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Navigating health insurance claims for medical aids and appliances can be confusing, but proper preparation ensures you receive your entitled benefits. This comprehensive guide walks you through completing the THF-AID-05/17 Aids and Appliances Form correctly to avoid delays and maximize your claim success.

Download the Form: Teachers Health Aids and Appliances Claim Form

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Before You Start: Eligibility & Preparation

Who Can Use This Form?

This benefit is exclusively available to members holding Top Extras cover with Teachers Health. The benefit provides practical support to manage a specific health or medical condition.

Critical Pre-Purchase Checklist

Do not purchase anything until you complete these steps:

1. Verify Cover & Limits:
   • Confirm you have Top Extras cover.
   • Call 1300 728 188 or check online for the current list of approved aids and appliances.
   • Check your annual benefit limits and remaining balance.
2. Understand Waiting Periods:
   Waiting periods vary significantly. Purchasing before serving the required period will result in a declined claim. Waiting Period Applicable Aids & Appliances 2 Months Blood glucose monitors, blood pressure monitors, breast pumps, nebulisers, TENS machines, allergy covers (mattress/pillow), crutches, surgical stockings/shoes/braces, compression garments, wigs. 12 Months Hearing aids, CPAP machines. 24 Months Wheelchairs.
3. Confirm Item Eligibility:
   • Benefits are NOT payable for items purchased overseas or that are second-hand.
   • Benefits are NOT payable if the cost can be claimed through Medicare or another government program (e.g., NDIS).
   • Specific Rules Apply: e.g., Compression Garments must be for specific medical conditions (lymphoedema, vascular issues, post-burns scarring, post-surgery) and exclude sports/pregnancy garments.

Document & Information Checklist

Gather these before seeing your health practitioner or making a purchase:

• Your Teachers Health member number
• Details of the specific aid or appliance you intend to buy (make/model if known)
• The medical condition it will manage
• Your practitioner’s name, provider number, and practice details
• Funds for the Purchase: You must pay for the item upfront and claim a benefit back.

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Section-by-Section Filling Instructions

Follow this order to complete the form correctly. All sections must be filled to avoid processing delays.

Part A: Details of Claimant

To be completed by the member making the claim.

1. Member Number: Enter your Teachers Health membership number.
2. Date of Birth: Use format DD / MM / YYYY.
3. Given Names & Surname: Your full legal name as it appears on your membership.
4. Accident/Injury Entitlement:
   • Answer “Yes” only if the need for this item relates to a Workers Compensation claim, Third Party insurance, or similar.
   • If “Yes”: You must download and complete a separate Accident and Injury Form from the Teachers Health website. This Aids & Appliances form alone will not be sufficient.

Part B: Health Practitioner’s Certification

To be completed by your treating GP, medical specialist, or eligible allied health provider (physiotherapist, chiropractor, occupational therapist, podiatrist).

⚠️ Important: You cannot complete this section yourself. Book an appointment with your practitioner specifically to complete this form.

1. Practitioner Details: Ensure they fill in their full name, provider number, phone number (with area code), and postcode.
2. Aid/Appliance & Medical Condition:
   • Prescribed Item: The practitioner must clearly indicate the exact aid or appliance being prescribed (e.g., “CPAP Machine – ResMed AirSense 11”).
   • Medical Condition: They must specify the patient’s condition that requires the item (e.g., “Obstructive Sleep Apnoea”).
3. Practitioner’s Declaration: The practitioner must:
   • Sign the declaration.
   • Apply their Practice Stamp (highly recommended).
   • Date the form.

✅ Pro Tip for Part B: Discuss the specific eligibility rules (e.g., for compression garments) with your practitioner to ensure their description aligns with Teachers Health’s requirements.

Part C: Claimant’s Declaration

To be completed and signed by the member (claimant).

This is a legal declaration. Read it carefully before signing.
You are declaring that:

• The claim is for you or a listed dependant.
• All information provided is true and correct.
• You are not double-dipping (claiming from Teachers Health and another source like Medicare for the same cost).
• You authorise Teachers Health to verify information with your providers.
• You understand benefits may be reduced or denied due to cover level, waiting periods, annual limits, or an expired form (this form is only valid for 12 months).

Sign and date this section in DD / MM / YYYY format.

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Submission Process: How to Claim

Step 1: Purchase the Item
After completing the form with your practitioner, purchase the approved aid or appliance from a legitimate supplier.

Step 2: Obtain the Correct Receipt
This is a critical step. The original receipt/account must be on official provider letterhead or stamped and include:

• Provider’s name and address
• Patient’s name
• Description of the aid/appliance
• Date of purchase
• Cost paid
• Confirmation that the item has been paid for

🚫 Not Accepted: Cash register dockets, bank statements, or credit card slips are not valid proof of purchase.

Step 3: Submit Your Complete Claim Package
Submit BOTH the fully completed form AND the original receipt together via one of these channels:

Method	Address/Details	Notes
Email	submitclaim@teachershealth.com.au	Attach clear, scanned copies of both documents.
Mail	GPO Box 9812, Sydney NSW 2001	Send the original paper form and receipt. Keep photocopies for your records.
Member App	Via the Teachers Health mobile app	Use the in-app claims function to upload digital copies.

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After Submission: What to Expect

1. Processing Time: Allow time for Teachers Health to assess your claim against your cover, waiting periods, and limits.
2. Assessment: The fund will check that the item is approved, the form is correctly completed, the receipt is valid, and all eligibility criteria are met.
3. Outcome: You will be notified of the result. If approved, the benefit will be paid according to your product’s schedule, typically into your nominated bank account.
4. Potential Issues: If information is missing, the form is outdated (>12 months old), or the item is ineligible, your claim will be delayed or declined. You will be contacted if more information is needed.

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Crucial Notes & Tips for Success

• Form Validity: A completed Aids & Appliances form is only valid for 12 months. For ongoing needs (e.g., replacement compression garments), you must submit a new form annually.
• No Form Cost Coverage: Teachers Health does not pay a benefit for the cost of the consultation where this form is completed.
• Specific Item Rules: Pay close attention to category-specific rules, especially for Compression Garments and Wheelchairs, which have strict definitions and the longest waiting periods.
• Common Rejection Reasons:
  • Missing practitioner signature or practice stamp.
  • Invalid or incomplete receipt (missing patient name or date).
  • Claiming before the waiting period has been served.
  • Form submitted without the required original receipt.
• Privacy: Your information is protected under Australian privacy law. View the Teachers Health Privacy Policy for details.

Frequently Asked Questions (FAQ)

Q: How do I know if an item is approved before I buy it?
A: Always check the latest approved list by calling Teachers Health on 1300 728 188 or visiting their website. The list in the form (updated May 2017) may not be current.

Q: Can my physiotherapist complete Part B of the form?
A: Yes, the form specifies that eligible “health practitioners” include GPs, medical specialists, physiotherapists, chiropractors, occupational therapists, and podiatrists, provided the item is within their scope of practice.

Q: I need to claim for two different aids. Do I need two forms?
A: It depends. Discuss with your practitioner. If both items are for the same underlying condition and prescribed at the same time, they may be listed on one form. If in doubt, contact Teachers Health for guidance.

Q: What if my claim is rejected?
A: You will receive a letter explaining the reason. Common reasons include ineligible cover, unserved waiting periods, or exhausted annual limits. You can seek clarification or lodge a complaint through the official channels outlined in your membership guide.

Need Help? For questions about your cover or the claims process, refer to the official Teachers Health Contact Guide for verified contact details.

By carefully following this guide, ensuring your practitioner provides detailed information, and submitting a valid receipt, you can streamline your claim process and access the practical health support you’re entitled to.