Teachers Union Health Fund Review 2024

Teachers Union Health Fund (TUH) was founded in 1972 by Queensland teachers, to help their fellow teachers access quality health care.

Today, TUH remains a not-for-profit fund, but is now available for anyone who is or was a member of any recognised Australian union to join (not just teachers’ unions), along with their immediate family members, including parents, children, siblings and grandchildren.

Hospital cover

Nobody chooses to go to hospital. But when you do, appropriate hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you’re likely to need, in line with your budget. If you earn over $90,000 individually or $180,000 as a couple, taking out appropriate hospital cover may help you avoid paying the Medicare Levy Surcharge (MLS) for the period you have that cover.

TUH offers six types of Hospital cover, ranging from Basic+ Hospital for budget cover to Gold Hospital for complete peace of mind.

Basic+ Hospital

Basic+ Hospital includes some of the common Bronze Hospital inclusions, making it a good budget option for those who just want the essentials.

Key inclusions:

• Tonsils, grommets and adenoids

• Joint reconstructions

• Hernia and appendix

Bronze+ Hospital

TUH’s Bronze+ Hospital covers all procedures commonly included in Bronze policies, with a number of bonus higher tier inclusions such as palliative care and pain management.

Key inclusions:

• Palliative care

• Eye (not cataracts)

• Pain management

Silver+ No Pregnancy Hospital

SIlver+ No Pregnancy has no exclusions except for pregnancy and IVF related services, and weight loss surgery, making it a popular option for older Australians who want comprehensive cover.

Key inclusions:

• Cataracts

• Insulin pumps

• Back, neck and spine

• Heart and vascular system

Silver+ Family Hospital

Silver+ Family Hospital provides complete cover except for cataracts and weight loss surgery, making it an option for young families looking for comprehensive cover while excluding unneeded treatments.

Key inclusions:

• Pregnancy and birth

• Assisted reproductive services

Gold Hospital

Gold Hospital is TUH’s top-tier option with cover for all Medicare cognised services.

Key private hospital inclusions

• Weight loss surgery

Ambulance Cover 

If you live in ACT or NSW, an ambulance levy to cover transportation or attendance by NSW ambulance is included in your Hospital cover. If you require ambulance assistance in another state, you will be covered if you have combined Hospital and Extras cover with TUH¹. 

If you live in any other state, you are entitled to cover for emergency ambulance transportation or attendance if you have both Hospital and Extras cover.

Extras cover 

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%. TUH’s extras reset on 1 January every year.

While we’ve summarised the key points of TUH extras policies below, it’s always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, is recognised by the health fund.

Take the time to work out what you need and what you’re prepared to pay. If this feels a bit overwhelming, you can speak to one of our experts.

TUH offers six extras policies, ranging from Basic Extras to cover the essentials and Comprehensive Extras for higher benefits on more services.

Basic Extras

Basic Extras offers affordable cover for key services such as General Dental and optical.

Key inclusions:

• General Dental ($400 annual limit)

• Optical ($160 annual limit)

• Physiotherapy, massage, osteopathy, chiropractic, psychology and pharmaceuticals ($200 per therapy, $250 psychology & pharmaceuticals. Overall annual limit $400)

Mid Range Extras

Mid Range Extras offers standalone limits for services such as chiropractic and physiotherapy as well as higher limits on Dental.

Key inclusions:

• General Dental ($600 annual limit)

• Major Dental ($1,000 annual limit)

• Psychology ($250pp), podiatry ($250pp), dietetics ($150pp), speech therapy ($150pp), occupational therapy ($150pp)  Overall annual limit $350

Healthy Options Extras

Healthy Options Extras includes services such as orthodontics and a 60% benefit on included extras up to your annual limit, making it an appealing option for small families.

Key inclusions:

• General & Major Dental ($1,000 annual limit)

• Orthodontic ($700p/y to lifetime limit of $2100)

• Acupuncture, massage, myotherapy, osteopathy, chiropractic, psychology/hypnotherapy, podiatry (Limited to $500pa per therapy to an overall maximum of $500 per year)

Everyday Extras

Everyday Extras is an ideal option for individuals who want higher overall limits on the services they use the most, including unlimited general and preventative dental.

Key inclusions:

• General Dental (no annual limit)

• Major Dental ($2,000 annual limit)

• Optical ($250 annual limit)

Family Extras

Family Extras offers no annual limit on general and preventative dental, as well as generous limits on a broader range of services.

Key inclusions:

• General and Preventative Dental (no annual limit)

• Major Dental, including Orthodontia ($2,000 annual limit)

• Hearing aids ($600 per ear annual limit)

Comprehensive Extras

Comprehensive Extras covers a wide range of services with higher overall limits than any other TUH policy, making it a good option for individuals and families who expect to be using their extras a lot. Annual limits also increase with years of membership.

Unlike with other TUH policies, there are no grouped therapies, meaning that services such as physiotherapy, chiropractic, osteopathic and acupuncture have their own individual limits.

Key inclusions:

• General Dental (no annual limit)

• Major Dental ($3,400 annual limit)

• Hearing aids ($1,000 per ear annual limit)

Combined Hospital + Extras Cover 

Bronze+ Young Choice

TUH’s Bronze+ Young Choice is a package policy that’s tailored towards young people and covers both hospital and extras. The combination of both packages makes it a popular option with those trying to get both hospital and extras cover in one convenient package.

Key inclusions:

• General dental ($600pa) and endodontics ($300pa) Overall annual limit $600

• Optical ($190 annual limit. Sub-limits apply)

• Palliative care

• Lung and chest

Waiting periods

Waiting periods are there to stop people from signing up, claiming and then cancelling their cover. It means once you take out a new plan, you may have to wait a certain amount of time before receiving your benefit.

When you switch to TUH from another provider, you won’t have to re-serve already completed  waiting periods, unless your new policy covers something you didn’t have before.

Hospital waiting periods

• 12 months for pregnancp and birth

• 12 months for pre-existing conditions

• 2 months for all other services

Extras waiting periods

• 12 months for major dental, orthodontia, orthotics, mechanical/health devices, hearing aids, hearing aid repairs and custom-made prosthesis

• 2 months for all other services, including optical, general dental and podiatry

• 1 day for emergency ambulance transport (only claimable when you hold both hospital and extra cover)

Member benefits

TUH members have access to Wellbeing Benefits, providing discounts across a number of popular retail and fitness businesses, many of which are Queensland-based

Members with Gold or Silver Hospital and Extras Cover also have access to the Care Coordination program, designed to assist members who have recently been discharged from hospital and have complex health needs.

How to claim

Hospital

Simply tell the hospital you are a member of a TUH policy. Your hospital account will be sent directly to TUH for them to assess on your behalf. If you’re billed directly via hospital or doctor, you can claim via the TUH member portal or via their smartphone app.

It is recommended you call your fund before your admission date to check what benefits you are entitled to and if any out-of-pocket expenses or excess will be payable on the day,

Extras

You can swipe your membership card to claim directly on the spot with your provider’s HICAPS or iSOFT terminal.

Members can also claim after the treatment via the TUH mobile claiming app or through email, fax or mail.

Hospital agreements

TUH has agreements with a large number of hospital and day surgery providers across Australia.

When comparing policies, it’s worth checking if your preferred local hospitals and clinics are covered. Our specialists at Compare Club can do this for you.

Customer service

TUH received 0.4% of all private health insurer complaints in 2021. They have a market share of 0.6%².

Frequently Asked Questions

Is TUH a not-for-profit fund?

Yes. As a not-for-profit fund, TUH is 100% owned by its members.

Who can apply? Are there restrictions? 

TUH membership is only available to current and past members of any Australian union (not just teachers’ unions), along with their immediate family members.

Is it easy to switch to TUH Fund?

TUH isn’t on our panel so you’ll need to contact them directly to switch. We’re confident the Compare Club team can find you a great deal from the insurers on our panel.

Do I need to re-serve waiting periods?

You can switch to an equivalent or lower level of cover without re-serving  waiting periods. You’ll need to serve new waiting periods if you have upgraded to a higher level of cover.

Can I change my level of cover?

Yes, you can modify your cover with TUH directly. 

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

What age are children covered up to?

Children are automatically covered under family cover until the day before they turn 21. 

If they are full-time students, they’ll be covered for no extra cost until the day before they turn 25 or cease full time study (whichever comes first).

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).