An appalling health fund
I have been a continual member of a private health fund since 1977. I recently switched to THF and was appalled at lack of service and embarrassed when standing at a medical practitioner's counter only to find claims were rejected even though I had full extras cover.
Don't waste your money
Paying TH for 3 years only to find out 12 hour before going to hospital, that my procedure (male reproductive system) is not covered under the basic hospital level. Three of the other funds that I checked DO include this in their basic plan.
I have guess teacher's don't have prostate problems.
I wasted about $14000 being a member of TH. Stay away from these rip offs
Read their PDS very very carefully and make sure you compare $ for $ what you get with other funds.
Health Partners was the one for us.
Poor call centre service standards
I recently tried to call THF to discuss my policy with them. After several attempts and being placed on hold for long periods I nominated for a same day call back. Several days later and I haven’t been contacted.
I since contacted THF by email and received an automatic reply saying they are busy and would respond within 8 working days; that’s nearly 2 weeks.
How can any organisation with this service standard say it is customer focused?
If you do want to join this fund they will gladly talk to you straight away and take your money. However, if you have an enquiry, be prepared for the fact that you won’t be able to get through to speak to a person at the fund.
I have been a member for over 40 years and usually pay a year in advance to avoid the price increase. This year because of circumstances beyond my control I was one week late and therefore was denied the discounted rate. Don't
expect any loyalty or special consideration from this fund even if you have been a long term member
Benefits great, Service appalling, attitude just as bad.
We contacted the fund on 26 February to inform them that our daughter had decided not to return to Uni and we wanted to keep her on our medical aid until her birthday in October this year. They informed us of the New rate of instalment and in fact told us that would be effective 1 April. So we thought that was great and moved on.
On Wednesday 27th my younger daughter informed me that the Hicaps system had declined to contribute to the Chiro and stated it as unfunded. This had caused her a fair degree of embarrassment. I thought it strange and phoned the support line at 4.54pm AEST. The call went to a service where they hold your place and ring you back. Never happened.
My partner logged onto the system and verified that it seemed to be unfunded from 22 March. She sent them an email trying to understand what this meant.
I phone at 8.56 am AEST on Thursday and got through after a fairly long hold time. It was confirmed to me that it was unfunded. I pointed out that the payment goes through monthly and that these were my issues.
1. They hold a debit order and could charge my account at any time if there was a shortfall because of the change to my subscription.
2. That at no stage did anyone give us an option or point out that we would be in arrears at some point in March. They didn't give us an option to pay that shortfall.
3. That no-one communicated to us when it went into arrears on 22 March.
I was told that it would clear when my next debit order went through. I asked what would happen if I was taken into a hospital - they said they would phone me - wow I have had a problem in June 2017 and would have been in no state to deal with this at that time.
They were dismissive of my points 1 to 3 above and you could hear the comment it's only a few days and she can submit the claim again and again throughout the conversation. I asked to be put through to a supervisor - That's not their policy and they won't escalate any problem that you feel is not being adequately addressed.
I then looked on their website and found a media and complaints number that is different and phoned that but it goes into the same queuing system.
We then went online and paid via credit card more than a month's subscriptions. We relogged into the system after the credit card payment had gone through and found that the system did not update our status. Despite the amount being approved online.
We checked the next morning and then our account had been updated.
Our email of Wednesday was only replied to on Saturday saying they noted we had spoken to someone else earlier.
I would advise all members to be very careful given that Private medical is really for unexpected medical issues and at that time you really are in no state to have issues with your subscription, that the call centre is really not there to help but want you to go away. That the time waiting for them to answer is unbelievable and they won't even tell you what number you are in the queue.
There is no way you can complain as there are no numbers to call and you cannot get to speak to a supervisor. Nor would they even take up my problem in that I believe they failed in their duty to provide me with a full understanding when I made these changes and that they had the power to put through a debit charge to rectify the shortfall and that being unfunded was a serious outcome and one I did not want to have. It's easy to put in a grace period until the next debit order into your program - after all, I must have been a member for over 5 years and have never had a financial problem. Or to initiate a debit for the shortfall or to even ask me to pay that shortfall over the phone.
Really the benefits are good as are most under the Members Own umbrella but the service and attitudes are appalling.
Very prompt to get premium deducted but extremely slow in processing claims with excuses of additional documents and paperwork.Member in Top Cover for more then 25 years and never felt so frustrated.
After taking out top cover to have a baby, I found that none of my claims were being looked at within 3-5 days (the period they say claims will be processed by), let alone processed. They take at least 2 weeks and then there always seemed to be something wrong or ‘missing’ I had to chase up. I am paying over $200 a month (just for me) and feel like they make it extremely difficult to get any money back. Their customer service is abhorrent and you get told different things by every person you speak to. If I wrote down all the things they have done wrong during my time with them, I’d be writing pages- but bottom line is that I only got some of my claims paid after threatening to speak to the Ombudsman (also the only time they processed anything in a timely manner). The first thing I plan on doing when I leave the hospital with my newborn is switching health funds because my experience with them since I actually started claiming anything has been horrendous. I’d strongly suggest that you go with a different health fund, or even no health fund would be better!
CLAIMS are a nightmare
They are quite happy to take your money and will process payments eagerly, dont expect to get a claim back within two weeks, if theres something stupid with the claim they will make you resubmit and wait another two weeks at MIN. if you have another health fund with equal cover go there, customer service is woeful
Member (Top Hospital/Top Extras) for 11 years and would advise you to stay away!
Teachers Health Fund member since 2007 - Top Extras, Top Hospital. Paying $99 a week for a family. Firstly, be prepared to wait up to two weeks for your claims to be processed. Secondly, getting through when you try to call them outside of school hours is nothing short of a nightmare. Finally, I made four claims under the Healthy Lifestyle Benefit for gym memberships after being advised of our eligibility due to lifelong medical conditions. I was told that I had up to two years to send the receipt accompanied by the Healthy Lifestyle Form filled out by a medical practitioner. Did exactly as advised. Two of the claims were paid the other two 'knocked back'. Same receipt. All filled out in January for the previous year. Asked for a review but told multiple times "so there are no surprises" that I should "not expect the decision to be overturned". I will go back to the doctor's if I have to and have him explicitly state that my family members had those conditions in 2018 and resubmit the claims. Thanks for wasting my time Teachers Health! Given the poor customer service, weekly cost and very few claims I have made over the past 11 years - I will be reassessing my Teachers Health Fund membership. Four claims. Two processed. Two refused. All the same. THF you really need to get your act together! Would not recommend.
Teachers Health for us!!
We have been with Teachers Health for probably 20 years, and largely been quite happy. However, with the rising rates over the last few years I decided to do some research. I contacted several 'Independent' groups and have spent much of my day on the phone. One person strongly recommended Australian Unity, and I was looking at changing, to save $600 per year, although being aware of less total cover for several extras (chiropractic, dental etc) Interestingly, whilst asking for time to contemplate the change, I was phoned by 2 others from other 'Independent' groups. Each worked through our usage, and cover needed, admitted that we'd be best to stay as we were, with Teacher's Health. So I really appreciated their honesty, as they would receive no commission etc from changing us, and admitted that we had the best cover for our current needs. How refreshing! But also reassuring that we are best to stay with Teachers Health. We feel we get good cover, prompt payments through the online system, and just have to cop these increases in costs as we do with so much today.
Claims becoming a joke.
I have been a member for 20 years and now they seem to have worked put a way to sliw down claims. I paid up front for my daughters dental surgery. I sent them the invoice from the provider which is exactly the same as previous claims and they say they cant pay it because the providers address isnt on the invoice. He has provided his provider number which should be enough. I call to clear it up and spends 25 mins waiting whilst listening to some pre recorded whiney voice singing their own praises. Pathetic service. I pay for top cover to cop this. Rubbish.
Disgusting ... shonky liars ... zero care ...
DISGUSTING !!!! Moved from another fund, was quoted wrong amount then they charged us more due to their error !!! No policy documents received, won’t help or honour their quote which we accepted so now moving to another fund ... BEYOND APALLING !!!!
T van Os
Caring for the individual
we have been with Teachers Health for 3 years but found we had an issue with our cover...I have to write and say thank you to Teachers health Fund . We felt definitely more than just a number and our needs were well and truly met !!!
In order to ensure I had the right cover and to assist us in making sure my son had the best care and cover he could have, Emilio Santos (rep) went beyond the call of duty to help us. THANK YOU , Thea
No Less Expensive
Transferred across to TUH three years ago because their premiums at the time were much more competitive than the two big private health insurers. (Plus, members could pay twelve months in advance and delay paying the increase until the following year; now members can only pay six months in advance.) However, in the past eighteen months the premiums have increased dramatically and now we are no better off. Also, we became entitled to an increased government rebate on premiums but it seems the company is the only one who benefits because the premium increase took all the government rebate and then some; so even though our rebate increased the premium was still much more than it was the previous year. As for making a claim, we've only had two minor in-hospital procedures (under $500 each) which were billed directly by the medical provider and we didn't have to deal with the fund or pay any out-of-pocket; happy with that aspect of the Fund but we paid much more in premium increases. The Funds say legislation will not allow them to offer "no claim bonuses" but really, if you're not using the benefits you shouldn't have to pay to prop up those who do. Yes, I know that's how insurance works but when the premiums amount to thousands of dollars a year, those who haven't had a claim shouldn't be hit with a massive premium increase.
Staff no assistance
My wife and I have been members for 20 years. Recently she had to have a day procedure some of which was covered by Medicare and part by Teachers Health. Around $2,500. Earlier I was told by someone in their office to pay up front then claim back. I then phoned their office and asked how to lodge the forms.
Lodge a 2 way form I was told.
What do I do with the form? You can take it to a Medicare office and then they will send it to us after they have paid.
The closest office is about 30 minutes away I told them. Well you can mail it to them they said.
Is there any easier way I asked?
You could send it to us. And what do you then do?
We send it to Medicare for you and then they send it back to us.
How long does this take I asked.
Around 6 to 8 weeks - they said.
I then made a few enquiries.
Use your MyGov account and link Medicare to it. Easy to open a MyGov acct.
Scan your receipts and lodge online through the Medicare link.
Did that and have the first part of the refund back in 4 days.
WHAT IS WRONG WITH THESE PEOPLE!! It's stressful enough having to go to hospital and pay out a fortune without having to deal with this totally useless organisation.
Greater than 20 years. I having been trying to claim for a service for more then 3 months. Teachers health keep delaying payment wanting a two way Medicare form but the provider claimed the Medicare on or behalf. This form is a waste of time because we have sent proof of payment and they know exactly the payment required. Teachers health did not assist with this extra paper work. It should be linked with Medicare!
Terrible customer service. Refusal to pay up front, then makes claiming difficult
Teachers Health have left me nothing short of broke. I was forced to pay for an entire surgery and my hospital stay up front. Then when it’s time to claim they make the whole process tedious and time wasting. Their loose words in their policy outline leaves the customer believing they are covered but then label things as ‘restricted’. I have heard that all insurance companies are the same but the staff at St Vincent’s Private were speechless after my recent surgery at how I was left to pay the entire amount up front, then claiming what little entitlement I can back, they wanted a receipt of payment (when the itemised Tax Statement showed $0.00 balance?)
Will probably serve all my waiting periods before I receive my card
Signed up on the 5 June, is now 24 July. Still haven't received my card. I rang them to check whether it had been sent. "It's in the mail," they said. It's not. It's been a week. Would like to be not lied to and to be able to use the service I'm paying for. How hard is it to send out a membership card?
I have been with THF for over five years. I was very impressed at the beginning but it seems loyalty doesn’t count, only dates and data. I was in top hospital cover for over four years, after having my kids I dropped it back to basic and then five months later upgraded again to mid cover. I get a phone call three days out from surgery that I’m not covered and still on a ‘waiting’ period. I have now had to cancel my surgery and wait in pain till I can get in again. Appreciation for being a long time top cover member is not even looked at, with less than two months left to wait for being on 12 months mid cover. Very impersonal service and a focus on data and dates has left a long time customer I’m chronic pain and looking for over health funds.
Long waiting time and unacceptable customer service.
I have been very disappointed with Teachers’s Health “ so far. Any correspondence I have made by the phone or email has not been responded to promptly . Lengthy delays on the phone and emails are answered up to 10 days later. I am EXTREMELY DISAPPOINTED in the time it takes to get your tax benefit statement. I made an appointment with my accountant based on previous years and had to postpone my appointment. To top this off I am going overseas Wednesday for 12 weeks and this has put a REAL spanner in the works. How hard is it?
When I swapped over from NIB I was assured quality customer service. I can only hope things improve, otherwise I will be changing back to NIB who pride themselves in customer service and organisation.
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