Top Extras

Top Extras

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Comprehensive Extras cover

Top Extras is our top level of Extras cover. That means higher benefits and/or limits on things our members use the most, like dental, optical and physio. Your limits for major dental treatment will even go up for the first six years you stay with us*.

Top Extras also covers things like seeing a speech therapist or dietitian, and devices like hearing aids and blood pressure monitors, which you can’t claim towards on our lower level Extras covers.

Healthy lifestyle programs, like weight management, gym membership and health screenings are also included (subject to eligibility).

Top Extras

Legend

More Information

Click on the service to learn more
Services
Benefit
Yearly Limits
Periodic oral examination (012) - limit of 2 services, per person/year
$40
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Intraoral radiograph - per exposure (022)
$30
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Removal of calculus (114) - limit of 2 services, per person/year
$70
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Topical application of remineralising agent (121) - limit of 2 services per year
$25
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Removal of tooth (311)
$90
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Filling: 1 surface metallic (511)
$63
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Filling: 3 surface metallic (513)
$109
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Filling: 1 surface adhesive restoration (531)
$80
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Filling: 3 surface adhesive restoration (533)
$115
Benefits
Yearly Limit
Yearly Limit

Unlimited (Unless stated otherwise)

Services
Benefit
Yearly Limits
Surgical removal of a tooth requiring bone removal (324)
$240
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Inlays/Onlays - tooth coloured 1 surface (551)
$273
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Inlay/Onlays - tooth coloured 2 surfaces (552)
$432
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Crown - veneered (615)
$750
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Bridge pontic - direct (642)
$520
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Dentures - upper and lower (719)
$1,000
Benefits
Yearly Limit
Yearly Limit

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 Top Extras cover.

Services
Benefit
Yearly Limits
$2,500
Benefits
Yearly Limit
Yearly Limit

$2,500 lifetime limit.

Services
Benefit
Yearly Limits
Frames
$100
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Single vision lens - pair
$140
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Bifocal lens - pair
$165
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Multifocal lens - pair
$165
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Contact lenses - rigid or soft
$175
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Contact lenses - disposable
$175
Benefits
Yearly Limit
Yearly Limit

$260 per person.

Services
Benefit
Yearly Limits
Chiropractic & Osteopathy – First visit
$45
Benefits
Yearly Limit
Yearly Limit

$480 per person ($300 sub-limit for group therapy).

Chiropractic & Osteopathy – Visits 2-6
$40
Benefits
Yearly Limit
Yearly Limit

$480 per person ($300 sub-limit for group therapy).

Chiropractic & Osteopathy – Visits 7+
$32
Benefits
Yearly Limit
Yearly Limit

$480 per person ($300 sub-limit for group therapy).

$20
Benefits
Yearly Limit
Yearly Limit

$480 per person ($300 sub-limit for group therapy).

Physiotherapy – First visit
$45
Benefits
Yearly Limits
Yearly Limits

$800 per person (sub-limits apply).

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Physiotherapy – Visits 2-6
$40
Benefits
Yearly Limits
Yearly Limits

$800 per person (sub-limits apply).

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Physiotherapy – Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

$800 per person (sub-limits apply).

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

$20
Benefits
Yearly Limits
Yearly Limits

$800 per person (sub-limits apply).

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Exercise physiology – First visit
$45
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Exercise physiology – Visits 2-6
$40
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Exercise physiology – Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Exercise physiology – group therapy/class therapy
$20
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

A $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies.

Ante or post-natal physiotherapy (per confinement only)
$78
Benefits
Yearly Limits
Yearly Limits

$78 per calendar year, included in overall physio limit

Orthoptics consultation - Visits 1-4
$40
Benefits
Yearly Limits
Yearly Limits

Included in overall physio limit.

Orthoptics consultation - Visits 5+
$35
Benefits
Yearly Limits
Yearly Limits

Included in overall physio limit.

Speech therapy - Visits 1-4
$70
Benefits
Yearly Limits
Yearly Limits

$600 per person.

Speech therapy - Visits 5+
$40
Benefits
Yearly Limits
Yearly Limits

$600 per person.

Occupational therapy - Visits 1-4
$70
Benefits
Yearly Limits
Yearly Limits

$500 per person. 

($300 sub-limit for group therapy)

Occupational therapy - Visits 5+
$44
Benefits
Yearly Limits
Yearly Limits

$500 per person. 

($300 sub-limit for group therapy)

Occupational therapy - group therapy
$20
Benefits
Yearly Limits
Yearly Limits

$500 per person. 

($300 sub-limit for group therapy)

Podiatry - first visit
$45
Benefits
Yearly Limits
Yearly Limits

$400 per person ($60 sub-limit for orthotic repair).

Podiatry - Visits 2-6
$40
Benefits
Yearly Limits
Yearly Limits

$400 per person ($60 sub-limit for orthotic repair).

Podiatry - Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

$400 per person ($60 sub-limit for orthotic repair).

Audiology consultation
$45
Benefits
Yearly Limits
Yearly Limits

No limit.

Dietitian - Visits 1-4
$60
Benefits
Yearly Limits
Yearly Limits

$400 per person.

Dietitian - Visits 5+
$40
Benefits
Yearly Limits
Yearly Limits

$400 per person.

Hypnotherapy consultation or session
$30
Benefits
Yearly Limits
Yearly Limits

$300 per person

Psychology assessment
$100
Benefits
Yearly Limits
Yearly Limits

$600 per person. Sub-limits apply.

Psychology - initial consultation
$100
Benefits
Yearly Limits
Yearly Limits

$600 per person. Sub-limits apply.

Psychology - subsequent consultation
$72
Benefits
Yearly Limits
Yearly Limits

$600 per person. Sub-limits apply.

Natural therapies (Remedial massage, Acupuncture, Chinese herbal medicine consultations, Myotherapy)
$34
Benefits
Yearly Limits
Yearly Limits

$600 per person

Benefits are for face-to-face consultation only. No benefits for remedies, medicines or food preparation

Services
Benefit
Yearly Limits
100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

National Healthy Eating Activity and Lifestyle (HEAL) program
100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

Flu vaccine (until 31 December 2023)
100%
Benefits
Yearly Limits
Yearly Limits

$200 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

Services
Benefit
Yearly Limits
$60
Benefits
Yearly Limits
Yearly Limits

$800 per person 

($280 sub-limit for erectile dysfunction and vaccines).

Services
Benefit
Yearly Limits
Emergency ambulance transport (using State Government ambulance service)
100%
Benefits
Yearly Limits
Yearly Limits

$6000 per person.

Services
Benefit
Yearly Limits
Blood pressure monitor (purchase)
75% up to $85
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Blood glucose monitor (including CGM)
75% up to $160
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

75% up to $400
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

75% up to $90
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

75% up to $500
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

75% up to $240
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Breast Pump (purchase)
75% up to $150
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Crutches (purchase)
75% up to $200
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Crutches/knee scooter hire
75% up to $200
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Nebuliser
75% up to $170
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Surgical corsets/braces/trusses
75% up to $500
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

75% up to $400
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Wheelchair repair (including batteries)
75% up to $75
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Wheelchair (hire)
75% up to $200
Benefits
Yearly Limits
Yearly Limits

$1,200 per person (sub-limits apply).

See if you need an Aids and Appliances form to claim.

Mastectomy Bra/Top
90%
Benefits
Yearly Limits
Yearly Limits

$400

100% up to $100
Benefits
Yearly Limits
Yearly Limits

$200

Services
Benefit
Yearly Limits
75% of cost
Benefits
Yearly Limits
Yearly Limits

$900 per person, per 3 years. See if you need an Aids and Appliances form to claim.

75% of cost
Benefits
Yearly Limits
Yearly Limits

$150 per person. See if you need an Aids and Appliances form to claim.

See Yearly Limit
Benefits
Yearly Limits
Yearly Limits

Increasing limits
Single
Years 1-5 $600
Years 5+ $900

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

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

1 pair of hearing aids per person every 3 calendar years.

See if you need an Aids and Appliances form to claim.

Services
Benefit
Yearly Limits
Wheelchair
50%
Benefits
Yearly Limit
Yearly Limit

$1900 limit every 5 years (sub-limit applies for a manual wheelchair)

Services
Benefit
Yearly Limits
Childbirth education
$300
Benefits
Yearly Limits
Yearly Limits

$300 per pregnancy

$0.15/km
Benefits
Yearly Limits
Yearly Limits

$400 per person. See claiming for travel FAQs

 

Home nursing - over six (6) hours
$95
Benefits
Yearly Limits
Yearly Limits

$800 per person

Home nursing - under six (6) hours
$33
Benefits
Yearly Limits
Yearly Limits

$800 per person

Lactation nursing - initial consultation
$60
Benefits
Yearly Limits
Yearly Limits

$800 per person

Lactation nursing - subsequent consultation
$40
Benefits
Yearly Limits
Yearly Limits

$800 per person

Important info

Benefits and limits

For each service that’s included on your cover you’ll see a maximum benefit amount (dollars and/or a percentage) that you can get back.

Apart from general dental, there’s also an annual limit, which is the maximum you can claim in a calendar year. For orthodontia, there’s a lifetime limit instead.

For some Extras there are also sub-limits, the maximum you can claim per year for a specific sub-category of that service (like group physio on your physio limit).

Benefits and limits vary on each level of cover so take the time to think about which Extras you’re likely to use, and how often.

 

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.

 

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.