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AIA Health Insurance Pty Ltd

Silver Plus Family Hospital 750 and Best 70% Back Extras

$529.40 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading or an insurer discount. Check with your insurer for details.

This policy covers: Only one person.

Policy ID: MYO/J41A/NMUQ10

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
This policy does not include cover for
Weight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $750 per person and $750 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members Waiting periods:
  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments
Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

All policies include membership to AIA Vitality, the science-backed health and wellbeing program that rewards you for looking after your health. If you have held an AIA Health Insurance policy for a minimum of six months and have an AIA Vitality status of Silver or above, we will refund $500 of your excess (Excess Refund) if you’re admitted to hospital. Exclusions apply on some clinical categories.

Extras Cover

Members can receive up to 80% back on dental services, No Gap Dental on selected preventative dental services & lower treatment costs at smile.com.au dentists. Dental services at other dentists can receive up to 70% back. See https://www.aia.com.au/en/products/health-insurance/find-a-provider.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Ante-natal/Post-natal classes* 2

$600 per policy

combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Audiology 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Blood glucose monitors* 12

$400 per policy

combined limit for blood glucose monitors & orthotics (podiatric orthoses)

  • Per monitor: 70% of charge
Chiropractic* 2

$400 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Dietetics/dietary advice 2

$350 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Endodontic 12

$1,000 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: 70% of charge
Exercise physiology 2

$600 per policy

combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services

  • Initial visit: 70% of charge
Eye therapy (orthoptics) 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
General dental* 2

$1,000 per policy

  • Fluoride treatment: 70% of charge
  • Scale & clean: 70% of charge
  • Periodic oral examination: 70% of charge
Health management / Healthy lifestyle 2

$200 per policy

  • Health management: 70% of charge
Hearing aids 12

$400 per policy

  • Hearing aid: 70% of charge
Major dental 12

$1,000 per policy

combined limit for endodontic & major dental

sub-limits apply

  • Surgical tooth extraction: 70% of charge
  • Full crown veneered: 70% of charge
Non PBS pharmaceuticals* 2

$300 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $40
Occupational therapy 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Optical 6

$250 per policy

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$800 per policy

$3,200 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge
Orthotics (podiatric orthoses) 2

$400 per policy

combined limit for blood glucose monitors & orthotics (podiatric orthoses)

  • Orthotics supply & fit: 70% of charge
Osteopathy* 2

$400 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Physiotherapy* 2

$600 per policy

combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Podiatry 2

$250 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Psychology 2

$300 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Remedial massage 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Speech therapy 2

$200 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Vaccinations* 2

$300 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $40
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Ante-natal/Post-natal classes*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for blood glucose monitors & orthotics (podiatric orthoses)}

Examples of maximum benefits

{Per monitor: 70% of charge}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 70% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 70% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

Examples of maximum benefits

{Fluoride treatment: 70% of charge}

{Scale & clean: 70% of charge}

{Periodic oral examination: 70% of charge}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Health management: 70% of charge}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

Examples of maximum benefits

{Hearing aid: 70% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Surgical tooth extraction: 70% of charge}

{Full crown veneered: 70% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $40}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{$3,200 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for blood glucose monitors & orthotics (podiatric orthoses)}

Examples of maximum benefits

{Orthotics supply & fit: 70% of charge}

Osteopathy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for ante-natal/post-natal classes, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$250 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $40}

Swimming lessons are covered under this policy - Benefit Limit $200 per person, per year. Smoking cessation services are covered under this policy - Benefit Limit $150 per person, per year. Psychology benefit includes counselling services.

This policy does not include General treatment (Extras) cover for
Chinese medicine
Home nursing

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: Cover for call-out fees where you're not taken to hospital are limited to 2 x ambulance attendances per insured person, per calendar year.

Insurer Details

AIA Health Insurance Pty Ltd

Silver Plus Family Hospital 750 and Best 70% Back Extras

$529.40 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/MYO/J41A/NMUQ10

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