Top Extras
Top Extras offers generous benefits and overall limits for a comprehensive range of Extras services such as major dental, optical and psychology.
It can be taken on its own or with Hospital Cover. Top Hospital and Top Extras cover is the product combination that more than 50% of our members have chosen.
| Service | Benefit (up to $) | Overall limit | |
| Dental | |||
| General Dental – 2 month waiting period | |||
| Periodic oral examination (012) – limit of 2 services per person/year | $40 | Unlimited (unless otherwise stated) |
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| 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 | ||
| Major Dental – 12 month waiting period | |||
| Inlays/onlays – tooth coloured – 1 surface (551) | $273 | Increasing limits | |
| Inlays/onlays – tooth coloured – 2 surfaces (552) | $432 | Year 2 | $1,100 |
| Bridge pontic – indirect (642) | $520 | Year 3 | $1,600 |
| Crown – veneered (615) | $650 | Year 4 | $2,100 |
| Dentures – upper and lower (719) | $830 | Year 5 | $2,600 |
| Year 6+ | $2,800 | ||
| Orthodontial treatment – 24 month waiting period. More information. | |||
| Benefits are paid once in a lifetime | Increasing limits | ||
| Orthodontia – year 3 | $1,500 | Year 3 | $1,500 |
| Orthodontia – year 4 | $2,000 | Year 4 | $2,000 |
| Orthodontia – year 5 | $2,500 | Year 5+ | $2,500 |
| Optical – 6 month waiting period | |||
| Frames | $90 | $250 per person | |
| Single vision lens – pair | $120 | ||
| Bifocal lens – pair | $135 | ||
| Multifocal lens – pair | $165 | ||
| Contact lenses – rigid or soft | $175 | ||
| Contact lenses – disposable | $175 | ||
| Repair of frames | $70 | ||
| Body and Mind Therapies – 2 month waiting period (except 12 month waiting period for psychology) | |||
| Chiropractic & Osteopathy – 1-4 visits |
$40 | $450 per person ($300 sub-limit for group therapy) |
|
| Chiropractic & Osteopathy – 5+ visits |
$32 | ||
| Chiropractic & Osteopathy – group therapy | $20 | ||
| Physiotherapy – 1-4 visits | $40 | $800 per person ($300 sub-limit for group therapy) |
|
| Physiotherapy – 5+ visits | $32 | ||
| Exercise Physiology – 1-4 visits | $40 | ||
| Exercise Physiology – 5+ visits | $32 | ||
| Physiotherapy & Exercise Physiology – group therapy | $20 | ||
| Ante or post natal physiotherapy course | $78 per confinement | ||
| Orthoptist (eye therapist) – initial | $40 | ||
| Orthoptist (eye therapist) – subsequent | $35 | ||
| Speech therapy – initial | $70 | $600 per person | |
| Speech therapy – subsequent | $40 | ||
| Occupational therapy – 1-4 visits | $70 | $500 per person | |
| Occupational therapy – 5+ visits | $44 | ||
| Podiatry – 1-4 visits | $40 | $400 per person ($60 sub-limit for orthotic repair) |
|
| Podiatry – 5+ visits | $32 | ||
| Audiology consultation | $45 | Unlimited | |
| Dietician – 1-4 visits | $60 | $400 per person | |
| Dietician – 5+ visits | $40 | ||
| Hypnotherapy | $30 | $300 per person | |
| Psychology consultation | $72 | $500 per person | |
| Psychology assessment | $100 | ||
| Complementary therapies – 2 month waiting period | |||
| AcupunctureBenefits are for consultation only. No benefits for remedies, medicines or food preparations. | $32 | $600 per person | |
| 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% | $200 per person $400 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 | $800 per person (sub-limits apply)$280 sub-limit for erectile dysfunction and vaccines |
|
| Home nursing < 6 hours | $33 | $800 per person | |
| Home nursing > 6 hours | $95 | ||
| Medical Appliances – 12 month waiting period | |||
| Sleep apnoea monitor | 75% | $800 | |
| 1 monitor every 3 calendar years | |||
| Artificial aids – 2 month waiting period | |||
| Blood pressure monitor | 75% up to $85 | $1,200 per person (sub-limits apply) | |
| Blood glucose monitor | 75% up to $160 | ||
| Compression garments | 75% up to $400 (includes $130 sub-limit for surgical stockings) | ||
| Breast pump | 75% up to $150 | ||
| Wigs | 75% up to $350 | ||
| Allergy cover for mattress and pillow | 75% up to $240 | ||
| Crutches – purchase | 75% up to $140 | ||
| Crutches – hire | 75% up to $140 | ||
| Nebuliser – 1 per calendar year | 75% up to $170 | ||
| Surgical corsets/braces/ trusses | 75% up to $500 | ||
| 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. | 75% up to $400 | ||
| TENS machine – 1 per calendar year | 75% up to $160 | ||
| Wheelchair hire | 75% up to $140 | ||
| Wheelchair repair (including batteries) | 75% up to $75 | ||
| Hearing aids – 12 month waiting period | |||
| Hearing aids | Increasing limitsIncreasing limits are calculated on years of continuous membership of Teachers Health Fund Top Extras cover. | Single | Pair |
| Years 1-2 | $300 | $600 | |
| Years 2-5 | $600 | $1,200 | |
| Years 5+ | $900 | $1,800 | |
| 1 pair of hearing aids per person every 3 calendar years | |||
| Wheelchair – 24 month waiting period | |||
| Wheelchair purchase | 50% | $1,900 (sub-limit applies for a manual wheelchair) | |
| 1 wheelchair per person/lifetime | |||
| 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. |
15c/km | $400 per person | |
| Emergency Ambulance transport – 1 day waiting period | |||
| Emergency Ambulance transport | 100% | $6,000 per person $12,000 per family | |
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.
