YOU RE ALL ABOUT THEM WE RE ALL ABOUT YOU TOPHOSPITAL

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1 YOU RE ALL ABOUT THEM WE RE ALL ABOUT YOU Our Hospital products provide benefits for a range of services received when you are admitted to hospital as an in-patient. TOPHOSPITAL Top Hospital is our premium product and includes cover for a wide range of services to provide total peace of mind if the unexpected occurs. Effective 1 April 2017

2 TOP HOSPITAL Top Hospital includes all hospital accommodation and theatre expenses at all agreement private hospitals and any public hospital for services covered by Medicare. Top Hospital has a choice of three different excess options, $0, $300 or $500, which is the amount you pay directly towards your hospital admission. The excess amount is only paid once per person per calendar year, to a maximum of twice per membership for Couple, Family, Extended Family, Single Parent and Single Parent Extended Family memberships and is waived for child dependants under the age of 21 or if you are admitted to a public hospital. SERVICE SERVICE HOSPITAL Private hospital (agreement hospital & same day surgeries) Choice of agreement hospital Shared room or private room (where available) Theatre fees, intensive care fees Labour ward fees Public hospital Shared room Private room (where available) Theatre fees, intensive care fees n/a 1 Labour ward fees n/a 1 MEDICAL SERVICES Choice of doctor Access Gap Cover Government approved surgically implanted prostheses 2 HOSPITAL SERVICES Removal of tonsils & adenoids Knee & shoulder investigations & reconstructions Appendicitis treatment Hernias Pregnancy & birth-related services Infertility treatments Hip, knee, shoulder & ankle replacements Coronary care & cardiothoracic surgery Dialysis procedures & treatments Major eye & eye lens surgery Bariatric surgery Psychiatric, rehabilitation & palliative care Sterilisation & reversal of sterilisation All other services where a Medicare benefit is payable Services not covered by Medicare (e.g. cosmetic surgery, laser eye surgery) OTHER 3 Emergency ambulance transport Non-emergency ambulance transport $3,000 per person/ calendar year Disclaimers: 1 Charges associated with these services are included in the accommodation charge that is paid by Teachers Health. 2 Some prostheses may have out-of-pocket expenses. Please contact us on for more information. 3 For more information on emergency and non-emergency ambulance transport visit teachershealth.com.au

3 WAITING PERIODS Waiting periods apply to all Hospital covers and must be served before benefits are paid. They apply to: new members to private health insurance existing Teachers Health members who upgrade to a higher level of cover or reduce their level of excess. In this case you will need to serve the relevant waiting period for the higher benefit entitlement members who transfer from another health fund who have not already completed the required waiting periods or are transferring to a higher level of cover. HOSPITAL WAITING PERIODS Pre-existing conditions Pregnancy & birth-related services Psychiatric, rehabilitation & palliative care All other hospital services Emergency ambulance transport Non-emergency ambulance transport 1 9 months 1 day 1 day WHAT ISN T COVERED There are some services that you may receive in hospital that are not covered by us. These include: telephone charges TV hire, internet access or other items of a non-medical nature surgically implanted prostheses not on the Government Prostheses list and nonprosthetic medical devices that may attract out-of-pocket charges pharmaceuticals that are not covered in the agreement with the hospital or that are listed under the Pharmaceutical Benefits Scheme (PBS) X-rays, scans and other tests benefits for hospital and medical services that do not attract a benefit from Medicare medical services received in a doctor s room any out-of-pocket expenses incurred when you are not admitted to hospital (e.g. doctor/specialist appointments, scans, blood tests etc). PRE-EXISTING CONDITIONS A pre-existing condition is an illness, ailment or condition where the signs or symptoms of which, in the opinion of the Fund Medical Advisor or other relevant medical practitioner appointed by Teachers Health, existed at any time during the six months before taking out private health insurance or transferring to a higher level of cover. This rule applies to: new members to private health insurance existing members who upgrade to a higher level of cover or reduce their level of excess.

4 FROM BOOKS OPEN TIL PENS DOWN WE VE GOT YOU COVERED Our Extras covers support your wellbeing and help you to lead a healthy lifestyle. TOPEXTRAS Top Extras is our premium level of Extras cover, providing generous benefit limits. Effective 1 April 2017

5 Putting you back in the picture of health

6 TOP EXTRAS This product sheet provides a summary of some of the benefits covered. For more information, visit teachershealth.com.au All limits are based on a calendar year from 1 January unless otherwise stated. SERVICE (UP TO) YEARLY LIMIT WAITING PERIOD DENTAL a large number of dental services are claimable. Contact us on to check what is covered. GENERAL DENTAL Periodic oral examination (012) limit of 2 services per person/year $40 Removal of calculus (114) limit of 2 services per person/year $70 Topical application of remineralising agent (121) limit of 2 services per person/year $25 Removal of tooth (311) $90 Filling: adhesive restoration - 3 surfaces (533) $115 MAJOR DENTAL Unlimited (unless otherwise stated) Removal of wisdom teeth requiring removal of bone (323) $170 Increasing limits 1 Removal of wisdom teeth requiring removal of bone & tooth division (324) $240 Year 1 Match existing cover up to $1,300 2 Inlays / Onlays - tooth coloured - 1 surface (551) $273 Year 2 $1,300 Inlays / Onlays - tooth coloured - 2 surfaces (552) $432 Year 3 $1,600 Crown veneered (615) $750 Year 4 $2,100 Bridge pontic direct (642) $520 Year 5 $2,600 Dentures - upper & lower (719) $1,000 Year 6+ $2,800 1 ORTHODONTIA TREATMENT - benefits paid once in a lifetime. Orthodontia year 3 $1,500 Increasing limits 3 Orthodontia year 4 $2,000 Year 3 $1,500 Year 4 $2,000 Orthodontia year 5 $2,500 Year 5+ $2, months OPTICAL Frames $100 Single vision lens pair $120 Bifocal lens pair $135 Multifocal lens pair $165 Contact lenses $175 $260 per person 6 months Disclaimers: 1 Increasing limits are calculated on years of continuous membership of Teachers Health Top Extras cover. 2 Only applies if you are transferring or upgrading your cover where previous benefits included Major Dental, with waiting periods served. 3 Increasing limits for Orthodontia are calculated on years of continuous membership of Teachers Health Top Extras cover and equivalent levels of cover with other health funds.

7 SERVICE (UP TO) YEARLY LIMIT WAITING PERIOD BODY & MIND THERAPIES Chiro & Osteo 1-4 visits $40 Chiro & Osteo 5+ visits $32 Chiro & Osteo group therapy $20 Physio 1-4 visits $40 Physio 5+ visits $32 Physio group therapy / class therapy 4 $20 Exercise physiology 1-4 visits $40 Exercise physiology 5+ visits $32 Exercise physiology - group therapy $20 Ante- or post-natal physio course $78 per confinement Speech therapy 1-4 visits $70 Speech therapy 5+ visits $40 Occupational therapy 1-4 visits $70 Occupational therapy 5+ visits $44 $450 per person $800 per person $600 per person $500 per person Podiatry 1-4 visits $40 $400 per person Podiatry 5+ visits $32 Audiology consultation $45 Unlimited Dietitian 1-4 visits $60 Dietitian 5+ visits $40 $400 per person Hypnotherapy $30 $300 per person Psychology consultation $72 $600 per person Psychology assessment $100 COMPLEMENTARY THERAPIES 5 Acupuncture, Alexander Technique, Aromatherapy, Bowen Therapy, Chinese herbal medicine consultations, Feldenkrais Method, Homeopathy, Kinesiology, Myotherapy, Naturopathy, Reflexology, Remedial Massage, Shiatsu, Western herbal medicine consultation $32 $600 per person HEALTHY LIFESTYLE - visit teachershealth.com.au for a comprehensive list. Weight management 6 Gym membership 6 Pilates 6 Other programs 75% $200 per person 6 months MEDICAL HEALTH Pharmaceuticals (non PBS requiring prescription by law) 7 $60 Home nursing < 6 hours $33 Home nursing > 6 hours $95 $800 per person (sub-limits apply 8 ) $800 per person

8 SERVICE (UP TO) YEARLY LIMIT WAITING PERIOD MEDICAL APPLIANCES CPAP machine purchase (treatment of sleep apnoea) 1 machine every 3 calendar years 75% $900 1 ARTIFICIAL AIDS 9 - visit teachershealth.com.au for a comprehensive list. Blood pressure monitor (purchase) 75% up to $85 Blood glucose monitor 75% up to $160 75% up to $400 (includes $130 Compression garments 10 sub-limit for surgical stockings) Wigs - chemotherapy/alopecia 75% up to $350 Other artificial aids 75% HEARING AIDS $1,200 per person Hearing aids - 1 pair of hearing aids per person every 3 calendar years WHEELCHAIR Increasing Limits 1 Single Pair Years 1-2 $300 $600 Years 2-5 $600 $1,200 Years 5+ $900 $1,800 1 Wheelchair 50% MISCELLANEOUS $1,900 limit every 5 years (sub-limit applies for a manual wheelchair) 24 months Travel 11 15c/km $400 per person EMERGENCY AMBULANCE TRANSPORT Emergency ambulance transport 100% $6,000 per person 1 day 4 $400 sub-limit per person applies to group therapy. Within the group therapy limit, a $200 class therapy sub-limit per person applies. 5 Benefits are for face-to-face consultation only. No benefits for remedies, medicines or food preparations. 6 Must be approved by Teachers Health and received as part of a health management program intended to prevent or ameliorate a specific health condition with a Healthy Lifestyle Program Form submitted every 1. Download the form from teachershealth.com.au 7 Teachers Health 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. Benefits are not payable for contraceptives prescribed in the absence of a medical condition. Evidence of this is required once per 1. 8 $280 sub-limit for erectile dysfunction medication and vaccines. 9 You are required to submit an Aids and Appliances Form every 1 to be eligible to claim a benefit. 10 Compression garments means compression garments used for the treatment of lymphoedema, or the treatment of vascular conditions, or to minimise scarring following severe burns, or prescribed post-surgery, but excludes pregnancy shorts and any sports-related or body enhancing garments. The garment and grade of compression required must be properly assessed and individualised to the patient s specific needs. 11 Actual travel expenses for the patient only, must be for a serious medical or dental 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 specialist medical practitioner, consultant physician or hospital.

9 TOP EXTRAS WAITING PERIODS Waiting periods apply to all Extras covers and must be served before benefits are paid. They apply to: new members to private health insurance existing Teachers Health members who upgrade to a higher level of cover. In this case you will need to serve the relevant waiting period for the higher benefit entitlement members who transfer from another health fund who have not already completed the required waiting periods or are transferring to a higher level of cover. EXTRAS WAITING PERIODS Orthodontia, Wheelchair purchase Major Dental, Medical appliances Optical, Healthy Lifestyle All other services Emergency ambulance transport 24 months 1 6 months 1 day GPO Box 9812 Sydney NSW Overseas callers info@teachershealth.com.au teachershealth.com.au The information contained within this brochure is current at the time of printing. Membership of Teachers Health is available to current and prior education union members and their families. Fund policyholders and those covered under a policy are subject to the rules and conditions of Teachers Health as well as applicable government legislation and laws. This brochure contains a summary of the main rules and conditions. Contribution rates and benefits are subject to change. Fund policyholders are encouraged to review the Teachers Health Privacy Policy, available at teachershealth.com.au. Teachers Health is a signatory to the Private Health Insurance Code of Conduct. Teachers Federation Health Ltd ABN trading as Teachers Health. A Registered Private Health Insurer. THF-TEPS-04/17