Better Set Extras

Our product names are designed to help you understand the features and benefits of the different levels of cover offered by AIA Health and how these options relate to one another.
 
Good Extras give you support for the everyday essentials with affordable claiming levels
 
Better Extras increase your claim-back percentage and annual limits across popular services like dental, optical and physio.
 
Best Extras give you our most generous claim backs and limits, helping minimize out-of-pocket costs across the widest range of services.

Who Better Set Extras is best for

  • People who want predictable, fixed benefits rather than percentage-back claiming.
  • Members who regularly use dental, therapies and optical services.
  • Families wanting clearer out-of-pocket expectations.

Better Set Extras - Key Features

  • Fixed benefits per visit – consistent set benefit amounts paid towards each service.
  • Dental benefits include Preventive, General & Major Dental with higher limits than Base/Good Sets.
  • Optical cover with a fixed annual limit per person (frames, lenses, contacts).
  • Therapy services covered with set benefit amounts (physio, chiro, osteo, remedial massage).
  • Waiting periods: 2 months most services, 6 months optical, 12 months major dental.
  • Effective date: Refer to fact sheet.

Dental

Amount you can claim Annual limit per person, per calendar year Total annual claiming limit Waiting period (months)
Extras Treatments At all other providers At smile.com.au dentists5
General and Preventative Dental1 Fixed Amount 60% $700 Service limits apply 2
No Gap Dental2 Not available 100%
Major Dental3
Periodontics (gum treatment) Fixed Amount 60% $700 $700 12
Endodontics (root canal treatment)
Occlusal Therapy
Oral Surgery
Crowns & Bridges
Dentures & Implants
Orthodontics4 Fixed Amount 60% $600 $2,400 Lifetime limit 12
By using the smile.com.au dental network, you can significantly reduce your out-of-pocket dental expenses.

Your dental extras explained

1. General and Preventative Dental
 
General and Preventative Dental includes a wide range of common dental procedures including check-ups, x-rays, cleaning, fluoride treatments, fillings and simple teeth extractions. There are limits to the number of General and Preventative Dental treatments that you may claim for in a calendar year.
 
Preventative Dental service limits include one comprehensive oral examination and two periodic dental examinations, per person, per calendar year.
 
There are a range of dental procedures that cannot be claimed when provided on the same day e.g. a filling on a tooth that has been removed. Dental benefits for some procedures cannot be paid unless tooth identification is supplied by the provider.
 
2. No Gap Dental
 
No Gap Dental benefit is available on eligible preventative dental services if you have served the two-month waiting period and use a smile.com.au dentist.
 
Please note that any benefits AIA Health pays towards No Gap Dental will count towards your Preventative and General Dental limits.
 
This benefit is limited to one service per treatment group per calendar year for each person listed on the policy. Eligible No Gap Dental item numbers for each treatment group are listed with your policy details. For Further details refer to your provided member guide and fund rules or call us on 1800 333 004
 
3. Major Dental
 
Major Dental includes endodontics, occlusal therapy, crowns, bridges, complete and partial dentures, dental implants, periodontics and oral surgery (includes surgical teeth extractions e.g. wisdom teeth).
 
4. Orthodontics with smile.com.au
 
smile.com.au is a dental network – it does not have orthodontists in its network. However, some dentists do provide basic orthodontic treatments that are eligible to receive smile.com.au dental network benefits including reduced fees and higher percentage back (e.g. Invisalign, Snap On Smile, Fastbraces, MYObrace and Clear Correct).
 
5. smile.com.au
 
We’ve partnered with smile.com.au to make dental care more affordable and accessible for you. If you have extras with dental cover you will save 15-40% off* smile.com.au standard fees for all dental treatments performed by a smile.com.au approved dentist. For the list of dentists to book with please visit dental member benefits at aia.com.au/health/member-benefits/dental-benefits.
 
These savings are in addition to your existing AIA Health Extras benefits. This means lower out-of-pocket costs for any treatment, as smile.com.au dentists will reduce their normal fees by at least 15%.
 
With close to 4,000 approved dentists in the smile.com.au network, chances are there is one near you. To find a participating smile.com.au dentist please visit dental member benefits at aia.com.au/health/member-benefits/dental-benefits. You can also check with your dental practice that your preferred dentist is registered with smile.com.
*Savings may vary between dentists. It is recommended that you obtain a quote prior to treatment.

Non-Dental

Amount you can claim Annual limit per person, per calendar year Additional Information Waiting period (months)
Extras Treatments Initial consultation Subsequent consultation
Non-PBS Pharmacy & vaccinations6 Up to $40 per item $350 2
Optical (prescription lenses, contacts and frames only) 100% $200 $400 Annual Policy Limit 6
Therapies
Physiotherapy (including hydrotherapy, myotherapy and exercise physiology) $40 $30 $450 $900 Annual Policy Limit 2
Chiropractic $40 $30 $450 $900 Annual Policy Limit
Osteopathy $45 $35
Podiatry $40 $30 $200
Mental Health (including psychology and counselling) $100 $50 $300
Audiology $70 $70 $120
Acupuncture $35 $30 $150
Remedial massage $35 $30 $150 $300 Annual Policy Limit
Health Aids
Medically prescribed appliances7 $100 $250 Benefit Replacement Period Apply 12
Blood glucose monitor $100
Hearing Aids $300 $300 Annual limit applies per person over a 3 year calendar period.
Wellness
Swimming Lessons8 $50 $100 2
Weight management programs (including dietetics)9 $40 $200
Health Checks10 $50 $100
Unless stipulated otherwise, consultations must be one-on-one with a registered provider.

Your non-dental extras explained

6. Pharmaceuticals
 
AIA Health will pay benefits of up to $40 per item, after the PBS threshold, up to your annual limits for all non PBS Pharmaceuticals and travel vaccines. Pharmaceutical benefits are only payable on drugs that are a Schedule 4 or Schedule 8 class.
 
7. Medically prescribed appliances
 
A doctor’s letter of recommendation dated within the last 12 months is required to be lodged with claims for a medically prescribed appliance, including;
  • blood glucose monitor
  • blood pressure monitors
  • nebuliser pump
  • sleep apnea machine
  • TENS machine
  • pressure garments
  • non-surgical prostheses
AIA Health does not pay benefits for the hire of any health appliance or any consumable products associated with these devices. A benefit replacement rule applies to medically prescribed appliances. You must wait three years before you can lodge another claim for the same item.
 
Orthopedic and orthotic appliances
 
Orthopaedic and orthotic appliances must be custom made by a podiatrist or orthotist, and not by a chiropractor or physiotherapist. For an orthosis to be custom made, a plaster cast or mould must be taken. Customising, heat moulding, trimming or adjusting an existing ‘off the shelf’ appliance does not involve this process and therefore does not constitute a custom-made appliance. Orthopaedic appliances attract benefits where the application of which has resulted from, and is required immediately following, an injury or surgery. A doctor’s letter of recommendation dated within 12 months is required prior to claiming. Orthopaedic and orthotic appliances are subject to a 12-month benefit replacement period.
 
8. Swimming lessons
 
AIA Health will pay benefits towards approved swimming lessons provided by recognised swimming providers. Swimming lessons must be for the purpose of improving or preventing a specific medical condition (for example, asthma) as part of a health management program or chronic disease management program. A doctor’s letter of recommendation dated within 12 months is required to be lodged with your claims.
 
9. Weight management programs
 
AIA Health will pay benefits towards any consultations you have at a registered dietitian who is a recognised provider or participation in recognised weight loss programs, including Weight Watchers and Fernwood Food Coaching. Benefits are not payable towards meals and supplements. A doctor’s letter of recommendation dated within 12 months is required to be lodged with your claims.
 
10. Health checks
 
AIA Health will pay benefits towards your preventative health checks provided by recognised providers, where Medicare benefits are not payable for the preventative health check, including:
  • mammograms and bowel cancer screening kits (1 each every 2 years)
  • prostate cancer and skin cancer checks (1 each per calendar year).
Note: if you have received a preventative health check through Medicare, you may not claim under this benefit during the same calendar year.

Frequently Asked Questions to do with AIA’s Extras Cover

Please consult the provided Member Guide and Extras Fact Sheets for the most up-to-date product details before purchasing.

As our primary method of communication is email, it is important that your contact details are kept up to date with your current email address to ensure you’re able to receive any correspondence.

Benefits will only be payable by AIA for services performed by any practitioner in a private practice who is appropriately registered with bodies recognised by AIA Health, where there is no Medicare benefit payable.
 
Note: A Recognised Provider may be de-recognised with AIA Health in certain circumstances in accordance with our Fund Rules - so it’s important to check they are still recognised by AIA Health. Your provider can confirm they are recognised or you can call us on 1800 943 010.

Waiting periods are the period of time during which you are not entitled to the benefits of your policy. Waiting periods can apply when changing your cover to include new or upgraded services. If you’re switching to AIA Health from another equivalent policy, you won’t need to re-serve waiting periods already served with the previous health insurer. Refer to your Member Guide for more information and details about waiting periods and how they work.

Benefit replacement period is the time you need to wait after purchasing an item covered by us before you can receive further benefits to replace the item.
 
Note: Benefit replacement periods are separate to waiting periods. All medically prescribed appliances and hearing aids have a benefit replacement period of three years for purchasing or replacing the same item.

  • Per Person Limit
    • Each person on your AIA Health cover can claim up to the per person limit within a calendar year. You may not be able to fully receive a per person limit if family limits have already been reached on the cover or you have reached your lifetime limit.
  • Family Limit
    • A family limit is the total amount that can be claimed by all members on your AIA Health cover within a calendar year. Family limits will also be subject to specified per person limits.
  • Annual Limit
    • Annual limits are the maximum amount of benefits AIA Health will pay towards services and/or items included on your cover per calendar year. Annual limits can be subject to per person, sub-limits, family limits, and lifetime limits. If you have claimed benefits with a previous insurer in a calendar year, these will be taken into account by AIA Health when applying limits for the first membership year.
  • Lifetime Limit
    • A lifetime limit is an individual limit that is the total benefit you can receive for an item or service over the lifetime of your policy. When you reach this limit, you can no longer claim that benefit again, even if you change your cover with AIA Health or move to another health insurer on a similar cover type (unless your new cover with AIA Health or another health insurer has a higher lifetime limit for that item or service).
  • Policy Limit
    • A policy limit is the total amount that can be claimed by all members on your AIA Health cover within a calendar year. Policy limits will also be subject to specified per person limits.
  • Flexi Limit
    • A Flexi limit is the total annual benefit amount that you can claim, as you choose, on any included service under your policy. Specified Flexi limits are per person, per calendar year. Some extras services may be subject to sub-limits.
      If you have claimed benefits with a previous insurer in a calendar year, these will be taken into account by AIA Health when applying limits for the first membership year.
  • Loyalty Benefit Limit
    • Flexi Extras come with loyalty benefits that reward you the longer you hold your cover. Your annual Flexi Limit will increase by $100 for each consecutive year served on a Flexi Extras product, up to 5 years. Limits will increase each year on your policy start date.
  • Initial Consultation
    • The maximum amount of benefits you will receive from AIA Health for the initial service received. You may not be able to fully receive an initial benefit amount if per person, sub-limits, family or annual limits have been reached.
  • Subsequent Consultation
    • The maximum amount of benefits you will receive from AIA Health for a subsequent service received. You may not be able to fully receive a subsequent benefit amount if per person, sub-limits, family or annual limits have been reached.

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AIA Health may make changes to this cover from time to time, including adding or reducing the benefits or services available to you, and notice of such changes will be provided via email in accordance with the PHI Act, Code of Conduct and Australian Consumer Law. The information provided here is a guide and you should always consult your provided member guide and up-to-date fact sheets at the point of purchase and claiming or call us on 1800 333 004.

Choose the right cover

When considering a private health insurance policy, you should review your current and future medical needs, budget, and healthcare priorities. Having a good understanding of these will help you decide if a cover is appropriate for your personal circumstances.
 
Before selecting a Extras Policy, you should review:
  • What services are covered
  • What waiting periods apply
  • What exclusions apply
  • What benefit limits apply on Extras cover

What makes AIA Health different?

At AIA Health, we believe that health insurance should benefit you every day and not just when things go wrong. That’s why our cover comes with access to AIA Vitality, our science-backed health and wellbeing program designed to support you at every stage of your health journey.

New member offer!

Get up to 10 weeks premium cashback when you join AIA Health by 31 March 2026*.

Take out an eligible policy by 31 March 2026 and you’ll get up to 10 weeks premium cashback on your health insurance over your first 3 years. *Get up to 10 weeks free on eligible combined Hospital & Extras products and up to 6 weeks free on eligible Hospital only products. T&Cs apply.