| Teachers Health | |
|---|---|
| Registered insurer | Teachers Federation Health Ltd (Teachers Health) |
| Who can join | Restricted: education union members and their families |
| Business structure | Member-owned mutual, not-for-profit |
| Hospital policies (30 June 2025) | 185,012 (3.0% of all hospital policies), covering 409,371 people |
| Hospital tiers on sale (1 September 2026) | Gold, Silver Plus, Basic Plus |
| Excess options on open hospital policies | $300, $500 |
| Age-based discount (18-29) | Not offered on its open hospital policies |
| Ambulance | Emergency and non-emergency ambulance included on its open hospital policies |
| Question | What the official data shows |
|---|---|
| Out-of-pocket costs in hospital | 89.9% of in-hospital medical services had no gap for the member (industry 87.1%), and 89.4% of hospital charges were covered (industry 89.0%), 2024-25 |
| Waiting periods and pre-existing conditions | The legal maximums apply: 12 months for a pre-existing condition (signs or symptoms in the 6 months before you joined or upgraded) and for pregnancy and birth, 2 months for other hospital treatment. Every hospital policy open to new members in the Government's data at 1 October 2026, at every fund, used the 12-month pre-existing wait |
| Switching from another fund | Waits you've already served on the same or a lower level of cover carry across to Teachers Health, and from it. Ask your old fund for a clearance certificate and keep the break between policies short |
| The Medicare Levy Surcharge | Excess options on its open hospital policies go up to $500, so all are within the $750 singles limit, and every policy was flagged as meeting the surcharge rules in the Government's data at 1 October 2026 |
| Adult children (dependants) | Up to age 31, studying or not, in the fund's own record (Government data, 1 October 2026). Adult dependants often need an extended family option |
| Claims experience | 2.2% of Ombudsman complaints about insurers on a 2.6% market share (ratio 0.85), and 5.5% of the complaints the Ombudsman investigated, 2024-25 |
General advice only. This information doesn't take into account your objectives, financial situation or needs. Consider whether the product is right for you and read the Product Disclosure Statement (PDS) and Target Market Determination (TMD) before you decide. We don't compare every product in the market, and we may earn a commission if you take up a product through our links.
Who can join Teachers Health
Its PrivateHealth.gov.au record says membership is open to current and former members of education unions, including primary, secondary and tertiary teachers, teachers' aides, lecturers, and support and administration staff from public, private and independent institutions, plus the family members of eligible people. Its other brands have their own eligibility rules, so check with the fund if you're joining through one of them.
PrivateHealth.gov.au lists Teachers Health as a mutual organisation operating on a not-for-profit basis, based in Sydney.
Benefits: among the highest payout ratios
Teachers Health paid 90.3% of its premium income as benefits in 2024-25, against an industry result of 84.5%. Management expenses were 11.9% (industry 10.9%). Retention was 91.8%, well above the industry's 85.0%.
Hospital charges covered were 89.4% and 89.9% of in-hospital medical services had no gap (industry 89.0% and 87.1%). Extras paid 42.8% of charges on average, below the industry's 50.7%.
Complaints
Teachers Health accounted for 2.2% of Ombudsman complaints against a 2.6% market share, slightly under its size. Its share of investigated complaints was 5.5%, about double its market share.
What Teachers Health sells
Its open hospital policies at 1 September 2026 are Gold, Silver Plus and Basic Plus, with $300 and $500 excess options. There was no Bronze-tier policy. None were listed with the age-based discount. All include emergency and non-emergency ambulance.
Teachers Health against the industry: 2024-25 data
Every year the Private Health Insurance Ombudsman compares all insurers on the same measures, and PrivateHealth.gov.au republishes the results on each insurer's profile. The table below is Teachers Health's, with the industry result beside each figure. Its complaints-to-market-share ratio was 0.85: a figure of 1.00 means complaints exactly in proportion to size.
| Measure | Teachers Health | Industry | Reading |
|---|---|---|---|
| Share of all Ombudsman complaints | 2.2% | Market share 2.6% | Fewer complaints than its size |
| Share of investigated complaints | 5.5% | Market share 2.6% | |
| Member retention (hospital cover) | 91.8% | 85.0% | Better than industry |
| Benefits paid as % of premiums | 90.3% | 84.5% | Better than industry |
| Management expenses % of premium income | 11.9% | 10.9% | Weaker than industry |
| Hospital charges covered | 89.4% | 89.0% | In line with industry |
| Medical services with no gap | 89.9% | 87.1% | Better than industry |
| Medical services with no gap or a known gap | 97.2% | 97.1% | In line with industry |
| Extras (general treatment) charges covered | 42.8% | 50.7% | Weaker than industry |
How to read it: complaint share is the fairest single comparison of service across funds of different sizes, because it's measured against market share. Benefits as a % of premiums shows how much of the premium pool went back to members as claims; a mutual that returns more is not necessarily cheaper, and a fund can move this figure by changing prices. The gap measures show how often members avoided an out-of-pocket medical bill after a hospital stay, which is what most people mean by "good cover".
Hospital agreements
| ACT | NSW | VIC | QLD | SA | WA | TAS | NT | |
|---|---|---|---|---|---|---|---|---|
| Private hospitals | 5 | 84 | 66 | 50 | 17 | 21 | 7 | 1 |
| Most held by any insurer | 7 | 95 | 73 | 63 | 17 | 23 | 7 | 1 |
| Day hospitals | 8 | 89 | 58 | 46 | 26 | 22 | 9 | 2 |
| Most held by any insurer | 11 | 109 | 73 | 58 | 35 | 28 | 12 | 2 |
What to check before you join Teachers Health
- A short tier list: Gold, Silver Plus or Basic Plus, with nothing at Bronze.
- Investigated complaints were double its market share in 2024-25.
- Extras benefits (42.8% of charges) were below the industry.
- Over 31 and joining for the first time? Work out your Lifetime Health Cover loading first, and if you earn over the threshold, check the Medicare Levy Surcharge you'd avoid.
Common questions about Teachers Health
Who can join Teachers Health?
Current and former members of education unions, including teachers, teachers' aides, lecturers and support and administration staff at public, private and independent institutions, plus their families.
Is Teachers Health not-for-profit?
Yes. PrivateHealth.gov.au lists it as a mutual organisation operating on a not-for-profit basis.
Is TUH part of Teachers Health?
TUH describes itself as part of the Teachers Health Group. It is listed separately on PrivateHealth.gov.au and is open to past and present union members and their families.
Other fund reviews
See every registered health insurer compared on complaints and benefits, or read how the private health insurance rebate and hospital cover tiers work.
General advice only. It doesn't consider your circumstances. Read the PDS and TMD before you decide.
This review is general information based on published government and regulator data. We don't rate or rank funds, and it doesn't consider your circumstances. Check a policy's Private Health Information Statement before you buy.