(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Victoria
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Bone, joint and muscle | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Brain and nervous system | Gastrointestinal endoscopy | Pain management |
| Breast surgery (medically necessary) | Gynaecology | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Hernia and appendix | Tonsils, adenoids and grommets |
| Diabetes management (excluding insulin pumps) | Joint reconstructions | Hospital psychiatric services |
| Digestive system | Kidney and bladder | Palliative care |
| Ear, nose and throat | Male reproductive system | Rehabilitation |
| Assisted reproductive services | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Back, neck and spine | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Blood | Insulin pumps | Pregnancy and birth |
| Cataracts | Joint replacements | Sleep studies |
| Dental surgery | Lung and chest | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess on admission. This is limited to a maximum of $500 per person and $1000 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
All policies include membership to AIA Vitality, the science-backed health and wellbeing program that rewards you for looking after your health. If you have held an AIA Health Insurance policy for a minimum of six months and have an AIA Vitality status of Silver or above, we will refund your excess in the event that you’re admitted to hospital.
Members can receive up to 70% back on dental services, No Gap Dental on selected preventative dental services & lower treatment costs at smile.com.au dentists. Dental services at other dentists can receive up to 60% back.
| Note, for items marked with an asterisk *: General and Preventative Dental are combined under one limit. Physiotherapy, Myotherapy and Hydrotherapy share an annual limit. Chiropractic and Osteopathy share an annual limit. Medically Prescribed Appliances, Orthotics and Blood Glucose Monitors share a limit. Non PBS pharmaceuticals pays back up to $40 per script after the current PBS amount is deducted; vaccinations fall under this Pharmacy limit. This policy also provides access to AIA Vitality where you can earn rewards for leading a healthy lifestyle. By reaching Silver Vitality Status or above you will get an additional 10% back on any non-dental benefits. www.aiavitality.com.au. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $800 per person | Periodic oral examination - 60% of charge Scale & clean - 60% of charge Fluoride treatment - 60% of charge |
| Major dental | 12 | $800 per person (combined limit for major dental & endodontic - Sub-limits apply) | Surgical tooth extraction - 60% of charge Full crown veneered - 60% of charge |
| Endodontic | 12 | Filling of one root canal - 60% of charge | |
| Orthodontic | 12 | $600 per person $2,400 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 60% of charge |
| Optical | 6 | $250 per person up to $500 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $100 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $40.00 |
| Physiotherapy* | 2 | $400 per person up to $800 per policy (combined limit for physiotherapy, exercise physiology & other services) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Chiropractic* | 2 | $300 per person up to $600 per policy (combined limit for chiropractic & osteopathy) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Podiatry | 2 | $200 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Psychology | 2 | $300 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Acupuncture | 2 | $150 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Remedial massage | 2 | $150 per person up to $300 per policy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Hearing aids | 12 | $300 per person 1 service(s) every 3 years (combined limit for hearing aids & other services) | Hearing aid - 60% of charge |
| Blood glucose monitors* | 12 | $250 per person 1 service(s) every 3 years (combined limit for blood glucose monitors & orthotics (podiatric orthoses)) | Per monitor - 60% of charge |
| Audiology | 2 | $150 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Dietetics/dietary advice | 2 | $200 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge |
| Health management / Healthy lifestyle | 2 | $100 per person | Health management - 60% of charge |
| Orthotics (podiatric orthoses)* | 12 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - 60% of charge |
| Osteopathy* | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $40.00 |
| Swimming Lessons are covered under this policy - Benefit Limit $100 per person, per year. Smoking Cessation services are covered under this policy - Benefit Limit $100 per person, per year. Psychology benefit includes counselling services. | |||
| Other treatments - check with your insurer |
In Victoria this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Cover for call-out fees where you're not taken to hospital are limited to 2 x ambulance attendances per insured person, per calendar year.
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.