Top Hospital Gold
Top Hospital is (unsurprisingly) our highest level of Hospital cover. It includes big ticket items like pregnancy and birth, heart procedures and hip or knee joint replacements – with no exclusions or restrictions. Your excess options are: $0, $300 or $500.
Scope of cover
What you need to know about waiting periods and choosing an excess.
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|
|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|
Choosing an excess
A higher excess can keep your membership costs down. The excess is an agreed amount that you pay directly to the hospital on your admission. You only pay the total excess once per person, per calendar year (if you claim on your Hospital cover that year). There’s no excess for any kids on your cover, if they’re under 32.
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.
*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.