Hospital covers compared

Transcription

1 Contribution rates for NSW & ACT 3 3 SINGLE Top Hospital $51.20 $ $73.20 $ Private Hospital Saver 300 $43.65 $94.60 $62.40 $ Private Hospital Saver 500 $41.55 $90.05 $59.40 $ Mid Hospital 300 $35.70 $77.35 $51.00 $ Mid Hospital 500 $32.30 $70.05 $46.20 $ Basic Hospital 300 $28.95 $62.75 $41.40 $89.70 Top Extras $21.00 $45.50 $30.00 $65.00 Essential Extras $14.25 $30.90 $20.40 $44.20 StarterPak $29.80 $64.60 $42.60 $92.30 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 Top Hospital $ $ $ $ Private Hospital Saver 300 $87.35 $ $ $ Private Hospital Saver 500 $83.15 $ $ $ Mid Hospital 300 $71.40 $ $ $ Mid Hospital 500 $64.65 $ $92.40 $ Basic Hospital 300 $57.95 $ $82.80 $ Top Extras $42.00 $91.00 $60.00 $ Essential Extras $28.55 $61.85 $40.80 $88.40 StarterPak $59.60 $ $85.20 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 Top Hospital $90.30 $ $ $ Private Hospital Saver 300 $77.25 $ $ $ Private Hospital Saver 500 $73.50 $ $ $ Mid Hospital 300 $62.80 $ $89.75 $ Mid Hospital 500 $56.90 $ $81.30 $ Basic Hospital 300 $50.95 $ $72.85 $ Top Extras $42.00 $91.00 $60.00 $ Essential Extras $28.55 $61.85 $40.80 $88.40 Top Hospital $ $ $ $ Private Hospital Saver 300 $ $ $ $ Private Hospital Saver 500 $ $ $ $ Mid Hospital 300 $92.80 $ $ $ Mid Hospital 500 $84.05 $ $ $ Basic Hospital 300 $75.35 $ $ $ Top Extras $54.60 $ $78.00 $ Essential Extras $36.95 $80.05 $52.80 $ Benefits Guide DESIGNED BY TEACHERS FOR TEACHERS Benefits Guide COUPLE/FAMILY Teaching is a demanding job, mentally, emotionally and physically. Like you, Teachers Health Fund understands how vital healthy and active teachers are, both to your school and the wider community. So we re here to help. Teachers Health Fund is the private health insurance fund created exclusively for the education community and their families. As a member-focused organisation and the largest industry-based health fund, Teachers Health Fund provides great value health insurance to its members through lower costs and generous benefits. SERVICES AND BENEFITS This brochure summarises the key services and benefits available for each level of cover with Teachers Health Fund. You can tailor your own cover by selecting what you need from our Hospital and Extras options. The level of cover you select may include waiting periods, restrictions, limitations and excesses. For a more comprehensive list and detailed information, visit teachershealth.com.au SINGLE PARENT HOW TO JOIN Joining Teachers Health Fund is easy. Simply: ЅЅ ЅЅ ЅЅ EXTENDED FAMILY COVER Visit teachershealth.com.au and apply online Call our contact centre on Complete an application form and post, fax or it to us As a restricted membership health fund, you must meet eligibility criteria to join Teachers Health Fund. For eligibility information visit teachershealth.com.au EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote. Emergency ambulance transport Government approved surgically implanted prostheses Access Gap Cover 1 day 2 months All other hospital services 2 months Psychiatric, rehabilitation & palliative care 9 months Pregnancy & birth related services 12 months Pre-existing conditions Waiting periods Choice of doctor Emergency ambulance transport6 Medical services Excess5 Labour ward fees Theatre fees, intensive care fees Private room (where available) Private Hospital Saver: $300 or $500 per person/ calendar year Top Hospital: $0 $300 or $500 per person/ calendar year 0 Other All other services where a Medicare benefit is payable Cosmetic surgery Shared room Public hospital Labour ward fees Theatre fees, intensive care fees Psychiatric, rehabilitation and palliative care Sterilisation and reversal of sterilisation Bariatric surgery Major eye and eye lens surgery Dialysis procedures & treatments Coronary care & cardiothoracic surgery Hip, knee, shoulder and ankle replacements Infertility treatments Shared room or private room (where available) Pregnancy & birth related services Choice of agreement hospital Glaucoma Hip & knee Hernias (agreement hospital1 and same day surgeries) Private hospital Appendicitis treatment Top Hospital Private Hospital Saver For more detailed information regarding Hospital services, visit teachershealth.com.au $300 Knee & shoulder investigations & reconstructions Mid Hospital Basic Hospital StarterPak* Waiting periods apply to all Hospital covers and must be served before benefits are payable. Hospital covers compared Removal of tonsils & adenoids Private hospital services Top Hospital Private Hospital Saver Mid Hospital Basic Hospital StarterPak*

2 Extras covers compared For more detailed information regarding Extras services, visit teachershealth.com.au Service Benefit (up to $) Top Extras (Yearly limits) Essential Extras (Yearly limits) StarterPak* (Yearly limits) Dental7 Service Benefit (up to $) Top Extras (Yearly limits) Essential Extras (Yearly limits) StarterPak* (Yearly limits) Body & Mind Therapies General Dental - 2 month waiting period Periodic oral examination (012) - limit of 2 services, per person/year * StarterPak is a combined Hospital and Extras product. See Hospital Covers Compared for information regarding the Hospital benefits. $40 Removal of calculus (114) - limit of 2 services per person/year $63 Topical application of remineralising agent (121) - limit of 2 services per year $25 Unlimited (unless stated otherwise) $500 per person $1,000 per family $500 per person $1,000 per family Major Dental - 12 month waiting period Crown veneered (615) $650 Dentures upper and lower (719) $830 Increasing limits8 Year 2 $1,100 Year 3 $1,600 Year 4 $2,100 Year 5 $2,600 Year 6+ $2,800 All per person and per family yearly limits are based on calendar year from 1 January each year, unless otherwise stated. Family limits are based on a set amount across all members of the family and these are indicated in the adjacent tables. Benefits are limited to one service per patient, per provider, per day. If a provider performs more than one consultation, the treatment that attracts the higher benefit will be paid. Where multiple visits/ services are performed on the same day at different times by the same provider then the visit/service that attracts the higher benefit will be paid. Recognised providers Benefits are only paid where the provider of the service or product is recognised by Teachers Health Fund at the time the service is received or the product is purchased. For more information visit teachershealth.com.au. To check if your provider is recognised by Teachers Health Fund, please contact us on Orthodontia Treatment - 24 month waiting period 7. A large number of dental services are claimable. Visit teachershealth.com.au for more information. Benefits are paid once in a lifetime Orthodontia Year 3 $1,500 Orthodontia Year 4 $2,000 Year 3 $1,500 Orthodontia Year 5+ $2,500 Year 4 $2,000 Increasing limits9 Year Increasing limits for Major Dental are calculated on years of continuous membership of Teachers Health Fund Top Extras cover. 9. Increasing limits for Orthodontia are calculated on years of continuous membership of Teachers Health Fund Top Extras cover and equivalent levels of cover with other health funds. $2,500 Optical 2 month waiting period (except 12 month waiting period for psychology) Chiropractic & Osteopathy 1-4 visits $40 Chiropractic & Osteopathy 5+ visits $32 Physiotherapy 1-4 visits $40 Physiotherapy 5+ visits $32 Exercise Physiology 1-4 visits $40 Exercise Physiology 5+ visits $32 Speech therapy initial $70 Speech therapy subsequent $40 Podiatry 1-4 visits $40 Podiatry 5+ visits $32 Dietician 1-4 visits $60 Dietician 5+ visits $40 Psychology consultation $72 Psychology assessment $100 $450 per person ($300 sub-limit for group therapy) $800 per person ($300 sub-limit for group therapy) $250 per person $500 per family $300 per person $600 per family $300 per person $600 per family $600 per person $400 per person ($60 sub-limit for orthotic repair) $200 per person $400 per family $400 per person $500 per person Healthy Lifestyle 12 month waiting period Weight management11 75% Gym membership11 75% Pilates11 75% 6 month waiting period Benefit Yearly limits Benefit Yearly limits Benefit Frames $90 $90 $90 Single vision lens - pair $120 $95 $95 Bifocal lens - pair $135 $95 Multifocal lens - pair $165 Contact lenses - rigid or soft $175 $165 $165 Contact lenses - disposable $175 $165 $165 $250 per person $95 $165 per person $330 per family $95 $95 Yearly limits $150 per person $300 per family $150 per person $300 per family $800 per person Sub-limits apply13 $300 per person $600 per family $400 per person $800 per family Medical Health $165 per person $330 per family 2 month waiting period Pharmaceuticals (non PBS requiring prescription by law)12 $60 Artificial Aids Complementary Therapies10 2 month waiting period 2 month waiting period Including, acupuncture, aromatherapy, naturopathy, reflexology, remedial massage $200 per person $400 per family 10. Benefits are for face to face consultation only. No benefits for remedies, medicines or food preparations. $32 $600 per person $400 per person $800 per family $200 per person $400 per family 11. Must be approved by Teachers Health Fund and received as part of a health management program intended to prevent or ameliorate a specific health condition, with written medical recommendaion every 12 months. Blood pressure monitor (purchase) 75% up to $85 Blood glucose monitor 75% up to $160 Compression garments14 75% up to $400 Wigs - chemotherapy/alopecia 75% up to $ $280 sublimit for erectile dysfunction and vaccines. $1,200 per person (sub-limits apply) 14. Compression garments with a compression grade or class greater than 1 (compression greater than 30mm Hg) and used for the treatment of lymphoedema, or the treatment of vascular conditions, or to minimise scarring following severe burns, or prescribed post-surgery. It does not include sports compression garments used to improve performance or postexercise recovery. Emergency Ambulance Transport 1 day waiting period Emergency ambulance transport (using state based ambulance service) 100% 12. Teachers Health Fund pays a benefit towards non-pbs prescription only medication supplied to treat a medical condition. You pay a co-payment equal to the current non-concessional PBS copayment amount. Benefit is not payable for contraceptives prescribed in the absence of a medical condition. Evidence of this is required every 12 months. $6,000 per person $12,000 per family $6,000 per person $12,000 per family Covered under Hospital cover

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4 Contribution rates for Queensland SINGLE 3 3 fortnightl y Top Hospital $54.15 $ $77.40 $ Private Hospital Saver 300 $46.60 $ $66.60 $ Private Hospital Saver 500 $44.90 $97.35 $64.20 $ Mid Hospital 300 $36.50 $79.15 $52.20 $ Mid Hospital 500 $33.15 $71.85 $47.40 $ Basic Hospital 300 $29.80 $64.60 $42.60 $92.30 Top Extras $22.65 $49.10 $32.40 $70.20 Essential Extras $14.70 $31.85 $21.00 $45.50 StarterPak $29.80 $64.60 $42.60 $92.30 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $ $ $ $ Private Hospital Saver 300 $93.20 $ $ $ Private Hospital Saver 500 $89.85 $ $ $ Mid Hospital 300 $73.05 $ $ $ Mid Hospital 500 $66.35 $ $94.80 $ Basic Hospital 300 $59.60 $ $85.20 $ Top Extras $45.35 $98.25 $64.80 $ Essential Extras $29.40 $63.70 $42.00 $91.00 StarterPak $59.60 $ $85.20 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $95.75 $ $ $ Private Hospital Saver 300 $82.30 $ $ $ Private Hospital Saver 500 $79.35 $ $ $ Mid Hospital 300 $64.30 $ $91.90 $ Mid Hospital 500 $58.35 $ $83.40 $ Basic Hospital 300 $52.50 $ $75.00 $ Top Extras $45.35 $98.25 $64.80 $ Essential Extras $29.40 $63.70 $42.00 $91.00 EXTENDED FAMILY COVER Top Hospital $ $ $ $ Private Hospital Saver 300 $ $ $ $ Private Hospital Saver 500 $ $ $ $ Mid Hospital 300 $94.95 $ $ $ Mid Hospital 500 $86.25 $ $ $ Basic Hospital 300 $77.50 $ $ $ Top Extras $58.80 $ $84.00 $ Essential Extras $38.20 $82.80 $54.60 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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6 Contribution rates for Victoria SINGLE 3 3 Top Hospital $55.40 $ $79.20 $ Private Hospital Saver 300 $48.30 $ $69.00 $ Private Hospital Saver 500 $46.60 $ $66.60 $ Mid Hospital 300 $38.20 $82.80 $54.60 $ Mid Hospital 500 $34.85 $75.50 $49.80 $ Basic Hospital 300 $31.05 $67.30 $44.40 $96.20 Top Extras $21.40 $46.40 $30.60 $66.30 Essential Extras $14.25 $30.90 $20.40 $44.20 StarterPak $30.20 $65.50 $43.20 $93.60 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $ $ $ $ Private Hospital Saver 300 $96.60 $ $ $ Private Hospital Saver 500 $93.20 $ $ $ Mid Hospital 300 $76.40 $ $ $ Mid Hospital 500 $69.70 $ $99.60 $ Basic Hospital 300 $62.15 $ $88.80 $ Top Extras $42.80 $92.80 $61.20 $ StarterPak $60.45 $ $86.40 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $97.85 $ $ $ Private Hospital Saver 300 $85.25 $ $ $ Private Hospital Saver 500 $82.30 $ $ $ Mid Hospital 300 $67.25 $ $96.10 $ Mid Hospital 500 $61.35 $ $87.65 $ Basic Hospital 300 $54.70 $ $78.15 $ Top Extras $42.80 $92.80 $61.20 $ EXTENDED FAMILY COVER Top Hospital $ $ $ $ Private Hospital Saver 300 $ $ $ $ Private Hospital Saver 500 $ $ $ $ Mid Hospital 300 $99.35 $ $ $ Mid Hospital 500 $90.65 $ $ $ Basic Hospital 300 $80.80 $ $ $ Top Extras $55.40 $ $79.20 $ Essential Extras $36.95 $80.05 $52.80 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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8 Contribution rates for Northern Territory SINGLE 3 3 Top Hospital $33.60 $72.80 $48.00 $ Private Hospital Saver 300 $28.10 $60.95 $40.20 $87.10 Private Hospital Saver 500 $26.45 $57.30 $37.80 $81.90 Mid Hospital 300 $23.90 $51.85 $34.20 $74.10 Mid Hospital 500 $22.25 $48.20 $31.80 $68.90 Basic Hospital 300 $19.70 $42.75 $28.20 $61.10 Top Extras $20.15 $43.65 $28.80 $62.40 Essential Extras $14.25 $30.90 $20.40 $44.20 StarterPak $19.30 $41.85 $27.60 $59.80 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $67.20 $ $96.00 $ Private Hospital Saver 300 $56.25 $ $80.40 $ Private Hospital Saver 500 $52.90 $ $75.60 $ Mid Hospital 300 $47.85 $ $68.40 $ Mid Hospital 500 $44.50 $96.45 $63.60 $ Basic Hospital 300 $39.45 $85.50 $56.40 $ Top Extras $40.30 $87.35 $57.60 $ StarterPak $38.60 $83.70 $55.20 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $59.20 $ $84.60 $ Private Hospital Saver 300 $49.55 $ $70.80 $ Private Hospital Saver 500 $46.60 $ $66.60 $ Mid Hospital 300 $42.10 $91.30 $60.20 $ Mid Hospital 500 $39.15 $84.85 $55.95 $ Basic Hospital 300 $34.75 $75.25 $49.65 $ Top Extras $40.30 $87.35 $57.60 $ EXTENDED FAMILY COVER Top Hospital $87.35 $ $ $ Private Hospital Saver 300 $73.05 $ $ $ Private Hospital Saver 500 $68.45 $ $97.80 $ Mid Hospital 300 $62.20 $ $88.90 $ Mid Hospital 500 $57.90 $ $82.70 $ Basic Hospital 300 $51.30 $ $73.30 $ Top Extras $52.05 $ $74.40 $ Essential Extras $36.95 $80.05 $52.80 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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10 Contribution rates for South Australia SINGLE 3 3 Top Hospital $49.95 $ $71.40 $ Private Hospital Saver 300 $42.80 $92.80 $61.20 $ Private Hospital Saver 500 $40.70 $88.25 $58.20 $ Mid Hospital 300 $35.70 $77.35 $51.00 $ Mid Hospital 500 $32.30 $70.05 $46.20 $ Basic Hospital 300 $28.95 $62.75 $41.40 $89.70 Top Extras $22.65 $49.10 $32.40 $70.20 Essential Extras $14.70 $31.85 $21.00 $45.50 StarterPak $29.80 $64.60 $42.60 $92.30 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $99.95 $ $ $ Private Hospital Saver 300 $85.65 $ $ $ Private Hospital Saver 500 $81.45 $ $ $ Mid Hospital 300 $71.40 $ $ $ Mid Hospital 500 $64.65 $ $92.40 $ Basic Hospital 300 $57.95 $ $82.80 $ Top Extras $45.35 $98.25 $64.80 $ Essential Extras $29.40 $63.70 $42.00 $91.00 StarterPak $59.60 $ $85.20 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $88.20 $ $ $ Private Hospital Saver 300 $75.60 $ $ $ Private Hospital Saver 500 $71.80 $ $ $ Mid Hospital 300 $62.80 $ $89.75 $ Mid Hospital 500 $56.90 $ $81.30 $ Basic Hospital 300 $50.95 $ $72.85 $ Top Extras $45.35 $98.25 $64.80 $ Essential Extras $29.40 $63.70 $42.00 $91.00 EXTENDED FAMILY COVER Top Hospital $ $ $ $ Private Hospital Saver 300 $ $ $ $ Private Hospital Saver 500 $ $ $ $ Mid Hospital 300 $92.80 $ $ $ Mid Hospital 500 $84.05 $ $ $ Basic Hospital 300 $75.35 $ $ $ Top Extras $58.80 $ $84.00 $ Essential Extras $38.20 $82.80 $54.60 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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12 Contribution rates for Western Australia SINGLE 3 3 Top Hospital $43.25 $93.70 $61.80 $ Private Hospital Saver 300 $36.95 $80.05 $52.80 $ Private Hospital Saver 500 $34.85 $75.50 $49.80 $ Mid Hospital 300 $32.30 $70.05 $46.20 $ Mid Hospital 500 $29.40 $63.70 $42.00 $91.00 Basic Hospital 300 $25.20 $54.60 $36.00 $78.00 Top Extras $20.15 $43.65 $28.80 $62.40 Essential Extras $14.25 $30.90 $20.40 $44.20 StarterPak $24.35 $52.75 $34.80 $75.40 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $86.50 $ $ $ Private Hospital Saver 300 $73.90 $ $ $ Private Hospital Saver 500 $69.70 $ $99.60 $ Mid Hospital 300 $64.65 $ $92.40 $ Mid Hospital 500 $58.80 $ $84.00 $ Basic Hospital 300 $50.40 $ $72.00 $ Top Extras $40.30 $87.35 $57.60 $ StarterPak $48.70 $ $69.60 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $76.40 $ $ $ Private Hospital Saver 300 $65.10 $ $93.00 $ Private Hospital Saver 500 $61.70 $ $88.20 $ Mid Hospital 300 $56.90 $ $81.30 $ Mid Hospital 500 $51.70 $ $73.90 $ Basic Hospital 300 $44.30 $96.05 $63.35 $ Top Extras $40.30 $87.35 $57.60 $ EXTENDED FAMILY COVER Top Hospital $ $ $ $ Private Hospital Saver 300 $95.75 $ $ $ Private Hospital Saver 500 $90.30 $ $ $ Mid Hospital 300 $84.05 $ $ $ Mid Hospital 500 $76.40 $ $ $ Basic Hospital 300 $65.50 $ $93.60 $ Top Extras $52.05 $ $74.40 $ Essential Extras $36.95 $80.05 $52.80 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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14 Contribution rates for Tasmania SINGLE 3 3 Top Hospital $48.70 $ $69.60 $ Private Hospital Saver 300 $43.65 $94.60 $62.40 $ Private Hospital Saver 500 $42.10 $91.30 $60.20 $ Mid Hospital 300 $34.40 $74.60 $49.20 $ Mid Hospital 500 $31.50 $68.25 $45.00 $97.50 Basic Hospital 300 $28.95 $62.75 $41.40 $89.70 Top Extras $20.55 $44.55 $29.40 $63.70 Essential Extras $14.25 $30.90 $20.40 $44.20 StarterPak $30.20 $65.50 $43.20 $93.60 Emergency Ambulance Cover $2.10 $4.55 $3.00 $6.50 COUPLE/FAMILY Top Hospital $97.40 $ $ $ Private Hospital Saver 300 $87.35 $ $ $ Private Hospital Saver 500 $84.25 $ $ $ Mid Hospital 300 $68.85 $ $98.40 $ Mid Hospital 500 $63.00 $ $90.00 $ Basic Hospital 300 $57.95 $ $82.80 $ Top Extras $41.15 $89.15 $58.80 $ StarterPak $60.45 $ $86.40 $ Emergency Ambulance Cover $4.20 $9.10 $6.00 $13.00 SINGLE PARENT Top Hospital $86.10 $ $ $ Private Hospital Saver 300 $77.25 $ $ $ Private Hospital Saver 500 $74.30 $ $ $ Mid Hospital 300 $60.60 $ $86.60 $ Mid Hospital 500 $55.40 $ $79.20 $ Basic Hospital 300 $50.95 $ $72.85 $ Top Extras $41.15 $89.15 $58.80 $ EXTENDED FAMILY COVER Top Hospital $ $ $ $ Private Hospital Saver 300 $ $ $ $ Private Hospital Saver 500 $ $ $ $ Mid Hospital 300 $89.50 $ $ $ Mid Hospital 500 $81.90 $ $ $ Basic Hospital 300 $75.35 $ $ $ Top Extras $53.30 $ $76.20 $ Essential Extras $36.95 $80.05 $52.80 $ EXTENDED FAMILY SINGLE PARENT Visit teachershealth.com.au or call for a quote.

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