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Teachers Health Fund

Teachers Health Fund

2.1 from 59 reviews

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.

Value for Money
Transparency
Customer Service
Plan CoverageHospital and extras
Claim MadeNo
Book AgainNo
1 comment
Hi Phillip, This does sound very unusual (and very frustrating!) if you have our Top Extras cover like you say. We’re certainly sorry for your experience, it’s definitely not what our members can expect from us. If you had benefits available then maybe it was a problem with HICAPS on the particular day, but unfortunately without a membership number we can’t look into your membership to investigate exactly what happened. If you’d like us to look into this further, please message us directly with your full name and member number, and someone from our team will be in touch. Thanks, Teachers Health

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.

John D
Adelaide

Value for Money
Transparency
Customer Service
Plan CoverageHospital and extras
Coverage TypeCouple
Claim MadeNo
Book AgainNo
4 comments
Hi John, The Teachers Health cover you opted for (Basic Hospital) mainly gives you the option to access the public system as a private patient. But additionally it also provides cover for a private hospital admission for a small range of services. When you opt for a lower level product like Basic Hospital you’re deciding against a higher level of cover for any services that we list as ‘Restricted’ (in our membership info and on our website). So it’s important to fully understand the cover you’ve chosen. We’ve reviewed the other health funds and among this basic level of cover, the majority of funds completely exclude ‘Male reproductive system’ – whereas we do provide cover as a private patient in a public hospital. Those funds that do include this surgery exclude a wide range of other services. There are lots of different products in the market covering different services and we know that it can be confusing, so we always encourage members to call us before any planned surgery to check exactly what you’re covered for if you’re not sure. And we have a range of hospital products available to meet the varying needs and budgets of our members – our Top Hospital product ensures you’re covered for any unexpected procedure. We can’t comment on your individual membership (any additional Extras cover you had or lifetime health cover loadings etc.) but the cost of our Basic Hospital product alone is approximately half of the cost you mention over a 3-year period. Regards, Teachers HealthNo. You haven't checked properly. The basic cover at the fund I have changed to DEFINITELY INCLUDES MALE REPRODUCTIVE SYSTEMS. Stop misleading the readers of this forum.Hi John, As we said, we’ve reviewed the other health funds and among this basic level of cover, the majority of funds completely exclude ‘Male reproductive system’ – whereas we do provide cover as a private patient in a public hospital. Those funds that do include this surgery exclude a wide range of other services. Regards, Teachers Health

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

Value for Money
Transparency
Customer Service
Plan CoverageHospital and extras
Coverage TypeSingle
Claim MadeNo
1 comment
Thanks for your feedback about being able to speak to someone here when you need to – any feedback is appreciated as it gives us an opportunity to improve. We do tend to see certain periods in health insurance which are busier for our contact centre staff than others (end of financial year etc.) and unfortunately during those times we might take longer to reply than usual. But our members’ experience is really important to us – it’s actually at the heart of our organisation’s values – and we’re looking at ways to improve our capabilities and so better support our members through those busy times. Thank you – Ben

Annual fees

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

Customer Service
Plan CoverageHospital and extras
Coverage TypeFamily
Claim MadeNo
Book AgainNo
2 comments
Hi Franca, Thank you for being a long-time member of Teachers Health – the fact you’re a loyal member is certainly not lost on us. We understand your frustration but unfortunately, to ensure equity for all members, we must abide by the cut-off dates that were communicated earlier this year. Communications regarding advanced payments were sent to members in early February this year. We do try to assist our members where possible, but we hope you can understand our position and reasoning behind this decision. Thanks - EvyNo I don’t accept it. The facts that the fund is supposed to be a non for profit organisation serving the interests of your members and it only manages to get a 2.1 rating on the product review site is a strong indiication that there is a serious failure within your management and it’s treatment of members.

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.

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeFamily Extension
Claim MadeNo
3 comments
Hi Joe W, A disappointing experience for you, and a disappointment to us that you that your family’s experience was not as it could have been. We understand how stressful it is when you’re in need of a service covered by your membership and we strive to be there to help at every step of the way. Your experience is not what we want for our members; and our sincere apologies to you and your daughter. When any member makes a change to their cover over the phone, our standard process is to explain to them during the call how their cover will be impacted. This includes whether their policy will go into arrears at any time. If the policy will go into arrears, the member should be made aware that their future direct debit will be for a larger amount. Alternatively, the member can make a manual payment to ensure their policy is financial, should they have any services coming up, or should the unexpected occur. Unfortunately, it appears that this process was not followed and the payment options not provided to you in this instance. We want to stress that your feedback has been noted and appreciated. We will provide coaching to our team members about the correct procedures to follow, and the impact on members when this doesn’t happen. Additionally, we do send members a confirmation letter when a membership change is made, this includes payment-related information. It sounds like this letter never reached you. We do have a complaints handling policy which we take very seriously. It’s important to us that we invite both negative and positive feedback, so we can improve where we may be falling short. You can read more at teachershealth.com.au/complaints. Should you wish to discuss this matter further you can also email our complaints team directly via complaints@teachershealth.com.au. Thank you for letting us know about your experience Joe, again our apologies. Thanks - EvyThanks for that I will certainly detail the incident more fully in a complaints email. I, however, think that critical to a number of comments that are recently being highlighted here are the claims system, The long wait times to get through to people and in my case the rigid policy of not allowing the member to speak to someone higher up in the organisation if you believe your issue has not been adequately dealt with. I am somewhat surprised that after all these complaints by others as well as myself that the organisation doesn't even need my details to verify the facts as I have stated. This seems to re-enforce my feeling that all these problems can be solved very simply and easily. Firstly at each change, the person could ask for a telephonic payment or to create a manual debit. No organisation should prohibit a customer from accessing a person higher up in the organisation if you feel the issue isn't being addressed. The only logical reason to do this is if the organisation doesn't really care about fixing the problem. Then as a very easy fix, any payment made via credit card on the website could be applied immediately it is approved. Or in the alternative, all members should be allowed to go 14 days into arrears - after all this is a teachers health fund and their families. However, I will take the time over the weekend to send in an email with all my details so that I can receive a more appropriate response.Hi Joe W, Thank you for taking the time to let us know more detail about your experience. We take feedback and complaints seriously, and be assured you’ll be dealing with an appropriately trained team member who can investigate. With privacy as a top priority, we won’t detail specific member information in a public forum. That’s why we invited you to email complaints@teachershealth.com.au in our reply so we can discuss your concern further. I’d expect the discussion with you to include all the points you’ve raised, as well as any other concerns that come to light. We understand frustration with call wait times, they’ve been longer than usual as we go through one of the busiest times for private health insurance – 1 April. It’s been made even busier this year with the Government’s Private Health Insurance Reforms. While we’ve implemented steps to address call volumes, it’s something we’ll continue to look at and address. We’re for teachers, and we know that waiting on the phone is not the best use of their time. Thanks again for taking the time to detail your experience as helps us identify areas of improvement. We look forward to hearing from you. Thanks - Evy

FRUSTRATED MEMBER

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.

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeCouple
Claim MadeYes
Claim DateFebruary 2019
Claim ApprovedNo
1 comment
Hi James, We’re sorry to hear about your recent experiences with claiming with us and for any inconvenience caused from delays. In order to process member claims, we do require all the necessary information and documents that are relevant to each claim. This is because as a private health fund, we are governed by strict rules on what we can and cannot pay for, and we need all supporting documentation and information to ensure we’re compliant. Unfortunately, this can occasionally slow down how fast we can process your claim. We do try to be as transparent as possible by providing information on how to claim on our website at teachershealth.com.au/members/making-a-claim/claiming-for-extras. With the above in mind, we’d like to chat to you to see if we can assist with the issues you’re facing and to also see how we can improve our processes for the future. We’ve been experiencing a higher number of claims than usual lately but we’re working to improve member experience. If you would like to get in contact with us, please send an email to social@teachershealth.com.au with your member number, name, DOB and address and our team will look out for your email and get in touch. Please note, however, we can’t guarantee the security of information sent via email, so if you’d prefer to speak to us over the phone instead, the easiest way would be to request a call back via teachershealth.com.au/contact-us and we’ll get back to you at a time that suits you. Thank you - Evy

Horrifying Experience

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!

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeSingle
Claim MadeYes
1 comment
Hi DelMac, We’re sorry to hear about your recent experiences with claiming. Two weeks is not our usual turnaround time for the payment of claims, in recent weeks we have been experiencing higher than normal volumes of claims and are currently working to address this. Our members are at the heart of what we do, so we’d like to chat to you to see if we can assist with the issues you’re facing, but also to see how we can improve processes for the future. If you would like to get in contact with us please send an email to social@teachershealth.com.au with your member number, name, DOB and address and our team will look out for your email and get in touch. Please note, however, we can’t guarantee the security of information sent via email, so if you’d prefer to speak to us over the phone instead, the easiest way would be to request a call back via teachershealth.com.au/contact-us and we’ll get back to you at a time that suits you. Take care - Catherine

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

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeFamily
Claim MadeYes
Claim Resolution Time2-4 weeks
Claim DateFebruary 2019
Claim ApprovedNo
1 comment
Hi Dave, We’re sorry to hear about your recent experiences with claiming. We do have rules to avoid fraudulent claims and to ensure that our members are receiving care from qualified providers. These rules include what must be displayed on receipts. If you want further information about this you can visit -www.teachershealth.com.au/members/making-a-claim/claiming-for-extras. Two weeks is not our usual turnaround time for payments of claims and we’d like to chat to you to see if we can assist with the issues you’re facing, but also to see how we can improve processes for the future. If you would like to get in contact with us please send an email to @teachershealth.com.au with your member number, name, DOB and address and our team will look out for your email and get in touch. Please note, however, we can’t guarantee the security of information sent via email, so if you’d prefer to speak to us over the phone instead, the easiest way would be to request a call back via teachershealth.com.au/contact-us and we’ll get back to you at a time that suits you. Thanks, Kristy

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.

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeFamily
Claim MadeYes
Claim DateJanuary 2019
Claim ApprovedNo
1 comment
Hi Mel E, We’re sorry to hear your recent experiences – it’s certainly not the type of experience we want our members to go through! We thank you for taking the time out to give us your feedback, as our member experience is important to us and we are always looking for ways to improve our services. Please be assured that when we’re asked to review a decision, we do so with our members’ experience in mind. We would like to look into this for you to see how we can help and improve on this in future. If possible, can you please contact us so we can get the full picture of your situation? All you need to do is email us at social@teachershealth.com.au with your member number, name, DOB and address and our team will look out for your email and get in touch. Please note, however, we can’t guarantee the security of information sent via email, so if you’d prefer to speak to us over the phone instead, the easiest way would be to request a call back via www.teachershealth.com.au/contact-us and we’ll get back to you at a time that suits you. Take care – Catherine

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.

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeCouple
Claim MadeYes
Claim Resolution Time<1 week
Claim ApprovedYes
1 comment
Hi Di, Thanks so much for your review and continued support for Teachers Health over 20 years! That’s truly wonderful. We don’t make any premium increases lightly but factors such as rising costs in health care, increased claims and an aging population sets the tone for these rates. As a not-for-profit fund, we do work hard to try and keep these premiums as low as we possibly can, whilst remaining financially stable. Thanks for sharing your findings. Best regards – THF

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.

Value for Money
Customer Service
Plan CoverageHospital and extras
Coverage TypeFamily Extension
Claim MadeYes
Claim DateJanuary 2019
Claim ApprovedNo
2 comments
Hi Palmfish, We’re sorry to hear about your recent experiences with claiming. It is true that we require receipts that must be on official letterhead or stamped with a provider stamp containing the address where the service was provided – please see www.teachershealth.com.au/members/making-a-claim/claiming-for-extras for more details. This is just a standard requirement for health funds and is done to prevent fraudulent claims. That being said, we’d like to chat to you about your experience and see if there’s any way we can help, and also to see how we can improve our processes in future. Could you please email us at social@teachershealth.com.au with your member number, name, DOB and address? My team and I will look out for your email. Please note, however, we can’t guarantee the security of information sent via email so if you’d prefer to speak to us over the phone instead, just call us on 1300 728 188 or you can also request a call back via https://www.teachershealth.com.au/contact-us/ We hope to hear from you soon. Take care – CatherineNo thanks.

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 !!!!

Insurance claim madeNo
1 comment
Hi Dancer D, We are sorry to hear about your recent experience moving funds and we apologise for any inconvenience this has caused you. Our members are at the heart of what we do so we do try our best, but by the looks of your message, things got a little messy on our end and we are currently investigating as to how this happened. Although you have voiced that you’re changing funds from ours, we would love the opportunity to chat with you to see if we can rectify anything for you and to improve our processes to avoid this happening again. If you have a moment could you please email us at social@teachershealth.com.au with your member number, name, DOB and address? My team and I will look out for your email. Please note, however, we can’t guarantee the security of information sent via email so if you feel more comfortable you are more than welcome to contact us on 1300 728 188 or request a call back via the following page and one of the team will be in touch at a time that suits you: https://www.teachershealth.com.au/contact-us/ We hope to hear from you soon. Take care – Catherine

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

Insurance claim madeYes
1 comment
Hi T van Os, We’re happy that you’re happy! Thank you for leaving us a review. We’ve passed this message on to Emilio. Thanks - THF

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.

Insurance claim madeYes
1 comment
Hi C. ANDERSEN, It sounds like you may be referring to TUH in your review. We’re Teachers Health (THF). We’re very different. Teachers Health is exclusively for members of the education community and their families. You can learn more about us at www.teachershealth.com.au. Thanks - THF

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.

Insurance claim madeYes
1 comment
Hi Illusion2000, We understand how stressful it is to go into hospital and we certainly strive to be there to help members at every step of the way. If a doctor or specialist is participating in the Access Gap Cover (AGC) scheme they will generally send any AGC bills direct to Teachers Health for payment. If a doctor or specialist is NOT participating in the Access Gap Cover (AGC) scheme, bills need to be taken directly to Medicare who will process the claim before we can pay any benefits - this may have been the case here. We’re sorry to read that you found the process wasn’t explained to you at full. We thank you for your feedback and would like to review the situation. Could you please send us an email to social@teachershealth.com.au from the email address we have on file for you? Or if you’re unsure of what that email is, please call us on 1300 728 188 and a team member can assist. Thanks - THF

Difficulty claiming

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!

Insurance claim madeYes
3 comments
Hi James, Thanks for your feedback. We do appreciate that you are frustrated over this situation and we’d like to look into this for you. Please send an email to social@teachershealth.com.au with your best contact number and member number and someone will be in touch. Thanks -THFI have sent many emails and forms but teaches still want more dispite me sending the Medicare details they want. Just make it easy and sort out your paper work in this electronic world. It is total that teachers can't pay their share until Medicare does. And why can medicare (gov) pay within 24hr of lodgement and teachers take longer then 3mths....Hi James, Thanks for your reply. We’d really like the chance to talk to you, so we can have a better understanding of the issues you faced as we agree, three months is a long time to process a claim and we certainly don’t usually take this long. Please email us at social@teachershealth.com.au with this comment and your best contact number and we’ll arrange for a team member to call you. Thanks – THF

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?)

Insurance claim madeYes
1 comment
Hi AJM, We’re sorry you’re disappointed in us. If this was a planned admission, the hospital should have conducted an eligibility check at least one week before your admission, during which time we encourage members to contact us so we can confirm what you’re covered for, and any potential out-of-pocket charges for your procedure. We’d like to look into this further for you and get a better understanding of your situation. Please can you send an email to social@teachershealth.com.au with this comment and your member number so we can get in touch. Thanks - THF

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?

Insurance claim madeNo
1 comment
Hi Jesse, You’re right, you should have received your card by now as it’s been a while since you joined. It may have been lost in the mail so we’d like to send you another card. Can you please send an email to social@teachershealth.com.au with this comment and your member number and I’ll arrange for someone to be in touch and re-order it for you. While we organise another card for you, you can start claiming on Extras straight away (if applicable waiting periods have been served) via our Teachers Health member app. All you need to do is download the app via the iTunes Store or Google Play, take a photo of your receipt and submit it via the app. You can also submit claims via Online Member Services (OMS) at online.teachershealth.com.au. For more info visit www.teachershealth.com.au/members/making-a-claim/claiming-for-extras. Thanks - THF

Impersonal service

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.

Insurance claim madeNo
1 comment
Hi KJC, We do appreciate your frustration but waiting periods are essential to keep health insurance fair for everyone. They’re put in place to protect all health fund members and so we don’t waive them. Unfortunately this does mean that sometimes you do need to wait a period of time before you can claim, including if you upgrade your cover to include things that weren’t covered before. We understand this can be upsetting when surgery is needed, but without waiting periods there is the possibility that people would simply wait until they needed a service and then take out the required level of private health insurance – which wouldn’t be fair to those members who maintain their level of cover. We do always encourage members to get in touch if they have any questions about their policy. If there’s anything else you’d like to discuss, please feel free to contact us on 1300 728 188 or email social@teachershealth.com.au. Thanks - THF

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.

Insurance claim madeYes
1 comment
Hi, We’re sorry to hear you’re disappointed with us. Each year we work hard to get statements out to members as soon as possible. The legislative deadline for health funds to return tax statements is 15 July. Our statements will be available on Online Member Services from tomorrow: https://online.teachershealth.com.au/ Thank you for your feedback about response times – it’s appreciated and helps us to improve. We’d like to get in touch with you to discuss your concerns. Please send an email to social@teachershealth.com.au with this comment and your member number and someone will be in touch. Thanks - THF

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Questions & Answers

Has anyone switched from Bupa (Advantage Hospital/Silver extras) to the Teachers Health Fund? I've tried previously to compare the two but it's a very complicated task. Bupa is costing me a packet. I'm a teacher, so I could do this move.
3 answers
I am unable to offer anything about Bupa, sorry. I have compared one or two other funds with the intention of moving to another fund, but owing to having built up loyalty benefits for years' of service, with higher benefits paid to me if the need arose, I would lose these higher benefits if I was to leave Teachers Health.Hi there, We can help compare your current health product with an equivalent Teachers Health product. We will provide you with a personalised, side-by-side comparison of the cost and benefits from each product. Just fill in this form on our website: https://www.teachershealth.com.au/compare Thanks -THFMuch appreciated both respondents here. Thank you!

Details

Teachers Health Fund
Contact Number 1300 727 538
24-Hour Phone Contact No
Online Live Chat No

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