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AIA Health Insurance Pty Ltd

Silver Plus Hospital 500 and Comprehensive 70 Extras (MO)

$347.80 / 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.

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.

Policy ID: MYO/J61/NDKI10 Source: Private Health Information Statement (PHIS)

Hospital Cover

Covered

Restricted Cover

Not Covered

This policy includes cover for

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)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Pregnancy and birth

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 $500 per person and $500 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
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.

Members can receive up to 75% back on dental services, No Gap Dental on selected preventative dental services, & lower treatment costs at www.smile.com.au dentists. Dental services at any other dentist will receive up to 60%. See https://www.aia.com.au/en/products/health-insurance/find-a-provider.

Policy ID: MYO/J61/NDKI10 Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Note, for treatments marked with * : General and Preventative Dental are combined under one limit. Physiotherapy, Hydrotherapy, Myotherapy, and Exercise Physiology share a limit. Medically Prescribed Appliances, Hearing Aids, Blood Glucose Monitors and Health Appliances and Aids share an annual limit. Non PBS pharmaceuticals pays back up to $40 per script after the current PBS amount is deducted; vaccinations fall under this Pharmacy limit. This policy also provides access to AIA Vitality where you can earn rewards for leading a healthy lifestyle! https://www.aiavitality.com.au

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$200 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Audiology

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Blood glucose monitors*

$500 per policy

combined limit for blood glucose monitors, hearing aids & other services

Per monitor: 70% of charge

Chiropractic

$400 per policy

combined limit for chiropractic & osteopathy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Dietetics/dietary advice

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Endodontic

$1,000 per policy

combined limit for endodontic & major dental

Filling of one root canal: 60% of charge

Exercise physiology*

$600 per policy

combined limit for exercise physiology, physiotherapy & other services

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Eye therapy (orthoptics)

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

General dental*

$1,000 per policy

Fluoride treatment: 60% of charge
Scale & clean: 60% of charge
Periodic oral examination: 60% of charge

Health management / Healthy lifestyle

$200 per policy

Health management: 100% of charge

Hearing aids*

$500 per policy

combined limit for blood glucose monitors, hearing aids & other services

Hearing aid: 70% of charge

Major dental

$1,000 per policy

combined limit for endodontic & major dental

Surgical tooth extraction: 60% of charge
Full crown veneered: 60% of charge

Non PBS pharmaceuticals*

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

Per eligible prescription: $40

Occupational therapy

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Optical

$250 per policy

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

Orthodontic

$1,000 per policy

$2,600 lifetime limit

Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge

Orthotics (podiatric orthoses)

$400 per policy

Orthotics supply & fit: 70% of charge

Osteopathy

$400 per policy

combined limit for chiropractic & osteopathy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Physiotherapy*

$600 per policy

combined limit for exercise physiology, physiotherapy & other services

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Podiatry

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Psychology

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Remedial massage

$200 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Speech therapy

$400 per policy

Initial visit: 70% of charge
Subsequent visit: 70% of charge

Vaccinations

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

Per service: $40

Swimming lessons - 2 month waiting period and $300 annual limit. Preventative health benefits - myOwn will pay benefits for preventative health screening services equivalent to 100% of the fee charged for bowel cancer identification kits (1 every 2 years) and Melanoma surveillance photography (1 per year) up to $200 per person.

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes

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 Hospital 500 and Comprehensive 70 Extras (MO)

$347.80 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

Call now 1800333004 Sponsor link

AIA Health Insurance Pty Ltd

http://www.aia.com.au/health

Health.MemberServices@aia.com.au

1800333004

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/J61/NDKI10