(before any rebate, loading or discount)
Covers only one person
Available in NSW & ACT
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Assisted reproductive services | Eye (not cataracts) | Pain management |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management with device |
| Blood | Gynaecology | Palliative care |
| Bone, joint and muscle | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Pregnancy and birth |
| Cataracts | Insulin pumps | Rehabilitation |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Skin |
| Dental surgery | Joint replacements | Sleep studies |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Tonsils, adenoids and grommets |
| Dialysis for chronic kidney failure | Lung and chest | Hospital psychiatric services |
| Digestive system | Male reproductive system | |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Weight loss surgery |
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 $750 per person and $750 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 $500 of your excess (Excess Refund) if you’re admitted to hospital. Exclusions apply on some clinical categories.
Members can receive up to 80% 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 70% back. See https://www.aia.com.au/en/products/health-insurance/find-a-provider.
| Note, for items marked with an asterisk *: General and Preventative Dental are combined under one limit. Physiotherapy, Myotherapy, Hydrotherapy and Ante-natal/Post-natal Classes 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 can 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 | $1,000 per policy | Periodic oral examination - 70% of charge Scale & clean - 70% of charge Fluoride treatment - 70% of charge |
| Major dental | 12 | $1,000 per policy (combined limit for major dental & endodontic - Sub-limits apply) | Surgical tooth extraction - 70% of charge Full crown veneered - 70% of charge |
| Endodontic | 12 | Filling of one root canal - 70% of charge | |
| Orthodontic | 12 | $800 per policy $3,200 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 70% of charge |
| Optical | 6 | $250 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $300 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $40.00 |
| Physiotherapy* | 2 | $600 per policy (combined limit for physiotherapy, ante-natal/post-natal classes, exercise physiology & other services) | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Chiropractic* | 2 | $400 per policy (combined limit for chiropractic & osteopathy) | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Podiatry | 2 | $250 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Psychology | 2 | $300 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Acupuncture | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Remedial massage | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Hearing aids | 12 | $400 per policy 1 service(s) every 3 years (combined limit for hearing aids & other services) | Hearing aid - 70% of charge |
| Blood glucose monitors* | 12 | $400 per policy 1 service(s) every 3 years (combined limit for blood glucose monitors & orthotics (podiatric orthoses)) | Per monitor - 70% of charge |
| Audiology | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Ante-natal/Post-natal classes* | 2 | Combined limit - see Physiotherapy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Dietetics/dietary advice | 2 | $350 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 70% of charge |
| Eye therapy (orthoptics) | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Health management / Healthy lifestyle | 2 | $200 per policy | Health management - 70% of charge |
| Occupational therapy | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - 70% of charge |
| Osteopathy* | 2 | Combined limit - see Chiropractic | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Speech therapy | 2 | $200 per policy | Initial visit - 70% of charge Subsequent visit - 70% of charge |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $40.00 |
| Swimming lessons are covered under this policy - Benefit Limit $200 per person, per year. Smoking cessation services are covered under this policy - Benefit Limit $150 per person, per year. Psychology benefit includes counselling services. | |||
| Other treatments - check with your insurer |
In NSW & ACT 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.