and certain weight management programs like Weight Watchers and Jenny Craig.

icon Phone
1300 806 808
icon Operating Hours
Mon to Thurs: 8:00am – 8:00pm
Fri: 8:00am – 6:00pm
Sat: 8:30am – 12:30pm
icon Enquiry Form
icon Email
icon Fax
1300 727 388

Teachers Health has locations in VIC, NSW, and SA. All offer eyecare and dental services.

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