Tell us your experience with TUH Health Fund

Do you have something to say about TUH Health Fund? Tell us your good experiences, bad experiences or otherwise and help inform the CHOICE Community.

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I joined my family up with TUH just over 12 months ago. I selected hospital cover and extras (particular health disciplines chosen according to our needs).

I have claimed for routine Osteopathy, Dental and Optometry visits. In each case the claim was put through at the point of sale, so I only paid the gap. No paperwork, no waiting, very easy to use.

I have Podiatry cover, and was surprised to find that TUH didn’t cover the partial nail avulsion the my son got done my the Podiatrist in his clinic.

I have Dermatology cover, and was surprised to find that TUH didn’t cover the small procedure done by the Dermatologist in his clinic either. Medicare covered part of the standard consultation fee only.

I plan to follow this up, as Podiatry and Dermatology are part of the reason I joined… Maybe I didn’t look at the details on exactly what item numbers can be claimed…

FWIW no health fund is legally able to pay a benefit for any out-patient procedure where Medicare pays a benefit.

This link might be enlightening.

Yes, I knew TUH couldn’t help with the consultation fee because of Medicare. I was just a bit disappointed that TUH didn’t help with the fees for the actual procedure (separate item numbers). It was only a small procedure this time, so not too bad. I’ll look into it before I go back next year in case I need something more invasive done. It may be something to do with “out of hospital”…

Medicare did not cover the Podiatry at all. So I had to pay in full for the whole procedure.

I checked my HCI cover and there are modest payments for podiatry and chiro services (combined limit) on the top extras plan, but not dermatology.

This link from a podiatry office might help.

If you have chronic health conditions you can see your Doctor to get a Health Care Plan that Medicare will allow you to claim up to 5 visits with services such as Podiatry, Psychology, Dietitian & Pyshiotherapy. Some providers completely bulk bill on these but others do charge a co-payment. This co-payment counts towards your Medicare Safety Net see [quote=“grahroll, post:7, topic:14537”]
Finally, even for self funded private health, Medicare users have currently the added benefit if they spend over a given amount per year (Calendar year not Tax year) on certain out patient health costs that the Medicare rebate they receive is increased substantially (https://www.humanservices.gov.au/individuals/services/medicare/medicare-safety-net) and the spend limits to achieve these are not onerous. I suspect this is what some junk policy users tap into to reduce their costs. Importantly is that if you are single you are automatically enrolled but if you are not single you do need to enroll for the safety net, I suspect many people are not aware of this and so rebates they receive are greatly diminished over what they could get.
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If you have Mental Health issues there is a specific Mental Health Care Plan that gives a greater amount of visits to a Psychologist.

Ask your Doctor about the plans and you can read a bit more about them at the following links.
https://www.psychology.org.au/medicare/fact_sheet/
https://www.humanservices.gov.au/individuals/subjects/chronic-medical-condition-assistance

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Also osteopathy and chiropractic.
You can also ask for a mix of services (up to a total of 5) if that suits you better.

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