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AIA Health Insurance Pty Ltd

Gold Hospital and Better 60% Back Extras

Corporate Policy

$509.26 / month

(Before Rebate, Discount & Loading)

Available in QLD

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.

Corporate policy: This is a corporate policy which is only available to employees/members of organisations with arrangements with this health insurer.

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/J99A/QLBI10 Source: Private Health Information Statement (PHIS)

Hospital Cover

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

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: No excess

Co-payments: Every time you go to hospital you will have to pay:

$350 per day for a shared room for overnight admissions - up to $1,400 per hospital stay
$350 per day for a private room for overnight admissions - up to $1,400 per hospital stay
$350 for day surgery (no overnight stay)
The maximum co-payment is $1,400 per year

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 your excess in the event that you’re admitted to hospital. Excess Refund is not available when claiming on the following clinical categories: Cataracts, Joint replacements, Dialysis for chronic kidney failure, Pregnancy and birth, Assisted reproductive services, Weight loss surgery, Insulin pumps, Pain management with Device & Sleep Studies.

Members can receive up to 70% 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 60% back. See https://www.aia.com.au/en/products/health-insurance/find-a-provider.

Policy ID: MYO/J99A/QLBI10 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, Myotherapy and Hydrotherapy share an annual limit. Chiropractic and Osteopathy share an annual limit. Medically Prescribed Appliances, Orthotics and Blood Glucose Monitors share a 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. By reaching Silver Vitality Status or above you will get an additional 10% back on any non-dental benefits. www.aiavitality.com.au.

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$150 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Audiology

$150 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Blood glucose monitors*

$250 per policy

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

Per monitor: 60% of charge

Chiropractic*

$300 per policy

combined limit for chiropractic & osteopathy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Dietetics/dietary advice

$200 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Endodontic

$800 per policy

combined limit for endodontic & major dental

sub-limits apply

Filling of one root canal: 60% of charge

Exercise physiology

$400 per policy

combined limit for exercise physiology, physiotherapy & other services

Initial visit: 60% of charge

General dental*

$800 per policy

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

Health management / Healthy lifestyle

$100 per policy

Health management: 60% of charge

Hearing aids

$300 per policy

Hearing aid: 60% of charge

Major dental

$800 per policy

combined limit for endodontic & major dental

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

Non PBS pharmaceuticals*

$100 per policy

combined limit for non pbs pharmaceuticals & vaccinations

Per eligible prescription: $40

Optical

$250 per policy

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

Orthodontic

$600 per policy

$2,400 lifetime limit

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

Orthotics (podiatric orthoses)*

$250 per policy

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

Orthotics supply & fit: 60% of charge

Osteopathy*

$300 per policy

combined limit for chiropractic & osteopathy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Physiotherapy*

$400 per policy

combined limit for exercise physiology, physiotherapy & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Podiatry

$200 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Psychology

$300 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Remedial massage

$150 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Vaccinations*

$100 per policy

combined limit for non pbs pharmaceuticals & vaccinations

Per service: $40

Swimming Lessons are covered under this policy - Benefit Limit $100 per person, per year. Smoking Cessation services are covered under this policy - Benefit Limit $100 per person, per year. Psychology benefit includes counselling services.

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

Ante-natal/Post-natal classes

Chinese medicine

Eye therapy (orthoptics)

Home nursing

Occupational therapy

Speech therapy

Ambulance cover

Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au). This includes cover whilst interstate.

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

Gold Hospital and Better 60% Back Extras

Corporate Policy

$509.26 / month

(Before Rebate, Discount & Loading)

Available in QLD

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/J99A/QLBI10