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Teachers Health Fund Review

Megan Fraser Updated: 21 May 2021
Types of Health Insurance

If you’re in the education community and are looking for a new health insurance policy, the Teachers Health Fund may be the right health care cover choice for you. Remember that it’s important to compare and review both funds and policies before making your final decision.

Teachers health insurance offers five Hospital plans and three Extras policies. There is also an option to combine Hospitals and Extras plans to craft a combined cover plan that best suits your health requirements and the needs of your family members.

Top 3 features of this insurer

  • There are five Hospitals policies and three Extras plans. There is also a combined package.
  • If you a member of the insurer, you receive access to a wide range of healthcare programs and services, such as gym memberships and no-gap dental check-ups.
  • You can purchase an Ambulance Only cover.

ComparingExpert does not currently have access to this provider. Visit Teachers Health Fund to request a quote and compare their price and benefits to the Australian private health insurance companies we have access to.

About Teachers Health Fund

The teacher’s federation of health was established by the NSW Teachers Federation in 1954 with the aim to provide educators with reliable and affordable health insurance. Today, the insurer caters for over 350 000 teachers and their families across Australia. The Teachers Health Fund is a not-for-profit health care insurer and is an active member of the Health Fund Alliance.

Teachers Health Cover Options

The company offers five different Hospitals cover plans, ranging from the Basic Hospital Cover to the Top Hospital or Gold cover policy. The insurer also has three Extras plans to choose from, which cover basic health care services such as optical and dental. In addition, you can purchase the Teachers Health Starter Pack where Hospital and Extras plans are combined.

Teachers health fund waiting periods

Teachers Health Fund Hospital cover

NameCost Per MonthBenefits
basic medal
Basic Hospital (Basic Plus)
$119.70
  • Dental surgery
  • Hernia and appendix
  • Joint reconstructions
  • Tonsils, adenoids and grommets
basic medal
Mid Hospital (Basic Plus)
$143.86
  • Chemotherapy, radiotherapy and immunotherapy for cancer
  • Eye (not cataracts)
  • Gastrointestinal endoscopy
  • Plastic and reconstructive surgery (medically needed)
  • Podiatric surgery
  • Skin
  • Sleep studies
  • Tonsils, adenoids and grommets
silver medal
Mid Classic (Silver Plus)
$148.23
  • Brain and nervous system
  • Breast surgery (medically necessary)
  • Chemotherapy, radiotherapy and immunotherapy for cancer
  • Eye (not cataracts)
  • Gastrointestinal endoscopy
  • Gynaecology
  • Heart and vascular system
  • Hernia and appendix
  • Lung and chest
  • Male reproductive system
  • Miscarriage and termination of pregnancy
  • Pain management
  • Palliative care
  • Plastic and reconstructive surgery (medically needed)
  • Podiatric surgery (provided by a registered podiatric surgeon – limited benefits)
  • Rehabilitation
gold medal
Top Hospital (Gold)
$206.54
  • Assisted reproductive services
  • Diabetes management (excluding insulin pump)
  • Dialysis for chronic kidney failure
  • Gastrointestinal endoscopy
  • Gynaecology
  • Heart and vascular system
  • Hernia and appendix
  • Hospital psychiatric services
  • Palliative care
  • Rehabilitation
  • Weight loss surgery
gold medal
Top Hospital Gold (Ambulance Exempt)
$208.93
  • All Benefits Applied plus same day surgeries

Source: PrivateHealth.gov.au (May 2021; Hospital only premium estimates for a single Adult with no dependents in NSW)

Teachers Health Fund Extras cover

There are three separate Extras cover plans to choose from, each with a unique set of benefits and coverage.

NameCost per month Waiting PeriodsAnnual Limits
Essential Extras$51.49
  • 12 Months: Major dental, Endodontic, Orthodontic,
  • 6 Months: Health management
  • 2 Months: General dental, Non PBS pharmaceuticals, Physiotherapy, Chiropractic, Podiatry, Psychology, Acupuncture, Remedial massage, Chinese medicine, Exercise physiology, Osteopathy.
  • Dental: $500 per person
  • Optical: $200 per person
  • Therapies: $300 per person
  • Healthy Lifestyle: $150 per person
  • Pharmaceuticals: $300 per person
  • Emergency Ambulance: $6000 per person
Top Extras$82.59
  • 12 Months: Major dental, Endodontic, Orthodontic, Hearing aids.
  • 6 Months: Optical, Health management
  • 2 Months: General dental, Non PBS pharmaceuticals, Physiotherapy, Chiropractic, Podiatry, Psychology, Remedial massage, Blood glucose monitors, Audiology, Ante-natal/Post-natal classes, Dietetics, Exercise physiology, Eye therapy, Occupational therapy, Orthotics, Osteopathy, Speech therapy, Vaccinations
  • Major Dental: $1,300
  • Orthodontia: $2,500 lifetime limit.
  • Optical: $260 per person
  • Therapies: $480 per person
  • Healthy Lifestyle: $200 per person
  • Pharmaceutical: $800 per person
  • Emergency Ambulance: $6000 per person.

Source: PrivateHealth.gov.au (May 2021; Extras only premium estimates for a single Adult with no dependents in NSW)

Combined StarterPak Hospital and Extras Package

MyOwn offers members the opportunity to purchase a combined policy which includes both Hospital and Extras policies. Features of their combined policy includes:

StarterPak (Basic Plus)

The Package Coverage consists of a combination of Top Hospital Gold and Basic Extra cover in terms of benefits, prices, and annual limits. The benefits are as follows:

  • Dental surgery
  • Hernia and appendix
  • Joint reconstructions
  • Tonsils, adenoids and grommets

Restricted cover as follows:

  • Back, neck and spine
  • Blood
  • Bone, joint and muscle
  • Brain and nervous system
  • Breast surgery (medically necessary)
  • Cataracts
  • Chemotherapy, radiotherapy and immunotherapy for cancer
  • Diabetes management (excluding insulin pump)
  • Digestive system
  • Ear, nose and throat
  • Eye (not cataracts)
  • Gastrointestinal endoscopy
  • Gynaecology
  • Hospital psychiatric services
  • Implantation of hearing devices

Teachers Health Ambulance cover

The company offers an ambulance only option if you do not wish to take out a Hospitals or Extras plan. The Ambulance Only option covers transport from the scene of an accident or medical event to a hospital, treatment at the scene, and certain air ambulance services.

Teachers health dental

This insurer does not offer specific cover for dental health insurance, however, if you’re a member of the company and have purchased a plan or policy, you are able to receive no-gap dental check-ups. These are viable when visiting a Teacher’s Health centre or a dental provider who has partnered with the insurer.

How to claim from teachers health

Generally, the bill you receive from in-hospital treatments are automatically sent to the insurance provider. However, when claiming for other medical and health procedures, there are a few options. You can submit a teacher’s health claim form through the website, email, post, or in-person when visiting a branch. You can simply swipe your membership card at the location of your health procedure, or you can claim online through the company’s membership service.

What benefits do teachers get?

Teachers receive a range of benefits, including:

  • Products specifically created for people in the education industry.
  • The Teachers Health member app to view your cover details, check your remaining annual benefits and make claims.
  • Access to Teachers Health Centers.
  • Helping people with asthma with free coaching services delivered over the phone.
  • New family program for members requiring additional support before, during, and after pregnancy.
  • Diabetes management for eligible members with either pre-diabetes, gestational diabetes, type 1 or 2 diabetes.

Frequently asked questions and answers

  • Can anyone join Teachers Health Fund?

    No, the company was designed and only caters for those in the education industry. The only members who can join the fund who are not part of the education and teaching industry are those who are dependants and family members to a teacher or staff of education.
  • Do teachers get healthcare?

    Yes, teachers can get special cover for healthcare. Teachers or educators that live in Australia can receive health insurance from the Teacher’s Health Fund, a non-profit company who aims to serve teachers affordable and accessible health care coverage in Australia.
  • What is Teachers Health Fund?

    The company was established by the NSW Teachers Federation in 1954 with the aim to provide educators with reliable and affordable health insurance. Today, the insurer caters for over 350 000 teachers and their families across Australia. The Teachers Health Fund is a not-for-profit health care insurer and is an active member of the Health Fund Alliance.
  • Does Teachers health cover gastric sleeve?

    Teachers or educators and their families who hold the Top Gold Hospitals plan are able to receive coverage for a gastric sleeve procedure. There are also various other weight loss benefits and aid one can receive when joining this health care fund.
  • Does Teacher’s health cover gym membership?

    Yes, if you are an active member for the insurer, you can claim Healthy Lifestyle benefits for programs and services like gym memberships. These include CrossFit, personal training, boot camps, aquaponics, and online fitness programs. However, you will require a health practitioner to ensure you are attending the gym to improve your health before receiving any benefits.

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