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Home » Our products » Extras cover » Essential Extras

Essential Extras

Essential Extras is an affordable level of cover for core, everyday services such as preventative and general dental, optical and physiotherapy.

It can be taken on its own or with Hospital cover.

Service Benefit (up to $) Overall limit
Dental
General Dental – 2 month waiting period
Comprehensive oral examination (012) – limit of 2 services per person/year $40 $500 per person
$1,000 per family
Bitewing x-ray (022) $28
Removal of calculus (114) – limit of 2 services per person/year $63
Topical application of remineralising agent (121) – limit of 2 services per person/year $25
Removal of tooth (311) $78
Filling: 1 surface metallic (511) $63
Filling: 3 surface metallic (513) $90
Filling: 1 surface adhesive restoration (531) $74
Filling: 3 surface adhesive restoration (533) $97
Optical – 6 month waiting period
Frames $90 $165 per person $330 per family
Single vision lens – pair $95
Bifocal lens – pair $95
Multifocal lens – pair $95
Contact lenses – rigid or soft $165
Contact lenses – disposable $165
Body and Mind Therapies – 2 month waiting period (except 12 month waiting period for psychology)
Chiropractic & Osteopathy – 1-4 visits $40 $250 per person $500 per family
Chiropractic & Osteopathy – 5+ visits $32
Chiropractic & Osteopathy – group therapy $20
Physiotherapy – 1-4 visits $40 $300 per person $600 per family
Physiotherapy – 5+ visits $32
Podiatry – 1-4 visits $40 $200 per person $400 per family
Podiatry – 5+ visits $32
Complementary therapies – 2 month waiting period
Acupuncture $32Benefits are for consultation only. No benefits for remedies, medicines or food preparations. $400 per person $800 per family
Remedial massage
Naturopathy
Reflexology
Chinese herbal consultations
Alexander Technique
Aromatherapy
Feldenkrais method
Homeopathy
Kinesiology
Myotherapy
Shiatsu
Western herbal medicine consultation
Healthy lifestyle – 12 month waiting period
Weight managementTo receive benefits towards your weight management program, you must provide a letter from your GP confirming that weight loss will help prevent or ameliorate a specific medical condition. Benefits are only available for recognised programs. There are no benefits available for meal replacement products / food. Programs currently recognised by Teachers Health Fund are:
-Weight Watchers
-GutBusters
-Jenny Craig
75% $150 per person $300 per family
Gym membershipTo receive benefits towards your gym membership, you must provide a letter from your GP confirming that attending the gym will help prevent or ameliorate a specific medical condition.
PilatesTo receive benefits towards your Pilates classes, you must provide a letter from your GP confirming that attending Pilates classes will help prevent or ameliorate a specific medical condition.
YogaTo receive benefits towards your yoga classes, you must provide a letter from your GP confirming that yoga classes will help prevent or ameliorate a specific medical condition.
Disease management  subscriptions / membershipsWe will pay a benefit towards your annual subscription / membership to organisations of the following conditions:
Asthma
Diabetes
Heart
Arthritis
Coeliac
Crohns
Colostomy / Ileostomy
Health screening services / preventative screeningWe will pay a benefit for the following procedures where there is no benefit claimable from Medicare:
Mammograms (excludes 3D and thermal image mammograms)
Skin cancer screenings / Mole Maps
Bowel cancer tests / scans
Bone mineral density tests
Thin Prep
HEAL – Healthy Eating Activity Lifestyle Program. More
Medical health – 2 month waiting period
Pharmaceuticals (non PBS requiring prescription by law)Teachers Health Fund pays a benefit towards non-PBS prescription 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
contraceptives prescribed in the absence of a medical condition. Evidence of this is required once per 12 months.
$60 $300 per person $600 per family
Emergency Ambulance transport – 1 day waiting period
Emergency Ambulance transport 100% $6,000 per person $12,000 per family

Services not covered under Essential Extras

Major Dental – 12 month waiting period
Inlays/onlays – tooth coloured – 1 surface (551)
Inlays/onlays – tooth coloured – 2 surfaces (552)
Bridge pontic – indirect (642)
Crown – veneered (615)
Dentures – upper and lower (719)
Orthodontial treatment – 24 month waiting period
Benefits are paid once in a lifetime
Orthodontia
Body and Mind Therapies – 2 month waiting period (except 12 month waiting period for psychology)
Exercise Physiology
Physiotherapy & Exercise Physiology – group therapy
Ante or post natal physiotherapy course
Speech therapy
Orthoptist (eye therapist)
Occupational therapy
Audiology consultation
Dietician
Hypnotherapy
Psychology consultation
Medical health – 2 month waiting period
Home nursing
Medical Appliances – 12 month waiting period
Sleep apnoea monitor
Artificial aids – 2 month waiting period
Blood pressure monitor
Blood glucose monitor
Compression garments
Wigs
Allergy cover for mattress and pillow
Crutches – purchase
Crutches – hire
Nebuliser – 1 per calendar year
Surgical corsets/braces/trusses
Surgical shoesSurgical 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. See more.
TENS machine – 1 per calendar year
Wheelchair hire
Wheelchair repair (including batteries)
Hearing aids – 12 month waiting period
Hearing aids
Wheelchair – 24 month waiting period
Wheelchair purchase
Miscellaneous – 2 month waiting period
TravelTravel 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.

If you wish to be covered for any of these services please see Top Extras cover.

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.  Please refer to our FAQs section under Benefits for more information.  To check if your provider is recognised by Teachers Health Fund, please contact us on 1300 727 538.

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Your Rebate

All Australian residents, who are entitled to Medicare, are able to claim an income tested rebate on their private health insurance; would you like to apply your rebate?

For individuals earning between $88,001 - $102,000 (or $176,001 - $204,000 for families*).
*For families with children, the thresholds are increased by $1,500 for each child after the first.

How rebate tiers workX

Most Australians with private health insurance currently receive a rebate from the Australian Government to help cover the cost of their premiums. The private health insurance rebate is income tested. The table below details the different rebate amounts and Medicare Levy Surcharge levels.

The rebate applies to hospital, general treatment and ambulance policies. It does not apply to overseas visitors cover. The rebate levels applicable for 1 July 2013 to 30 June 2014 are:

Singles
Families
≤$88,000
≤$176,000
≤$88,001-102,000
≤$176,001-204,000
≤$102,001-136,000
≤$204,001-272,000
≤$136,001
≤$272,001
Rebate
< Age 6530%20%10%0%
Age 65-6935%25%15%0%
Age 70+40%30%20%0%

Single parents and couples (including de facto couples) are subject to family tiers. For families with children, the thresholds are increased by $1,500 for each child after the first. http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/insurancerebate.htm