AIA Health Insurance
Silver Hospital 500 and Good Set Extras
AIA Health Insurance
How $300.61 is worked out
- Premium as filed - $396.15 a month (hospital share $289.50)
- Government rebate - 24.1% of the premium (never of the loading): -$95.54
- A month - $300.61
Go to insurer no commission on this policy
Hospital: what is covered
Covered (26)
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Heart and vascular system
- Hernia and appendix
- Implantation of hearing devices
- Joint reconstructions
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Skin
- Tonsils, adenoids and grommets
Restricted (3)
- Hospital psychiatric services
- Palliative care
- Rehabilitation
Not covered (9)
- Assisted reproductive services
- Cataracts
- Dialysis for chronic kidney failure
- Insulin pumps
- Joint replacements
- Pain management with device
- Pregnancy and birth
- Sleep studies
- Weight loss surgery
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Silver
- Hospital - Private or public hospital
- Excess - Capped per person and per policy per year. $500 per person a year. $1,000 per policy a year. No excess for dependants.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Offered for 18 to 29 year olds
- Accident cover - Yes
- Travel and accommodation benefits - No
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: 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 $250 of your excess (Excess Refund) in the event that you’re admitted to hospital.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental | 2 months | Check-up (item 012): $30.00; Scale and clean (item 114): $51.00; Fluoride treatment (item 121): $22.00 | $700 per person a year (shared with other services) |
| Major dental | 12 months | Tooth extraction (item 322): $111.00; Crown (item 615): $500.00 | $700 per person a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $121.00 | $700 per person a year (shared with other services) |
| Glasses and contact lenses | 6 months | Single vision glasses: 100% back; Multifocal glasses: 100% back | $200 per person a year, $400 per policy a year |
| Physiotherapy | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $350 per person a year, $700 per policy a year (shared with other services) |
| Chiropractic | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $350 per person a year, $700 per policy a year (shared with other services) |
| Psychology | 2 months | First visit: $50.00; Follow-up visit: $25.00 | $100 per person a year |
| Acupuncture | 2 months | First visit: $35.00; Follow-up visit: $30.00 | $150 per person a year, $300 per policy a year (shared with other services) |
| Remedial massage | 2 months | First visit: $35.00; Follow-up visit: $30.00 | $150 per person a year, $300 per policy a year (shared with other services) |
| Dietitian | 2 months | First visit: $40.00; Follow-up visit: $40.00 | $100 per person a year (shared with other services) |
| Exercise physiology | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $350 per person a year, $700 per policy a year (shared with other services) |
| Health management programs | 2 months | Benefit: $40.00 | $100 per person a year (shared with other services) |
| Osteopathy | 2 months | First visit: $45.00; Follow-up visit: $35.00 | $350 per person a year, $700 per policy a year (shared with other services) |
Not covered: Braces, Prescriptions not on the PBS, Podiatry, Hearing aids, Blood glucose monitors, Audiology, Antenatal and postnatal, Chinese herbal medicine, Eye therapy (orthoptics), Home nursing, Occupational therapy, Orthotics, Speech therapy, Vaccinations.
Other services, as filed: Health Checks such as mammograms, bowel cancer testing kit, prostate cancer checks and skin cancer checks are also covered under this policy. $50 per health check, per person, up to the annual limit of $100. Psychology benefit includes counselling services.
Ambulance
Emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in Northern Territory
AIA Health Insurance has agreements with 3 private hospitals here, as filed with the Ombudsman.
The list
- Darwin Day Surgery - Wanguri (day hospital)
- Darwin Private Hospital - Tiwi
- NT Medical Specialist - Wanguri (day hospital)
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
84.0% is the Commonwealth Ombudsman's figure for AIA Health in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement J27A/DMFI2Y, filed by AIA Health Insurance Pty Ltd, issued 1 Apr 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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