Making getting money back on claims quick and simple.
Open the AIA Health app or login to the
AIA Health Portal.
AIA Health Portal.
Three quick steps to claim
Login to your account
Make your claim
Select ‘Claims’ and follow the steps to submit your claim.
Receive your payment
Your claim will be reviewed and applicable benefits will be put into your nominated account.
Making claims easier than ever
5 minutes
Average claim application time
5 days
Claim approval time*
99% of claims paid within 3 days
Claim settlement rate
*Claim approval time for member claims only not provider claims
Your claims checklist
Before claiming, make sure you:
- have provided your nominated bank account details so we can pay your claim – you can update your details with the AIA Health app
- check you’re covered for the treatment and have served any related waiting periods – you can check your coverage and limits with the AIA Health app,
- have already had the treatment or service, as you can’t claim in advance.
Ready to make a claim?
Open the AIA Health app or login to the AIA Health Portal.
Claiming for Extras & Hospital
Claiming on Extras
Any member on your policy can submit a claim for extras. There are several ways to claim your extras with AIA Health, including:
- at your service provider by providing your AIA Health membership card, or
- online with the AIA Health app or AIA Health Portal.
Claiming on hospital cover
Going to hospital can be a busy time, so we want to make it easier by giving you clarity on claiming. Usually the hospital will take care of claiming for things like your hospital stay and procedure costs.
Excesses or other out-of-pocket hospital costs can be paid by you directly to the hospital, either in advance or on the day of your admission.
Your medical specialists, such as your surgeon or anaesthetist, will create their own invoice. You will need to pay them directly. You can then make a claim firstly through Medicare, where you'll be given a Medicare Benefits Statement. You'll then need to provide this Statement to us so we can pay our portion of the claim.
Helpful tips
Ask your specialist about their billing process
Some specialists will lodge the claim through Medicare and to us on your behalf, so be sure to ask them about their billing process so you know what to expect.
Check your premiums are up to date
Leading up to your admission, the hospital will complete a check with us to ensure you are covered for your admission. We recommend checking your premiums are up-to-date to avoid any issues.
Your hospital excess
If you are being treated in one of our agreement hospital for a covered treatment, you will only need to pay an excess and we will cover the remaining cost of your hospital treatment.
Medicare Benefit Schedule
For your medical treatment, your doctor will charge you with a Medicare Benefit Schedule (MBS) Item number. The MBS is a list of medically necessary procedures that can be performed in Australia. The Australian Government and Medicare set the MBS fee for each procedure as a guideline for what doctors can charge patients treated in the public system.
Get more back on claims
Increase what you get back on claims by engaging with AIA Vitality (excludes dental). Automatically receive an extra 10 per cent back on treatments if you have achieved AIA Vitality Silver Status or above at the time of your treatment, so you can keep more in your pocket. This offer is limited and only available on percentage back Extras products.
We’ll refund your hospital excess
If you have held AIA Health insurance cover for at least six months and have an AIA Vitality Status of Silver or above, we’ll refund your hospital excess. Simply submit a claim, including your invoice to get the excess refunded. T&Cs apply.
Other ways to make a claim
Experience the AIA Health app
Frequently asked questions about claims
Firstly, you’ll need to ensure that you’ve served relevant waiting periods before making a claim. Then, if you have Extras cover, simply use your membership card at participating service providers to make a claim on the spot. Alternatively, you can make a claim with the AIA Health app, within the AIA Health Portal, or by post. If you would like more information refer to the Member Guide.
You can see them all online. Simply login to the AIA Health Portal and head to the Claims section to look at your history.
Processing times can take between three to five business days. We try our best to process claims as quickly as possible.
To provide or update the bank account details where you would like your claim payment made, visit the AIA Health Portal or AIA Health app and follow the prompts. Alternatively, contact our team on 1800 333 004 for AIA Health members or 1800 161 218 for Corporate members.
Yes, if this service is included in your cover. Please check the applicable Product Fact Sheet to determine what is included in your cover.
It doesn’t happen often, but there are instances where benefits are not paid or paid at a lower level. This happens when:
- the treatment is not covered under your policy
- the treatment was not provided by a recognised provider
- the treatment was not provided in Australia
- you’ve already claimed the maximum allowable benefits during a specified period
- you’ve transferred to AIA Health Insurance from another fund and have already claimed for that treatment
- it’s been more than two years since the treatment you’re claiming for
- the health care account has been incorrectly itemised
- you have an outstanding excess to pay on your chosen level of cover
- the service is subject to a waiting period or another limit
- treatment was provided to or from a family member or business associate
- if AIA Health Insurance believes that you are not receiving acute care after 35 days of continual hospitalisation
- surgery is performed in hospital by a registered podiatrist/podiatric surgeon
- when no MBS item number is provided by the health practitioner (we need an MBS item number to be able to process your claim)
- if the MBS item/treatment is being performed for a cosmetic reason and not medical, or
- the treatment was the second treatment performed on you in a day by a single practitioner.
To find out more, we recommend reviewing your cover’s detailed terms and conditions available here.
