(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Western Australia
# 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).
| Back, neck and spine | Hernia and appendix | Tonsils, adenoids and grommets |
| Blood | Implantation of hearing devices | Assisted reproductive services |
| Bone, joint and muscle | Insulin pumps | Cataracts |
| Brain and nervous system | Joint reconstructions | Dialysis for chronic kidney failure |
| Breast surgery (medically necessary) | Kidney and bladder | Heart and vascular system |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Male reproductive system | Hospital psychiatric services |
| Dental surgery | Miscarriage and termination of pregnancy | Joint replacements |
| Diabetes management (excluding insulin pumps) | Pain management | Lung and chest |
| Digestive system | Pain management with device | Palliative care |
| Ear, nose and throat | Plastic and reconstructive surgery (medically necessary) | Pregnancy and birth |
| Eye (not cataracts) | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) | Rehabilitation |
| Gastrointestinal endoscopy | Skin | Weight loss surgery |
| Gynaecology | Sleep studies |
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 $500 per admission. This is limited to a maximum of $500 per person and $1000 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 Western Australia 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.