Important information about changes to your cover

Changes to your Top Extras cover effective 1 April 2017

Changes to your Essential Extras cover effective 1 April 2017

Changes to your StarterPak cover effective 1 April 2017

FAQs – Contribution rate changes explained

The annual contribution rate and benefit review can be confusing so here are some Q&As to explain more about the process.

Do all funds carry out a review of their rates?

Yes, all Australian private health insurers review their rates annually. The Federal Government is responsible for regulating this process and requires that all health insurers provide justification as to why changes to rates are necessary. Ministerial approval is required for any rate increase.

Why is it necessary?

Teachers Health conducts a review each year to ensure that our range of products and benefits remain competitive and sustainable. Our pricing policy continues to reflect the rising costs of healthcare, including services and prostheses costs, increases in claims benefits paid (12% increase in the last financial year), increased utilisation of health services and our ageing membership base. As a not-for-profit organisation, we do not pay dividends to shareholders. Any surplus generated by Teachers Health is reinvested in the business for the benefit of our members to enable the Fund to improve benefits and keep contribution rates as low as financially sustainable whilst achieving a responsible level of operating surplus to ensure the commercial stability of the Fund.

How much have Hospital, Medical and Extras services claims increased?

In financial year 2015–16 claims costs for Teachers Health grew by $53.3 million or 12% to $495.1 million. In financial year 2015-16, Teachers Health returned 91 cents in Hospital, Medical and Extras benefits for every dollar of contributions received.

Is the difference between the high increase in claims costs and the low increase in contribution rates a cause for concern?

No, contribution rates are set following consideration of independent actuarial advice. In addition, Teachers Health has an investment portfolio and other businesses (including optical, dental and physiotherapy as well as travel and other general insurance policies) that generate additional income for the organisation. Our administrative costs are also among the lowest in the industry, representing 6.7% of contribution income for financial year 2015-16, well under the industry-average of 8.6%, and we continually look for opportunities to improve efficiencies and lower administration costs, whilst maintaining a high level of customer satisfaction.

When do contribution rate changes happen?

The contribution rate changes were approved by the Federal Government on 10 February 2017. The changes will be communicated to members in March 2017 and will take effect in early April 2017.

Why is private health insurance so important?

Private health insurance protects your most important asset – your health. It gives you peace of mind knowing that you and your family are covered in the event of needing medical assistance. It gives you control over when and where you’re treated and the ability to choose your own doctor. It also allows you to avoid the lengthy public hospital waiting lists. With Extras cover you can also claim benefits on services that aren’t generally covered by Medicare, including optical, dental, physio, chiro, speech therapy and remedial massage.

Teachers Health top five hospital admissions in FY15-16

Total Hospital + Medical benefits paid (including associated rehabilitation)

Skull tumour


Aortic aneurysm


Heart valve replacements


Pancreatic cancer


Spinal fusion



Think you’ve found a cheaper rate?

It’s important to compare apples with apples and think about the services you’re covered for, not just price. Don’t forget we offer a free online comparison service, providing you with a personalised side-by-side comparison of the cost and benefits of products. Click here to request a comparison.

It’s also important to remember that the comparison websites do not include all health funds. As a not-for-profit health fund, we choose not to pay the commissions associated with comparison websites to protect our members’ money. We only feature on the Members Own Health Fund comparison site – Members Own health funds are not-for-profit health funds. Visit for more information.  

Further questions?

If you have any questions concerning this, please contact us on 1300 728 188.