Basic Hospital

Basic Hospital
Basic +

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in .

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Basic Hospital Basic +

Start with the basics

If you’re looking for a more affordable option, but want to be able to choose your doctor, Basic Hospital could work for you. You’ll be able to go to a private hospital for a few services, and a public hospital for many more (on restricted cover). The Basic Hospital excess is $300.

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
Accommodation – shared and private room (where available)
Current
Theatre fees, intensive care fees
Current
Labour ward fees
Current
Shared room
Current
Private room (where available)
Current
Services for which a Medicare benefit is not payable e.g. cosmetic surgery & laser eye surgery
Current

Important info

What you need to know about restricted services, waiting periods and choosing an excess.

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.

Learn more about restricted services

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 waiting periods:

Pre-existing conditions* 12 months
Pregnancy & birth related services 9 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

 

Excess

The excess is an agreed amount that you pay directly to the hospital on your admission. You’ll only pay the total excess once per person, per calendar year (if you claim on your Hospital cover that year).  

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.