StarterPak Basic +
Combined Hospital and Extras cover
Entry-level Hospital cover that allows you to choose your doctor, get a few services in a private hospital and many more in a public hospital (on restricted cover). There’s a few you can’t claim for at all. You won't have to pay an excess for a hospital admission on StarterPak.
StarterPak also includes the most commonly used Extras to help you proactively manage your health.
Hospital cover
Legend
Scope of cover
Important info
What you need to know about restricted services and waiting periods.
Restricted services
Here’s an overview of what we’ll pay for and what you’ll have to pay for if going to hospital for treatment for a service that’s restricted. Note that scheduling of treatment will be up to the treating specialist and/or hospital.
In a public hospital:
- We pay – accommodation in a shared room (as long as the hospital doesn’t charge above the default rate set out by the Federal Government), and medical costs.
- You pay – any excess (if applicable), and any gap if your hospital charges above the default rate.
In a private hospital:
- We pay – accommodation in a shared room (at the default rate set out by the Federal Government), and medical costs.
- You pay – any excess (if applicable) and the balance of accommodation costs, plus any theatre costs. This could be costly, so ensure the hospital provides you with the potential costs upfront.
You should make sure you have a breakdown of all out-of-pocket costs you’ll need to pay before agreeing to treatment. This is called informed financial consent.
Hospital waiting periods
To keep health insurance fair for everyone, you may need to wait for a while before you can claim. This can happen if you:
- are new to private health insurance
- upgrade your cover to include things that weren’t covered before
- upgrade your cover when you join from another health fund.
If you’re switching to Teachers Health from another fund, join us within 60 days to avoid re-serving any applicable waiting periods.
Standard hospital waiting periods:
Pre-existing conditions* | 12 months |
Psychiatric, rehabilitation and palliative care | 2 months |
All other hospital services | 2 months |
Emergency ambulance transport | 1 day |
Non-emergency ambulance transport | 1 day |
Services not recognised by Medicare
You won't be covered for services that aren't eligible for a Medicare benefit. This includes non-medically required treatments or services provided by and not limited to, dentists, podiatrists and, cosmetic or podiatric surgeons.
Extras cover
Legend
More Information
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$500 per person, $1,000 per family.
$180 per person, $360 per family.
$180 per person, $360 per family.
$180 per person, $360 per family.
$180 per person, $360 per family.
$180 per person, $360 per family.
$180 per person, $360 per family.
$400 per person / $800 per family. Sub-limits apply.
$400 per person / $800 per family. Sub-limits apply.
Combined limit - see Chiropractic.
Combined limit - see Chiropractic.
Combined limit - see Chiropractic.
Combined limit - see Chiropractic.
$200 per person, $400 per family.
Benefits are for face-to-face consultation only. No benefits for remedies, medicines or food preparation
$300 per person, $600 per family.
Sub-limits apply.
$300 per person, $600 per family.
Sub-limits apply.
$300 per person, $600 per family.
Sub-limits apply.
$300 per person, $600 per family.
Sub-limits apply.
$300 per person, $600 per family.
Sub-limits apply.
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$150 per person, $300 per family. See more info on programs and claiming.
(Sub-limit of $30 for flu vaccine. See more info on how to claim.)
$400 per person, $800 per family.
Important info
DIY dentistry
Please be aware you can claim for face-to-face dental consultations only. You can’t claim for home (DIY) dentistry – this includes teeth whitening kits, orthodontic aligners and occlusal splints. If unsure, contact us to find out whether a benefit is payable – we’re here to help.
*A pre-existing condition is an illness, ailment or condition where the signs or symptoms of which, in the opinion of the Fund Medical Advisor or other relevant medical practitioner appointed by Teachers Health, existed at any time during the six months before taking out private health insurance or transferring to a higher level of cover. This rule applies to new members to private health insurance and existing members who are upgrading their level of cover. If you are a new member to private health insurance you will have to wait 12 months before you can receive benefits for items or services related to a pre-existing condition. If you change to a higher level of cover, you may have to wait 12 months to receive benefits, including benefits for services not previously covered. A 12 month waiting period applies to all pre-existing conditions except pregnancy & birth related services, which is a 9 month waiting period and psychiatric, palliative care and rehabilitation, which is a two month waiting period.