Territory Health Fund prides itself on offering products with market leading benefits. We review these benefits each year to ensure we maintain a very competitive and value for money product. We also want you to experience the genuine value we offer our Members thanks to our generous benefits that grow each year.

Below you'll find all of the details of the changes to our benefits which will take effect on 1 April 2018.


There has been an increase in benefits paid towards Crowns for Members with Essential extras.

Changes to dental benefits
Dental item description Current benefit New benefit
Essential Extras
Crowns and bridges $550 $560
These great benefits on our other Extras products below are staying the same:
Premium Extras
Crowns and bridges $800  
Select Extras
Crowns and bridges $560  
Young Extras
Crowns and bridges $500  


Healthy Living

We want you to be the healthiest version of you and our Healthy Living benefit is designed to help you achieve that. We have listened to our Members and expanded benefit program inclusions. We will now pay benefits towards aquatic exercise and rehabilitation at swimming pools and health and fitness centres. This new benefit will cover the cost of pool entry and aquatic exercise classes (excluding swim classes or lessons). Claiming your new benefit is easy, you’ll just need to submit a Health Management Program Benefit Approval Form along with your tax invoice. This new benefit is another way we are ensuring it’s easier for you to become the healthiest version of you.

Here is a list of the items included under Healthy Living that will help you stay well:

• Participation in a choice of approved weight management programs^^

• Quit smoking programs

• Approved health management programs* including gym memberships, personal training programs, yoga and Aquatic
exercise/rehabilitation* including pool entry and exercise classes (excludes swim classes/lessons)

• Skin checks through mole mapping

• Consultation fees for diabetes education

• Consultation fees for metabolic dieticians and nutritionists when providing assistance with weight management

• Bowel screening tests and bone density tests

• PSA test (one per year) – we cover a second yearly text not covered by Medicare.

*To comply with private health insurance legislation, you must have been referred by your health care professional to participate in a health management program to address or improve a specific medical condition. A Health Management Program Benefit Approval Form must accompany a claim for these benefits.

^^Before enrolling in a weight management program please contact the Fund to clarify the eligibility to benefits.

Therapies - Exercise Physiology

We are making it easier for you to claim your benefits. We have removed conditions placed on Exercise Physiology and no longer require a letter from your GP or Allied Health professional. Later this year you will have the ability to claim through HICAPS or CSC HealthPoint. We will advise Members when this becomes available.


We’ve also expanded the benefits included under pharmaceuticals for immunotherapy and hormone replacement therapy.

Help for families with older children

Having a family can be expensive. Our Extended Family covers have always represented a great way for older dependants* to stay covered on their family cover longer providing a cost saving in comparison to the dependant having to take out an equivalent cover on their own.

Up until now the product options available for these Extended Family covers have been limited to our packaged covers with Value Plus Hospital covers packaged with only Premium or Essential Extras.

We are now going to provide more flexibility for those families with older children by allowing our Value Plus Hospital covers to be available as stand-alone products for Extended Family covers. As well we will now allow any of our extras products to be packaged with these hospital covers providing more product flexibility and diversity for families with different budgets or cover requirements.

*A dependant child can remain covered under a family cover up to age 21 years. If a dependant child is single and studying full-time at a school, college or university; or an apprentice, single and earning less than $30,000 p.a. they can remain covered under a family cover until aged 25 years. For student dependants if study ceases, defers or reduce to part- time or in the case of an apprentice dependant their training ceases they can no longer be covered on a family policy.

Changes to Fund rules

Upon feedback from our Members we have reviewed our overseas suspension rules and process and have updated it to make it simple and easier for Members.

From 1 May 2018, when travelling overseas and applying to suspend your policy the only information you will now be required to submit to us with your suspension application is a copy of your travel itinerary. This itinerary should specify your departure date and your intended return date to Australia. What this change will also allow us to do is automatically reactivate your policy upon your return to Australia without you doing anything further. That’s right no more boarding passes or passport copies for you to have to organise on your return home!

Now we also know money can be tight after a return from an overseas holiday so to ensure your policy reactivation can automatically take effect on your return date to Australia, we will now require you to be paid a minimum of one month in advance from the date of your policy suspension. This way you can come home and not have to immediately find the money to kick-start your health cover.

A further change is that a  minimum period of 6 months must be served between reactivation and suspension for overseas travel. Please refer to our Membership Guide.

Your feedback is welcome

The changes to these benefits and some of our Fund rules are based on Member and Territory Health Fund staff feedback.

Did you know we aim to increase benefits every year because we pride ourselves on offering products with market leading benefits that grow with our Member’s needs and reflect industry changes?

The primary purpose of these changes is to ensure the benefits we pay are competitive and continue to offer great value for money.

We welcome your thoughts and feedback on this year’s changes. And, if you’d like to learn more, contact our friendly team today for a chat