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 |
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| 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 |
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| 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) |  |
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| 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 | |
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| Orthodontia | |||
| Body and Mind Therapies – 2 month waiting period (except 12 month waiting period for psychology) | |||
| Exercise Physiology | |
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| 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 | |
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| Medical Appliances – 12 month waiting period | |||
| Sleep apnoea monitor | |
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| Artificial aids – 2 month waiting period | |||
| Blood pressure monitor | |
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| 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 | |
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| Wheelchair – 24 month waiting period | |||
| Wheelchair purchase | |
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| 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. |
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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.
