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.

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.

Only the member - the person whose name the policy is under - and anyone the member authorises can make changes to your cover.

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.

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.

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.

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.

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.

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.

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.

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:
 

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.

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.

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.

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.

A child dependant can remain covered under a family or single parent policy until their 25th birthday. They must be living at home and not married or in a defacto relationship. Once removed from a policy, they'll have two months to take out their own policy to avoid re-serving waiting periods if they transfer to an equivalent or lower level of cover.

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.

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.

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).

You can see them all online. Simply log in to our member portal and head to the Claims section to look at your history.

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.

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.

We always want to make sure our members are being treated well and we're happy to receive any feedback you may have. We aim to resolve problems at the first point of contact. If you need to make a complaint, here’s how you can go about it.
 

You can also use any of the methods above to request a copy of our full Complaints Handling policy.

We will always do our best to resolve any issue you have, but if you’re not happy with our solution you can contact the Commonwealth Ombudsman

We’re committed to a quick and fair resolution of all complaints so this is what you can expect from us:
 

The Australian Government has introduced a range of changes to how private health insurance operates to make it simpler and more affordable. The main changes are: the introduction of Gold, Silver, Bronze and Basic levels of cover; standard clinical definitions of what is included in your cover; higher excess options to make your premium lower; the exclusion of some natural therapies from cover and the option to offer a discount of up to 10% for people who are aged 18-29. These changes will make it easier to compare cover across different health funds and in some cases make cover more affordable.

One of the recent reforms that Australian Government made to health insurance is for all covers to be grouped into tiers: Gold, Silver, Bronze and Basic. The tier the cover is in must be included in its name, which is why our product names are changing. This means that is now easier for you to compare covers across different health funds as all Gold covers (for example) must meet a minimum set of requirements.

One of the recent reforms that Australian Government made to health insurance is standardise the clinical definitions used to describe the services that are included or excluded from a cover. Because this will be uniform across all health funds, it'll be easier for you to know what is and isn't included in your cover and compare this across different health funds.

Young Australians are eligible to receive up to a 10% discount on their private hospital insurance premiums when they hold an eligible product.
 

The discount you receive depends on your age when you first take out an eligible hospital cover and ranges from 10% (if you take out cover before the age of 26) to 2% (if you take out cover at the age of 29).

The Age Based Discount is calculated on your base premium before the application of any Australian Government Rebate, Lifetime Health Cover loading and/or any other eligible discount. The Age Based Discount only applies to hospital cover or the hospital component of a package – it doesn’t apply to extras.

The discount is ongoing, which means if you keep your eligible hospital cover, your discount remains until you turn 41. From then, the discount will reduce by 2% per year until it reaches zero.

The discount is only available on selected products but is available to new and existing policy holders. You have to be the Principal member or Partner on a hospital cover and aged between 18-29.

 

The discount is based off your age when you first purchase an eligible hospital product offering the Age Based Discount.
 

If you’re on a couple or family hospital cover, the Age Based Discount is calculated by taking an average of the discount applied to the adults on the hospital cover. So, if the Principal member has a 10% Age Based Discount and their partner has no discount, or 0%, the discount applied overall to the hospital cover is 5% (10% ÷ 2).
 

The Department of Health has a lot of useful information and a range of helpful fact sheets.

Click here to login to our Online Member Services portal and head to the 'Forms' page.