Private Health Information Statement - Combined policy

Silver Hospital 750 and Lite 70 Extras (MO)

Monthly Premium

$463.91 #

(before any rebate, loading or discount)

Covers 2 adults (and no-one else)

Available in Victoria

Closed to new members

# 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.

Hospital cover

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).

This policy includes cover for

Hospital Cover Legend
Back, neck and spineEye (not cataracts)Miscarriage and termination of pregnancy
BloodGastrointestinal endoscopyPain management
Bone, joint and muscleGynaecologyPlastic and reconstructive surgery (medically necessary)
Brain and nervous systemHeart and vascular systemPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Breast surgery (medically necessary)Hernia and appendixRehabilitation
Chemotherapy, radiotherapy and immunotherapy for cancerImplantation of hearing devicesSkin
Dental surgeryJoint reconstructionsTonsils, adenoids and grommets
Diabetes management (excluding insulin pumps)Kidney and bladderHospital psychiatric services
Digestive systemLung and chestPalliative care
Ear, nose and throatMale reproductive system

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesInsulin pumpsPregnancy and birth
CataractsJoint replacementsSleep studies
Dialysis for chronic kidney failurePain management with deviceWeight 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.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

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.

General Treatment Cover

Members can receive up to 75% back on dental services, No Gap Dental on selected preventative dental services, & lower treatment costs at www.smile.com.au dentists. Dental services at any other dentist will receive up to 60%. See https://www.aia.com.au/en/products/health-insurance/find-a-provider.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: General and Preventative Dental are combined under one limit. Physiotherapy, Myotherapy, Hydrotherapy, Chiropractic, and Osteopathy covered under a combined annual limit. This product also provides access to AIA Vitality where you can earn rewards for leading a healthy lifestyle! https://www.aiavitality.com.au
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$800 per personPeriodic oral examination - 60% of charge
Scale & clean - 60% of charge
Fluoride treatment - 60% of charge
Major dental12$500 per person
(combined limit for major dental & endodontic)
Surgical tooth extraction - 60% of charge
Full crown veneered - 60% of charge
Endodontic12Filling of one root canal - 60% of charge
Optical6$200 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Physiotherapy*2$400 per person
(combined limit for physiotherapy, chiropractic, osteopathy & other services)
Initial visit - 70% of charge
Subsequent visit - 70% of charge
Chiropractic*2Initial visit - 70% of charge
Subsequent visit - 70% of charge
Acupuncture2$175 per personInitial visit - 70% of charge
Subsequent visit - 70% of charge
Remedial massage2$175 per personInitial visit - 70% of charge
Subsequent visit - 70% of charge
Osteopathy*2Combined limit - see PhysiotherapyInitial visit - 70% of charge
Subsequent visit - 70% of charge

This policy does not include General treatment (Extras) cover for

General treatment legend
Blood glucose monitorsOrthodonticOther treatments - check with your insurer
Hearing aidsPodiatry
Non PBS pharmaceuticalsPsychology

Ambulance cover

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.

Other features of this ambulance cover

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.

Disclaimer

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.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

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.

Not Covered

These categories are not covered by this policy.