(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Victoria
# 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.
Membership of this insurer is restricted to education union members and their families
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Dental surgery | Dialysis for chronic kidney failure | Miscarriage and termination of pregnancy |
| Hernia and appendix | Digestive system | Pain management |
| Joint reconstructions | Ear, nose and throat | Pain management with device |
| Tonsils, adenoids and grommets | Eye (not cataracts) | Palliative care |
| Assisted reproductive services | Gastrointestinal endoscopy | Plastic and reconstructive surgery (medically necessary) |
| Back, neck and spine | Gynaecology | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Blood | Heart and vascular system | Pregnancy and birth |
| Bone, joint and muscle | Hospital psychiatric services | Rehabilitation |
| Brain and nervous system | Implantation of hearing devices | Skin |
| Breast surgery (medically necessary) | Joint replacements | Sleep studies |
| Cataracts | Kidney and bladder | Weight loss surgery |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Lung and chest | |
| Diabetes management (excluding insulin pumps) | Male reproductive system |
| Insulin pumps |
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.
Excess: You will have to pay an excess of $300 per admission. This is limited to a maximum of $300 per person and $600 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
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, having a baby, or managing their physical and/or mental health.
In Victoria 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.
https://www.teachershealth.com.au/health-insurance/our-products/emergency-ambulance/
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.