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Teachers Health Fund
for private health insurance?

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19 replies to this topic

#1 Kalota

Posted 08 November 2012 - 04:57 PM

I need to start up my own health insurance policy (I was on a family policy with Medibank Private) but am no longer eligible as my circumstances have changed.

I am a teacher and all my research seems to suggest that Teachers Health Fund would be the cheapest private health insurance for me and my partner. Does anyone have any information or experience with this fund to share? I really don't know what I'm doing in terms of health insurance, it does my head in!

I think I'm just going to get hospital cover, but I noticed that pregnancy and birth is not included in standard hospital cover. My partner and I are NOT planning on conceiving for at least a few years, but what happens if you don't choose to add pregnancy & birth to your cover but then want to add it on later?

Thanks so much for any help and any experience with this health fund!

#2 FeralRebelWClaws

Posted 08 November 2012 - 05:04 PM

I looked at what was covered for DF and I a few years ago and we were better off with HCF. I checked again not that long ago it was the same story.

We only use dental, chiro, physio and optical.

#3 Kalota

Posted 08 November 2012 - 05:06 PM

QUOTE (PussyDids @ 08/11/2012, 06:04 PM) <{POST_SNAPBACK}>
I looked at what was covered for DF and I a few years ago and we were better off with HCF. I checked again not that long ago it was the same story.

We only use dental, chiro, physio and optical.

Thanks PussyDids, I might investigate HCF. All we want is hospital cover.

Am just wondering about the pregnancy thing though, I would hate to have to have a hugely long waiting period if we wanted to start TTC and didn't chose that level of cover first!

Edited by Kalota, 08 November 2012 - 05:08 PM.

#4 wannabe30

Posted 08 November 2012 - 05:13 PM

I'm  with teachers. I started on a basic level of cover then before TTC I upgraded to full cover to make sure I was covered for obstetrics. I think the waiting period was nine months, but you can easily call them to confirm. Private cover won't actually give you much back in terms of your obstetricians fees - It's mainly useful for covering the cost of a private room at the hospital.

#5 ~Nic~

Posted 08 November 2012 - 05:14 PM

Generally speaking, you can upgrade your cover any time to include things like pregnancy, but you need to do so a few months before you fall pregnant. It's normally a 12 month wait for pregnancy, so you you need to allow 12 months from the date you upgrade the cover to the date you will be in hospital to have the bub. As long as you upgrade a few months before you fall pregnant you should be ok, but you need to clarify that with the fund first. Some funds have different rules - some have up to a 2 year wait for pregnancy in a private hospital, so you need to specifically ask Teachers Health if you upgrade your cover, exactly what date will you be covered for an admission for pregnancy. The other thing to take into account with the waiting period is say for example you upgrade on the 1st of January 2013, so your pregnancy cover kicks in 1st January 2014, you fall pregnant and bub is due after your waits are up, but what happens is bub is born early? Or if you need to be admitted to hospital due to complications before the waiting period is up? I work in the call centre of one of the health funds, and I hear way too often about people who thought that they would be covered for pregnancy because the upgraded their cover the week before they found out they were pregnant, and it sucks to be the person to say that no, you're not covered. Definitley ask as many questions as you can well and truly in advance so there are no nasty surprises.

Good luck!


#6 José

Posted 08 November 2012 - 05:14 PM

I am with AHM and would be better off with teachers- lower premiums and better benefits on extras. I know people with teachers and they are happy.

ETA I agree with nic. I got caught out when trying to book in for a d & c following miscarriage. I hadn't served the full waiting period at the time ofthe miscarriage.

Edited by feliz6, 08 November 2012 - 05:21 PM.

#7 Dylan's Mummy

Posted 08 November 2012 - 05:23 PM

Most funds havea 12 month wait for obstetrics. The wait starts from when you join a cover that includes obstetrics or from whe you upgrade to a cover that includes obstetrics. Most funds go by when the baby is due. For example if you upgrade/join on 1 December and your baby is due on or after 1 December then you will be covered, even if the baby is early (be sure to check with the funds if they have this in their policy).  If the baby is born prio to the 12 month, They will most likely ask for a certificat from your dr to prove that the baby was due on or after the 12 month mark. So be sure to upgrade about 4 months before you start trying for a baby just to be safe.

I work for a fund and we use the above with our covers.

#8 Kalota

Posted 08 November 2012 - 06:51 PM

Thanks guys. I've investigated further and I am DEFINITELY better off with the teachers fund at the moment for the cover we are looking for.

Now I just need to work out whether to have basic hospital cover or mid-range hospital cover. If I get mid-range, I WILL be covered for pregnancy.

Although my DF and I are not TTC, I am leaning towards just getting obstetrics cover anyway. Because of certain medical circumstances I am not on birth control and I did actually fall accidentally pregnant this year and had a miscarriage - none of the procedures relating to my miscarriage were covered by my private health insurance at the time as I only had BASIC hospital cover, and for this reason I feel like I should get mid-range health cover JUST in case... We also do not know WHEN we want to start TTC yet, and if it is relatively soon that we decide (based on a few life factors), it'd probably be worth just starting up with mid-range hospital cover to cover it just in case it happens.

The waiting period for Teacher's Health Fund is 9 months, but like a PP said, that does't mean anything if your child arrives early or you have a miscarriage etc.

What do you guys think? I don't know what to do!

ETA: A lot of your posts are making me swing towards getting pregnancy/obstetrics cover, purely because of the waiting period dilemmas! Knowing over 12 months in advance when you are going to start TTC is not always what happens! Argh I don't know what to do!

Edited by Kalota, 08 November 2012 - 06:55 PM.

#9 SplashingRainbows

Posted 08 November 2012 - 07:02 PM

If you can comfortably afford the higher premium that is what I would do (did do actually).

If the higher cover would put a strain on finances then I would be more hesitant.

The way I look at it is that insurance is for peace of mind and I was definitely happy to pay for that peace of mind. Not to mention on my policy (nib) the higher premium gave us back more in extras and other benefits too.

#10 Kalota

Posted 08 November 2012 - 07:34 PM

QUOTE (brighton14 @ 08/11/2012, 08:02 PM) <{POST_SNAPBACK}>
If you can comfortably afford the higher premium that is what I would do (did do actually).

If the higher cover would put a strain on finances then I would be more hesitant.

The way I look at it is that insurance is for peace of mind and I was definitely happy to pay for that peace of mind. Not to mention on my policy (nib) the higher premium gave us back more in extras and other benefits too.

Thanks for your reply, brighton original.gif

We can definitely afford the higher premium, it won't be putting a strain on finances per se, but I'm just tossing up whether to save an extra bit of money or not! I guess if it's not putting any strain on fiancnes we may as well just go for the higher cover. We are also opting for a higher excess to lower the premium.

Will have to have a bit more of a think about it, but thank you everyone for your wise and informative responses!

#11 ~spirited~

Posted 09 November 2012 - 12:29 PM

I'm with teachers health, and now so is DH (and DS). We have the starterpak cover (hospital and some extras). We are not covered for obstetrics, but we made the decision prior to TTC that we would go though the public system anyway.

The cover has been worth it for us in terms of extras (mainly physio, dental and optical, and i have just joined a gym and can get some money back on that) but the hospital cover did come in handy last year when DH had day surgery at a private hospital.

#12 Kalota

Posted 09 November 2012 - 06:54 PM

Thanks everyone for the responses! Greatly appreciated!

We have decided not to sign DF up yet, we will wait until he is closer to 30 and then sign him up then (he has no medical issues unlike me and won't be the one having the baby if we conceive biggrin.gif)

So I'm just going to get myself covered with the Teachers Health Fund (by FAR the cheapest for me at the moment) with a mid-level hospital cover with no extras.

DF we are just going to sign up for ambulance membership.

When we are closer to turning 30 we will get a couples/family cover.

Thanks so much everyone for the responses and helping me make my decision!

#13 fleeting

Posted 09 November 2012 - 08:43 PM

We're with them (family of 6) and I haven't been able to fault them. I think we've been members for about 4 years.

#14 Kalota

Posted 10 November 2012 - 09:11 AM

Does anyone know what happens if you're with the Teachers Health Fund, but then you take maternity leave OR an extended break from teaching? Or if you're no longer a member of the union?

#15 José

Posted 10 November 2012 - 09:32 AM

I dint know for certain but in guessing its like the credit union- now the tm bank. Once you've joined ur o.k  to stay.

#16 JaneLane

Posted 10 November 2012 - 09:52 AM

There would be no problem staying with them if you are no longer a member of the union etc. I have been with them since I was born as my mum is a teacher and now my own family policy with them as I am a teachers family member- you don't need to be one yourself to be with them, same with TMB.

I have top hospital and extras family cover which is quite expensive but we do pay a lot less at the dentist etc which is great.  With no excess, they paid the full room fees for both my 5 day hospital stays with my c-section births. If you choose a private OB you don't get much back on their fees at all though. My OB charged $6000 for DS1 and $6500 for DS2 and I think I got back less than $200 for each

#17 puuky

Posted 10 November 2012 - 10:24 AM

As PPs said there is no problem taking maternity leave or an extended break from teaching. I haven't worked or been a financial member of the Union since having my son almost 4yrs ago- no issues.

I'd personally reconsider adding your DP to your PHI, as you never know when you might need it. DH is fit and healthy, but twice in the last few years something unexpected health wise has come up and he has been able to be treated much quicker through the private system rather than going on the public waiting list, and with very little out of pocket expenses.

#18 Kalota

Posted 19 November 2012 - 05:22 PM

Thanks so much for all of the responses everyone! What do you mean you don't get much back if you get a private OB? Coz I've chosen mid-level hospital cover ("private hospital saver") it is called and it is supposed to cover obstetrics and pregnancy, but it is just hospital cover not extras cover, so does that mean it only covers birth in the private hospital or....? I'm a little confused. Thanks so much for any help!

#19 Expelliarmus

Posted 19 November 2012 - 07:19 PM

There's just a lot of gaps is all. It's like that with any fund it's about the OB, not the funds. Funds and Medicare just don't cover it all when using a private specialist.

#20 Kalota

Posted 30 November 2012 - 08:12 PM

QUOTE (howdo @ 19/11/2012, 08:19 PM) <{POST_SNAPBACK}>
There's just a lot of gaps is all. It's like that with any fund it's about the OB, not the funds. Funds and Medicare just don't cover it all when using a private specialist.

Thanks for the clarification, howdo :-)

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