Private Health Information Statement - Combined policy

AIA Silver Hospital 750 and AIA Mid 60 Extras

Monthly Premium

$353.37 #

(before any rebate, loading or discount)

Covers one adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult)

Available in Western Australia

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.

This policy covers children up to and including the age of 17, students up to and including the age of 24 and non-students up to and including the age of 30, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.

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 $750 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

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

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Optical over pays back 100% up to annual limit ($250). Physiotherapy, Myotherapy, Hydrotherapy, and Exercise Physiology share annual limit. Chiropractic and Osteopathy share annual limit. Remedial Massage and Acupuncture share annual limit. Medically Prescribed Appliance, Hearing Aids, Blood Glucose Monitors and Health Appliances and Aids share annual limit. Pharmacy pays back up to $40 per script after the current PBS amount is deducted; vaccinations fall under Pharmacy limit. This policy also provides access to AIA Vitality. https://www.aiavitality.com.au
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$800 per person
(no limit on preventative dental)
Periodic oral examination - 60% of charge
Scale & clean - 60% of charge
Fluoride treatment - 60% of charge
Major dental12$800 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
Orthodontic12$800 per person
$2,000 lifetime limit
Braces for upper & lower teeth, including removal plus fitting of retainer - 60% of charge
Optical*6$250 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals*2$300 per personPer eligible prescription - 60% of charge
Physiotherapy*2$500 per person
(combined limit for physiotherapy & exercise physiology)
Initial visit - 60% of charge
Subsequent visit - 60% of charge
Chiropractic*2$300 per person
(combined limit for chiropractic & osteopathy)
Initial visit - 60% of charge
Subsequent visit - 60% of charge
Podiatry2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Psychology2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Acupuncture*2$300 per person
(combined limit for acupuncture & remedial massage)
Initial visit - 60% of charge
Subsequent visit - 60% of charge
Remedial massage*2Initial visit - 60% of charge
Subsequent visit - 60% of charge
Hearing aids*12$300 per person
(combined limit for hearing aids & blood glucose monitors)
Hearing aid - 60% of charge
Blood glucose monitors*12Per monitor - 60% of charge
Audiology2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Dietetics/dietary advice2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Exercise physiology*2Combined limit - see PhysiotherapyInitial visit - 60% of charge
Subsequent visit - 60% of charge
Eye therapy (orthoptics)2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Health management / Healthy lifestyle2$150 per personHealth management - 100% of charge
Occupational therapy2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge
Osteopathy*2Combined limit - see ChiropracticInitial visit - 60% of charge
Subsequent visit - 60% of charge
Speech therapy2$300 per personInitial visit - 60% of charge
Subsequent visit - 60% of charge

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

General treatment legend
Other treatments - check with your insurer

Ambulance cover

In Western Australia 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.