Member Benefits
Learn more about the range of benefits available to AIA Health Insurance members.
We’re here to help protect your family, your lifestyle and your future.
For Individuals
For Business
Helps protect your loved ones if you are diagnosed with a terminal illness or pass away.
A lump sum benefit if you're no longer able to work due to an injury or illness.
Helps ease the financial burden should you suffer a traumatic event.
Can provide you with a monthly income if you become disabled due to injury or illness.
AIA Vitality is a personalised, science-backed health and wellbeing program that supports you every day to make healthier lifestyle choices.
The AIA Vitality Content Hub is your go to for science-backed, health and wellbeing inspiration and advice.
We strive to assist you for all your inquiries with high touch customer service.
Contact AIAWe’re here to help in a time of crisis.
{{title}}
{{label}}We understand that when you need to make a claim it may be a difficult time for you or your loved ones. We know you want the process to be as fast, easy and transparent as possible.
Our priority is to support you through the process, ensuring that you understand what’s happening every step of the way and that you get what you need as soon as possible.
Call us
1800 333 004
Between 8am and 6pm (AEST) Monday to Friday.
Or follow the steps below for health insurance extras, hospital and medical claims.
For life insurance, income protection, total and permanent disablement or crisis recovery claims, please contact us via the dedicated phone number listed in the ‘Life Insurance Claims’ section above.
Health insurance extras claims
As a health insurance member you can claim by using one of the methods listed below:
AIA Health Insurance
Att: Health Insurance Claims
PO Box 7302
Melbourne VIC 3004
Our health insurance claim form is available here. A copy of your paid invoice is required to process your claim.
Hospital claims
Following a hospital admission, the hospital will send the bill directly to us, which we will pay on your behalf. You may be required to pay an excess prior to your admission.
Medical claims
You can claim for provider fees by either:
If your provider has opted for the Access Gap Scheme, they will bill us directly. You may be required to pay the gap (if applicable) to the provider first.
How long will it take for my Extras claim to be assessed?
For Extras claims, your claim will be assessed within five business days from the date your claim is received.
What is an agreement hospital?
AIA Health Insurance is partnered with the Australian Health Service Alliance Ltd (AHSA), which provides our members with access to most Private Hospitals and Day Surgeries in Australia. When you are treated for a service included under your policy in an agreement hospital, we will cover the associated hospital costs less any excesses.
Do I have to pay an excess?
All AIA Health Insurance products have a $500 or $750 excess, however, you may be eligible to have your full excess refunded if you hold an AIA Vitality status of Silver or above. There are no excesses for dependents.
What is Excess Refund?
AIA Health Insurance rewards its members for taking an active role in their health and wellbeing. If you have held an eligible product for a minimum of six months and have an AIA Vitality status of Silver or above on the day you’re admitted into hospital, we will refund your excess.
Excess Refund is not available when claiming on services within the following clinical categories: Cataracts, Joint replacements, Dialysis for chronic kidney disease, Pregnancy and birth, Assisted reproductive services, Weight loss surgery, Insulin pumps, Pain management and Sleep Studies.
How do I know what my out of pocket costs will be?
To understand what you’re covered for and any associated out of pocket costs, please contact our Member Services team on 1800 333 004.
What is Access Gap?
If your doctor participates in Access Gap, they’ll agree to either remove (No Gap) or reduce (Known Gap) your out-of-pocket medical expenses. Where a Known Gap has been agreed, you will be made aware of your costs as part of your Informed Financial Consent.
Doctors can choose to opt in or out on a patient-by-patient basis so it’s important to ask them upfront.
What happens if I have an accident?
All AIA Health Insurance products include cover for accidents. An accident is an unforeseen event – occurring by chance and caused by an external force or object – which results in involuntary injury to the body requiring immediate treatment. An accident does not include any unforeseen conditions the onset of which is due to medical causes nor does it include pre-existing conditions, falling pregnant or accidents arising from surgical procedures. For an accident to be covered, treatment must be sought through a Doctor or an Emergency Department within 48 hours of sustaining the injury.
What happens if I have a pre-existing condition?
A pre-existing condition (PEC) is one where signs or symptoms of your ailment, illness or condition, in the opinion of a medical practitioner appointed by AIA Health Insurance (not your own doctor), existed at any time during the six months preceding the day on which you commenced cover for the relevant service.
If you have transferred from another health insurer without a break in cover, you do not need to re-serve hospital waiting periods you have previously completed. However, if you are adding or upgrading your hospital cover, you do need to complete waiting periods for the new or upgraded items. This includes reducing a hospital excess.
Pre-existing conditions related to palliative care, psychiatric and rehabilitation services will serve a two month waiting period. If you have less than 12 months membership on your current hospital cover, you’ll need to contact us by phone or email 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.
Call us
1800 333 613
Between 8am and 6pm (AEST) Monday to Friday.
Or contact your financial adviser directly.
Who is entitled to receive the proceeds from my life insurance policy when I die?
The Nominated Beneficiary or the Policy Owner’s estate.
Why is it important to have a will?
A will is your chance to say what you want to happen to your estate after you have died. You can choose an executor and beneficiaries and decide how your assets are to be distributed.
What does ‘certified’ copy mean?
A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents in the relevant jurisdiction.
Why do I need to send in proof of age when it is on the death certificate?
The date of birth recorded on a death certificate is given verbally and no proof is required when the death certificate is completed.
What is the difference between the Life Assured and Policy Owner?
Life Insured: person who is insured.
Owner: person who gets proceeds of the claim.
Who has access to personal information on my policy including medical information?
Generally, AIA and the Life Insured only. If AIA has received an Authority form, completed by the Life Assured and giving consent to release information to another specific person, then we can release information to that person. There are certain exceptions under privacy legislation relating to the disclosure of personal information which can apply. Please note that this does not apply to death claims.
What is the difference between an executor and a beneficiary?
Executor: administers the estate and ensures the deceased’s will is followed.
Beneficiary: benefits from the estate as per the wishes of the will-maker or nomination by the Life Insured.
What does ‘certified’ copy mean?
A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents in the relevant jurisdiction.
Who has access to personal information on my policy including medical information?
Generally, AIA and the Life Insured only. If AIA has received an Authority form, completed by the Life Assured and giving consent to release information to another specific person, then we can release information to that person. There are certain exceptions under privacy legislation relating to the disclosure of personal information which can apply.
What does total permanent disablement mean?
This will depend on the wording of your policy, including the type of cover you have taken out and any exclusions on your policy. Generally, total permanent disablement means that you are, after consideration of medical and other evidence, so incapacitated that you are unlikely to ever be able to work (depending on the cover you have taken out, this will either mean working in your usual occupation, or in any occupation).
For the full definition please refer to your policy document. For more information on our current Total Permanent Disablement product, see our product page for this cover.
What is the difference between the Life Insured and Policy Owner?
Life Insured: person who is insured.
Owner: person who gets proceeds of the claim.
What does ‘certified’ copy mean?
A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents.
Who has access to personal information on my policy including medical information?
Generally, AIA and the Life Insured only. If AIA has received an Authority form, completed by the Life Assured and giving consent to release information to another specific person, then we can release information to that person. There are certain exceptions under privacy legislation relating to the disclosure of personal information which can apply.
What conditions am I covered for?
Please refer to your policy schedule for the full list of conditions and the specified definition that you are covered for.
What is the difference between the Life Insured and Policy Owner?
Life Insured: person who is insured.
Owner: person who gets proceeds of the claim.
We have one of the largest and most experienced claims teams in Australia and we will guide you through the claim process in a quick and simple manner.
Our claims philosophy is simple – helping you when you need it most, making sure every claim that should be paid is paid promptly and that we always treat you with empathy, compassion and respect.
We also understand that everyone has different needs and your health and wellbeing goes beyond payments. That’s why we offer supported return to work, work-readiness and wellness programs that are evidence backed and results driven, at the right time for you.