Member Benefits
Learn more about the range of benefits available to AIA Health Insurance members.
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{{label}}The key to good health and wellbeing isn’t ‘all or nothing.’ It’s the small ‘something’s’ in between. With health insurance from AIA we’ll protect you when things go wrong and reward your for your small somethings through AIA Vitality, like e-Gift, gym membership discounts and much more!
Join AIA Health on an eligible combined Hospital and Extras policy before 31 July and you’ll receive a 6-week premium refund from 31 October. T&Cs apply.
Great value protection
Health cover designed to protect you with up to 80% back on extras.
Cover for emergencies
All our products include cover for accidents and emergency ambulance services, so you know you’re covered when you need it most.
Waiting periods recognised
We’ll honour waiting periods you’ve served with your previous fund, so you’re covered right from the start.
Call us
Between 8am–6pm (AEST/AEDT), Monday to Friday, excluding public holidays.
Get a quote online
In under 60 seconds! Compare our full range of products online.
Request a call back
Request a call back from one of our experts.
AIA Health comes with our science-backed AIA Vitality program.
The AIA Vitality app helps you get more out of life by actively taking control of your health and wellbeing. It gives you the support and motivation you need to make healthy living choices every day.
The more steps you take to know and improve your health, the more you'll earn in rewards including discounted gym memberships, cashback on eligible Virgin Australia flights and more!
We've delayed our 2022 premium increase.
To continue supporting our members through the ongoing impacts from the pandemic, our annual 1 April premium increase has been delayed until 1 September 2022.
We've also brought back our Extra Value Protect benefit for a third year. A first for health insurance and exclusive to AIA Health with AIA Vitality, Extra Value Protect is a unique benefit that allows you to get up to 100% back on your Extras premium. Find out here.
Beyond rewards with AIA Vitality, you can also unlock additional health insurance benefits by engaging and reaching AIA Vitality Silver Status, including:
Premium Discount
Maintain a 5% discount on your premium
Excess Refund
Claim 100% of your hospital excess
Extras Boost
Get an additional 10% back on your non-dental Extras
You'll also have access to a wide range of benefits, including affordable dental and discounts on optical!
Fantastic Health Insurance Policy
I definitely feel the policy is worth having. Victor was very efficient in explaining the AIA health Insurance Policy to me.
I also feel you help your members by ensuring they get a good return of money by the Vitality Programme which other funds do not do. The two free months on joining is a bonus as well.
Yvonne
Finally feel I have made the right choice!
After speaking with Jason at AIA he was able to assist me in obtaining the exact cover I need for myself, hubby and family. Not only has my premium improved but I have value for money as I also have more Extras that were not included in my existing health fund. Everything was explained in detail and felt secure in making the move as I was with my existing fund for over 20 years.
Vivien
Great Service
Rebecca was EXTREMELY helpful and knowledgeable in being able to answer all of my questions easily and clearly. Was not pushy and understood what I was looking for, would very much recommend to anyone looking to change to another insurance company. Just the Vitality program alone makes it better value for money with the vouchers you can earn just for living day to day. If like me you have held health insurance for years but hardly ever used it, look at the AIA Vitality program and get something back
Shane
Call us
Between 8am–6pm (AEST/AEDT), Monday to Friday, excluding public holidays.
Get a quote online
In under 60 seconds! Compare our full range of products online.
Request a call back
Request a call back from one of our experts.
What is Hospital cover?
Hospital cover helps to cover the cost of treatment you receive in hospital. Each level of AIA Health Insurance Hospital Cover (from Basic to Gold) is differentiated by the list of treatments that are included. For example, cover to be treated in a Private Hospital for pregnancy is only available on our Gold Hospital cover.
Why should I take out Hospital cover?
Hospital cover helps to cover the costs of being treated in hospital. Having Hospital cover means you can be treated in a private hospital and avoid public hospital waiting lists. You get more control over where you're treated, and who treats you.
What is Extras cover - and should I take this out too?
Extras cover is for treatments that do not take place in a hospital, like visits to the dentist, physiotherapy or optical services. AIA Health Insurance Extras cover can only be taken with Hospital cover. The types of services you can claim under your Extras cover will depend on the level of cover you take out, but essentially this type of cover is to help with services and treatments received out-of-hospital, that aren't covered by Medicare.
While we're at it, what's combined cover?
Combined cover is when you take out both Hospital and Extras cover. That's why you'll hear the term 'Hospital and Extras' thrown around so much when it comes to health insurance - it's a popular choice.
This rebate on private health insurance sounds good. How do I get it?
Most Australians with private health insurance currently receive a rebate from the Australian Government to help cover the cost of their premiums, either as:
The level of your rebate depends on your income and your age. To find out more and to find out how much you could get back head to the Private Health Insurance Rebate Calculator on the Australian Taxation Office website.
What is the Medicare Levy Surcharge (MLS)?
The MLS is simply an extra tax that people above a certain income threshold have to pay if they don't have eligible private hospital cover. It's calculated in three tiers for singles and couples/families. You can find out more about that here.
What is Lifetime Health Cover (LHC) loading?
The Lifetime Health Cover (LHC) loading is a Government loading on your private hospital cover premiums. It was introduced on 1 July 2000, to encourage people to take out private hospital cover earlier in life and encourage them to maintain it. LHC is a 2% loading on top of your premium for every year you don't have hospital cover after you turn 30. The maximum loading is 70%. You can find out more here.
What is a waiting period?
A waiting period is the time between joining or upgrading your level of cover and the date from which you're allowed to start claiming. Waiting periods exist for all services within both hospital and extras covers and apply to:
Waiting periods for Hospital treatment range from one day to 12 months.
Waiting periods for Extras treatments vary by the treatments vary from two to 12 months, depending on the type of service. These are listed below:
What is a agreement private hospital or day surgery?
We have agreements with hundreds of private hospitals and day surgeries in Australia - that's what we're talking about when we say participating private hospital. To find out whether your hospital is a participating one call us on 1800 333 004. If you're admitted to a private hospital that's not on our list you may have to pay higher out-of-pocket fees.
What is a non-agreement hospital?
AIA Health Insurance is a member of the Australian Health Services Alliance (AHSA). A non-agreement hospital is a hospital that has not signed an agreement with the AHSA. If you receive treatment from one of these you may incur large out-of-pocket expenses. Call us on 1800 333 004 or email us at health.memberservices@AIA.com.au to find out if the hospital you want to be treated at is a participating hospital so you can avoid these costs.
What is a pre-existing condition?
A pre-existing condition is a condition - assessed by one of our medical practitioners - that you've had or shown symptoms of having within the past six months before you joined us, or changed your cover. This affects your cover quite a bit, and there's more on this in our member guide.
What is Medical Gap Cover?
The Federal Government sets a schedule of fees for eligible services provided by doctors to inpatients in hospital. Medicare pays 75% of these fees and health funds like AIA Health Insurance pay the remaining 25%. Doctors and providers are not restricted to charging this fee and are able to set their own fees, which can be higher than the scheduled fees. If your doctor chooses to charge a higher fee, there will be a gap between what the doctor charges and what the Government and AIA Health Insurance will pay. This is the 'Gap' and can leave you with significant out-of-pocket expenses. If your doctor participates in AIA Health's Access Gap Cover, we'll pay more than the 25% of the schedule fee - leaving you with drastically reduced, or even eliminated out-of-pocket expenses. The best way to find out if your doctor is registered for Access Gap Cover is to ask them.
Does my cover include ambulance cover?
AIA Health Insurance covers you for all clinically necessary ambulance services for emergencies in Australia. Emergencies are circumstances when immediate hospital treatment is required for a serious and acute injury or condition where the viability or function of an organ or body part is threatened. Check with your state Ambulance authority to ensure you have the right level of cover for non-emergency ambulance transport within Australia.
What are Private Health Information Statements (PHIS)?
A Private Health Information Statement (PHIS) is a summary of the key product features of your cover. You will receive a link to download a copy of your PHIS when you join AIA Health Insurance and it is available to download from our Online Member Services portal.
I'm a member. Where can I find my policy details?
Members can find their policy details on our Online Member Services portal:
When should I let you know I'm going to hospital?
If you have less than 12 months membership on your current hospital cover, you’ll need to contact us by phone on 1800 333 004 or by email at health.memberservices@AIA.com.au before being admitted so we can determine whether the waiting period for pre-existing conditions applies.
It can take up to five working days to complete this assessment, so make sure you factor this in when you book your stay. If you go ahead with your admission without confirming your entitlements and we subsequently determine your condition to be pre-existing, you’ll have to pay all outstanding hospital and medical charges not covered by Medicare.
Is my doctor registered for Access Gap Cover?
The best way to find out is to ask them. Every doctor is different and some will even opt in or out on a patient-by-patient basis. If your doctor participates in AIA Health Insurance's Access Gap Cover they can either choose to participate as a no gap charge or a known gap as follows;
Just remember to check with your doctor before agreeing to any treatment.
How can I save on dental treatments with smile.com.au?
Members with extras cover with dental are eligible to save between 15-40% off dental treatments performed by a smile.com.au approved dentist. Read more.
Is AIA Vitality a type of health insurance?
No. AIA Vitality is a science-backed program that helps you learn about your health, improve it and stay motivated with rewards. Find out more.
We've got the basics covered above. For anything we haven't covered, head to privatehealth.gov.au
I think I have to switch health insurers. How do I do this?
This one's on us. All you need to do is give us the details of your current insurer and we'll take care of the rest.
When does my cover start?
Your cover starts as soon as we receive your first payment and you can begin claiming as soon as any applicable waiting periods are over.
How do I change my personal details?
You can amend your details at any time by logging in to the Online Member Services portal and editing your AIA Health Insurance profile. Alternatively, you can give us a call on 1800 333 004. This goes for changing your address details, payment details or if you change your name when you get married.
Who can make changes to my cover?
Only the member - the person whose name the policy is under - and anyone the member authorises can make changes to your cover.
What happens if I need to go to hospital?
We recommend you contact us prior to your admission to find out if the hospital you are to be admitted to is on our participating hospital list and to confirm that you have the right level of cover for the treatment you are seeking. If the hospital you are admitted to isn’t one of our participating hospitals, you may not be covered in full for your accommodation or theatre costs. Contacting us first means you will know what types of benefits you will receive and what your out-of of-pocket costs will be.
When you are admitted to hospital, the hospital will ask if you have private health insurance and will check your eligibility with us. All AIA Health Insurance hospital covers includes an excess cost to help lower your premium and you will be asked to pay the excess when you are admitted to hospital.
What are the payment methods available?
You can choose to pay via direct credit with a credit card or direct debit via your bank. Each method and its benefits are detailed in our member guide. Payment cycles are weekly, monthly or annually. Please call us on 1800 333 004 if you want to change how you pay your premium.
What happens if we're planning to have a baby?
If you’re planning to start or grow your family and your hospital cover doesn’t include pregnancy, you’ll have to upgrade your cover at least 12 months before giving birth to ensure all waiting periods have been served. Newborn babies aren’t admitted as patients in hospitals unless there are complications or your baby requires medical attention. In these instances your baby will be covered provided they are added to the policy. Adding a newborn is easy; you can do this yourself through the membership portal or give us a call and we will add the baby for you.
How can I get a new member card?
If your card is lost or stolen you should contact us as soon as possible to avoid fraudulent claims and we'll send you a brand new one. Remember, whenever you get a new card from us, your old one automatically becomes invalid so throw it away to avoid any confusion.
What is an excess?
An excess is an upfront payment that you are required to make when submitting a hospital claim. A higher excess will reduce your premium. A lower excess means you’ll pay less on admission to hospital, but your premium will be higher. Some AIA Health Insurance products offer you a choice of excess options, either $500 or $750 for an individual. The excess applies to the policyholder (and partner where applicable) once per person, per calendar year. Child dependants covered on a family policy are not required to pay an excess.
How do I get a 100% refund on my hospital excess?
Where your policy includes an Excess Refund, it means that if you hold this policy or another eligible policy for at least six months and hold Silver AIA Vitality status or higher, AIA Health Insurance will refund 100% of your hospital excess.
You will need to pay your excess when you’re admitted to hospital and then you can claim this amount back. See your member guide for more details.
Can I claim on orthotic and orthopaedic appliances?
To qualify for benefit payments, these must be custom-made by practitioner podiatrist or orthotist. For an orthosis to be custom made, a plaster cast or mould must be taken. Please note that customising, heat moulding, trimming or adjusting an existing ‘off the shelf’ appliance does not constitute a custom-made appliance. Orthopaedic appliances attract benefits where the application of which has resulted from, and is required immediately following, the injury or surgery, and a doctor's letter of recommendation is required prior to claiming.
Am I covered for health appliances?
AIA Health Insurance does not pay benefits for the hire of any health appliance or equipment. We will, however, fund a percentage of the purchase of the following appliances up to your annual limits, providing you lodge a doctor’s letter of recommendation with your claim:
What are benefit replacement periods?
A benefit replacement rule applies to some items/services covered by AIA Health Insurance’s extras cover. This means that after you claim for an item, you must wait a specified period before you can lodge another claim for the same type of item. Call our Member Service Team on 1800 333 004 to find out which treatments have benefit replacement periods.
Can I claim for weight loss programs?
You can claim for weight loss programs under our Dietetics Extras cover but only when it has been recommended, in writing, by a doctor for preventing or improving a specific health condition. Also, the weight loss provider must be a member of the Weight Management Council of Australia and agree to abide by the Weight Management Code of Practice.
Here are some well-known providers that we’re happy to approve:
Please note that we only cover weight loss program fees and will not provide any benefits for meals, groceries or exercise components.
Where can I find recognised Extras providers?
You can only claim extras benefits where treatment is received in person from a recognised health practitioner, received in Australia. To find out if your practitioner is recognised you can ask your practitioner before you make your appointment or call us on 1800 333 004 (we’re open from 8am to 6pm AEST). You cannot claim for treatments you provide to yourself or to members of our family or business partners and members of their family.
Can I claim for Extras purchased over the internet?
Yes - but only when purchased online from Australian optical and pharmaceutical providers when a script is provided. For a company to be considered an Australian provider, an ABN needs to be visible on the company’s website. Benefits for services, treatments and other costs received overseas are excluded and will not receive any benefit.
I have adult children who are still studying - are they covered by my family policy?
Family cover provides cover for the member, their partner and their children including dependant students up to the age of 25. Cover for child dependants ceases once they turn 21, unless they qualify to remain on the policy as a student dependant. When a child dependant turns 21, they have two months to get their own cover and not have to serve any waiting periods if moving to equivalent or lower cover. Student dependants also have two months from either turning 25 or ceasing to be a student to get their own cover. For mid-year school, apprenticeship and traineeship leavers who transfer from their parent’s AIA Health Insurance policy within two months of leaving school or finishing an eligible apprenticeship or traineeship through a registered training group will not have to serve waiting periods if they transfer to an equivalent or lower level of cover. A letter from their school or registered training group confirming the date of completion is required. For end of year school, apprenticeship and traineeship leavers, they are covered until 31 March of the following year and will not have to serve waiting periods if they transfer to an equivalent or lower level of cover.
Are there some Extras I can't claim for?
You can only claim on Extras treatments that are specifically included in your cover. Here’s a list of some of the treatments (not all) that aren’t covered:
General
Pharmacy
Dental
Foot orthotics
Orthopaedic appliances
Pressure garments
For more information please see our member guide.
When you join us you'll receive a full welcome pack with all you need to make the most of your cover. If you can't see what you're looking for above, take a look at our member guide or call us on 1800 333 004.
What does Travel and Accommodation cover me for?
Where your policy includes a travel and accommodation benefit this can be used to claim towards the travel and accommodation costs of either yourself or a carer (if applicable) for a hospital admission.
Benefits are only eligible where the round trip is at least 200km within Australia. Benefits are capped at $50 per day for accommodation and 15 cents/km for travel for you and your carer.
How do I make a claim?
There are lots of ways to make a claim. You'll just need to make sure you've served all your waiting periods before you start the claims process. Then, if you have Extras cover, you can simply use your membership card. Alternatively, you can use our member portal, or even claim by post. We've detailed the ins and outs in the member guide (plus some extra process info that may come in handy).
Where can I see the claims I've made?
You can see them all online. Simply log in to our member portal and head to the Claims section to look at your history.
Why wasn't my claim paid?
It doesn’t happen often, but there are instances where benefits are not paid at all or are paid at a lower level. These are when:
To find out more, we recommend checking out your cover’s detailed terms and conditions published in our Fund Rules. These are available by calling us on 1800 333 004.
Tell me more about AIA Vitality?
We thought you'd never ask. AIA Vitality is what makes us different. For all the details on how the program can boost your wellbeing and help you to maintain a level of good health, head to the AIA Vitality page.