Top Extras

Our Top Extras cover offers generous benefits with overall limits for a comprehensive range of services including major dental, optical and psychology services.

More than 75% of our members prefer to combine their Top Extras cover with Top Hospital cover.

We've included a list of the most commonly claimed items. Call us on 1300 727 538 to check if you're covered for an item number that is not listed below. 

Dental

Service Benefit (up to $)

General Dental - 2 month waiting period

Periodic oral examination (012) - limit of 2 services, per person/year

$40

Unlimited
(Unless stated otherwise)

Bitewing x-ray (022)

$30

Removal of calculus (114) - limit of 2 services, per person/year

$70

Topical application of remineralising agent (121) - limit of 2 services per year

$25

Removal of tooth (311)

$90

Filling: 1 surface metallic (511)

$63

Filling: 3 surface metallic (513)

$109

Filling: 1 surface adhesive restoration (531)

$80

Filling: 3 surface adhesive restoration (533)

$115

Major Dental -12 month waiting period

Removal of wisdom teeth requiring removal of bone (323)

$170

Yearly Limits:
Increasing Limits
Year 1 Match existing cover up to $1,300
Year 2 $1,300
Year 3 $1,600
Year 4 $2,100
Year 5 $2,600
Year 6+ $2,800

Increasing limits are calculated on continuous membership of Teachers Health Fund Top Extras cover

Removal of wisdom teeth requiring removal of bone and tooth division (324)

$240

Crown - veneered (615)

$650

Dentures - upper and lower (719)

$1,000

Orthodontia Treatment - 24 month waiting period

Orthodontia - Year 3

$1,500

Yearly Limits:
Increasing limits
Year 3 $1,500
Year 4 $2,000
Year 5+ $2,500

Benefits are paid once in a lifetime.

Increasing limits are calculated on continuous membership of Teachers Health Fund Top Extras cover and equivalent cover with other health funds

Orthodontia - Year 4

$2,000

Orthodontia - Year 5+

$2,500

Optical

Service Benefit (up to $)

6 month waiting period

Frames

$100

Yearly Limits:
$260 per person

Single vision lens - pair

$120

Bifocal lens - pair

$135

Multifocal lens - pair

$165

Contact lenses - rigid or soft

$175

Contact lenses - disposable

$175

Complementary Therapies

Service Benefit (up to $)

2 month waiting period

Acupuncture

$32

Yearly Limits:
$600 per person

Remedial Massage

$32

Alexander Technique

$32

Aromatherapy

$32

Bowen Therapy

$32

Chinese Herbal Medicine Consultations

$32

Feldenkrais Method

$32

Homeopathy

$32

Kinesiology

$32

Myotherapy

$32

Naturopathy

$32

Reflexology

$32

Shiatsu

$32

Western Herbal Medicine Consultations

$32

Body & Mind Therapies

Service Benefit (up to $)

2 month waiting period

Chiropractic & Osteopathy - 1-4 visits

$40

Yearly Limits:
$450 per person
($300 sub-limit for group therapy)

Chiropractic & Osteopathy - 5+ visits

$32

Chiropractic & Osteopathy - group therapy

$20

Physiotherapy - 1-4 visits

$40

Yearly Limits:
$800 per person
($300 sub-limit for group therapy)

Physiotherapy - 5+ visits

$32

Physiotherapy - group therapy

$20

Exercise Physiology - 1-4 visits

$40

Combined limit - see Physiotherapy

Exercise Physiology - 5+ visits

$32

Exercise Physiology - group therapy

$20

Speech therapy - 1-4 visits

$70

Yearly Limits:
$600 per person

Speech therapy - 5+ visits

$40

Podiatry - 1-4 visits

$40

Yearly Limits:
$400 per person
($60 sub-limit for orthotic repair)

Podiatry - 5+ visits

$32

Dietitian - 1-4 visits

$60

Yearly Limits:
$400 per person

Dietitian - 5+ visits

$40

Psychology consultation

$72

Yearly Limits:
$600 per person

Psychology assessment

$100

Audiology consultation

$45

No limit

Hypnotherapy consultation or session

$30

$300

Occupational therapy

Visit 1-4 $70 Visit 5+ $44

$500

Orthoptics consultation

Visit 1-4 $40 Visit 5+ $35

(Included in overall physio limit)

Ante or post-natal physiotherapy course (per confinement only)

$78

Yearly Limits:
$78 per calendar year, included in overall physio limit

Healthy Lifestyle

Service Benefit (up to $)

6 month waiting period

Weight management

75%

Yearly Limits:
$200 per person

For more information on programs and how to claim, click here.

Gym membership

75%

Pilates

75%

Yoga

75%

Disease management subscriptions / memberships

75%

Health screening services / prevention screening

75%

National Healthy Eating Activity and Lifestyle (HEAL) program

75%

Medical Health

Service Benefit (up to $)

2 month waiting period

Pharmaceuticals (non PBS requiring prescription by law)^

$60

Yearly Limits:
$800 per person
($280 sub-limit for erectile dysfunction and vaccines)

Mastectomy Bra

90%

Yearly Limits:
$350

Travel - Calculated at $0.15 per kilometre

$0.15/km

Yearly Limits:
$400

Travel must be for a serious medical condition where the distance travelled is more than 200km return and the treatment is not available closer to home. Proof of attendance is required from the treating provider

Home nursing - over six (6) hours

$95

Yearly Limits:
$800

Home nursing - under six (6) hours

$33

Medical Appliances

Service Benefit (up to $)

12 month waiting period

CPAP machine (purchase)

75% up to $800

Yearly Limits:
1 monitor every 3 years

Most aids require the Aids and Appliances form to be completed

Artificial Aids

Service Benefit (up to $)

2 month waiting period

Blood pressure monitor (purchase)

75% up to $85

Yearly Limits:
$1,200 per person
(sub-limits apply)

Most aids require the Aids and Appliances form to be completed

Blood glucose monitor

75% up to $160

Compression garments~

75% up to $400

Wigs - chemotherapy / alopecia

75% up to $350

Allergy cover for mattress and pillow

75%

Sub-Limit:
$240

Breast Pump (purchase)

75%

Sub-Limit:
$150

Crutches (purchase)

75%

Sub-Limit:
$140

Crutches (hire)

75%

Sub-Limit:
$140

Nebuliser

75%

Sub-Limit:
$170

Surgical corsets/braces/trusses

75%

Sub-Limit:
$500

Surgical shoes

75%

Sub-Limit:
$400

Surgical shoes must be custom made by a surgical shoe maker and prescribed by a podiatrist or medical practitioner. Any ‘off-the-shelf’ products are not eligible for a benefit

Surgical stockings

75%

Sub-Limit:
$130
(sub-limit of Compression Garment limit)

TENS machine

75%

Sub-Limit:
$160

Wheelchair repair (including batteries)

75%

Sub-Limit:
$75

Wheelchair (hire)

75%

Sub-Limit:
$140

Hearing Aids

Service Benefit (up to $)

12 month waiting period

Hearing aids

Yearly Limits:
Increasing limits
Single
Years 1-2 $300
Years 2-5 $600
Years 5+ $900

Pair
Years 1-2 $600
Years 2-5 $1,200
Years 5+ $1,800

Increasing limits are calculated on continuous membership of Teachers Health Fund Top Extras cover

Most aids require the Aids and Appliances form to be completed

Emergency Ambulance Transport

Service Benefit (up to $)

1 day waiting period

Emergency ambulance transport (using State Government ambulance service)

100%

Yearly Limits:
$6,000 per person

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. To check if your provider is recognised by Teachers Health Fund please contact us on 1300 727 538

For more information on Orthodontia click here 

^Teachers Heath Fund pays a benefit towards non-PBS prescriptions only medication supplied to treat a medical condition. You pay a co-payment equal to the current non-concessional PBS co-payment amount. Benefit is not payable for contraceptive prescribed in the absence of a medical condition. Evidence of this is required once per 12 months. No benefit for erectile dysfunction medication.

~Compression garments used for the treatment of lymphoedema, or the treatment of vascular conditions, or to minimise scarring following severe burns or prescribed post-surgery, but excludes pregnancy shorts and any sports related or body enhancing garments. The garment and grade of compression required must be properly assessed and individualised to the patient’s specific needs.

Frequently Asked Questions