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REQUEST A QUOTELOGIN TO MY APIA HEALTH
 
When you take out any combined Hospital and Extras cover before 30 June 2016, we will waive waiting periods on some Extras benefits that ordinarily have a two month waiting period, like general dental and physio. This means you can claim straight away on these services.!
  • 1. Hospital Cover
  • 2. Extras Cover
  • 3. Your Cover
  • More Information
 

Hospital Cover

Select from Essentials or Premium cover

 

18 Claimable Services

  •  Accidental Injury

      Accidental Injury

    Waiting Period: 1 day

    The immediate necessary treatment required as a result of an accident. To be covered you must provide documented proof that you have sought treatment at a hospital emergency department within 24 hours of the accident. If further treatment in hospital is needed as an admitted patient, you will need to be re-admitted to a hospital within 90 days of the initial visit. For example:

    • if you were sent home with bandaging or a half-plastered limb so that swelling can reduce before a full cast is applied to the injured limb
  •  Ambulance (unlimited emergency)

      Ambulance (unlimited emergency)

    Waiting Period: 1 day

    If you need immediate medical attention and your condition means that you cannot be transported in another way, you are covered for:

    • Emergency Ambulance transport to hospital provided by a State or Territory Ambulance service anywhere in Australia
    • Emergency Ambulance call out fees (where the customer is treated at the scene by paramedics and it is determinded that transport to hospital is not required)
    • Transport between hospitals when the transfer is required as a result of the existing hospital not specialising in the treatment required

    Disclaimer: Emergency Ambulance transport is paid at 100% of the cost. No hospital excess is applicable for this service.

  •  Assisted Reproductive Services

      Assisted Reproductive Services

    Under all Apia covers no benefits are payable towards Inpatient services relating to egg retrieval and implantation. This includes:

    • IVF
    • GIFT
  •  Back Surgery

      Back Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to treat back abnormality or injury. This includes:

    • spinal fusion
    • discectomy (surgical removal of a herniated disc)
  •  Brain Surgery

      Brain Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to treat conditions of the brain or skull. This may include:

    • removing a brain tumour
    • bleeding (haemorrhage) in the brain
    • blood clots (hematomas) in the brain
    • weaknesses in blood vessels (brain aneurysm repair)
    • craniotomy
  •  Cancer Treatment

      Cancer Treatment

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to remove cancer and cancer treatments which are PBS approved for the specific type of cancer being treated (dependent on your level of cover). This may include:

    • surgery
    • radiation (radiotherapy)
    • chemotherapy
  •  Colonoscopies

      Colonoscopies

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Medical procedure to examine the large intestine (colon) and/or to diagnose and investigate:

    • cancer of the colon (bowel cancer)
    • colon polyps)
    • unexplained abdominal pain
  •  Cosmetic Surgery

      Cosmetic Surgery

    Under all Apia covers, no benefits are payable towards procedures or hospital costs associated with cosmetic surgery to enhance appearance.

  •  Dental Surgery

      Dental Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Teeth extractions where a hospital admission is required for a general anaesthetic. This may include:

    • surgical removal of impacted wisdom teeth
  •  Eye Treatment

      Eye Treatment

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery and treatment relating to the eye. This may include:

    • cataract removal
    • lens-related services
  •  Gastroscopies

      Gastroscopies

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Medical procedure to examine the oesophagus (throat), stomach and duodenum (first part of the small intestine). Gastroscopies can be used to diagnose and investigate:

    • difficult or painful swallowing
    • pain in the stomach
    • bleeding
    • ulcers
    • cancers
  •  Gynaecological Services

      Gynaecological Services

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Procedures dealing with the health of the female reproductive system (uterus, vagina and ovaries) where not related to infertility. This may include:

    • abdominal or vaginal hysterectomy
    • endometriosis
  •  Heart Procedures

      Heart Procedures

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    The medical treatment or surgical procedure for cardiac conditions such as heart disease, arrhythmias, congenital defects. This may include:

    • surgical insertion of pacemakers and defibrillators
    • stent insertion
    • coronary angioplasty and artery bypass grafts
    • heart transplants
    • operations for congenital defects and heart valve defects
  •  Hernia Repair

      Hernia Repair

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to repair a hernia. A hernia is the protrusion of organs, such as intestines, through a weakened section of the abdominal wall. The most common sites are:

    • in the groin
    • abdominal areas such as the navel
  •  Infertility Investigations

      Infertility Investigations

    Under all Apia covers no benefits are payable towards surgery to investigate a female's fallopian tubes and the condition of uterus and ovaries in relation to infertility. It can also treat conditions effecting fertility such as:

    • Endometriosis
    • tubal microsurgery
    • removal of fibroids
    • correction of uterine abnormalities
  •  Joint Investigations

      Joint Investigations

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to examine the inside of a joint for accurate diagnosis and removal of loose bodies. This may include the investigation of the:

    • knee
    • shoulder
    • elbow
    • ankle
  •  Joint Reconstructions

      Joint Reconstructions

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to reconstruct damaged ligaments. This may include the reconstruction of the:

    • knee
    • shoulder
  •  Joint Replacement

      Joint Replacement

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to replace a joint in the body with an artificial prosthesis. This can be the replacement of the entire joint or a component of it. This may include the replacement of the:

    • hip
    • knee
    • shoulder
  •  Obesity Surgery

      Obesity Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to reduce the capacity of the stomach as a treatment for morbid obesity. This may include:

    • gastric banding surgery
    • stomach bypass
  •  Palliative Care

      Palliative Care

    Waiting Period: 2 months

    The care of patients with serious illness to relieve pain. Palliative Care:

    • provides relief from pain and other distressing symptoms
    • does not hasten or postpone death
    • supports people to live as actively as possible until death
  •  Pregnancy & Birth

      Pregnancy & Birth

    Under all Apia covers no benefits are payable towards childbirth or complications during pregnancy. This may include:

    • child birth
    • early labour
    • pregnancy induced diabetes
    • hypertension
  •  Psychiatric Treatment (MBP)

      Psychiatric Treatment (MBP)

    Waiting Period: 2 months

    Treatment of mental illness or addiction in a psychiatric facility. This may include treatment for:

    • depression
    • eating disorders
    • drug and alcohol rehabilitation

    Minimum Benefits Payable (MBP) means if you are attending a private hospital, there will be significant out-of-pocket costs for the treatment. MBP is the minimum amount of benefits we are required to pay under the Private Health Insurance Act, to or on behalf of a customer for hospital treatment under a hospital cover. Minimum benefits are equivalent to what is paid for a private patient receiving treatment in a shared ward of a public hospital. For psychiatric treatment, minimal benefits are payable if no Medicare benefit is payable for that part of the treatment. If the treatment is limited to MBP and is important to you we recommend you consider a higher level of cover.

  •  Rehabilitation

      Rehabilitation

    Waiting Period: 2 months

    Physical therapy and exercise treatment at a rehabilitation facility following an inpatient admission. This may include:

    • stroke recovery
    • strengthening of joints and limbs
    • cardiac rehabilitation
  •  Renal Dialysis

      Renal Dialysis

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Treatment to replace the function of the kidneys. Primarily used by people with temporary or permanent renal failure.

  •  Stroke Treatments

      Stroke Treatments

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Treatment for a stroke. A stroke or CVA is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to lack of blood flow (ischemia) caused by a:

    • blockage (thrombosis, arterial embolism)
    • haemorrhage
  • 21 Claimable Services

  •  Accidental Injury

      Accidental Injury

    Waiting Period: 1 day

    The immediate necessary treatment required as a result of an accident. To be covered you must provide documented proof that you have sought treatment at a hospital emergency department within 24 hours of the accident. If further treatment in hospital is needed as an admitted patient, you will need to be re-admitted to a hospital within 90 days of the initial visit. For example:

    • if you were sent home with bandaging or a half-plastered limb so that swelling can reduce before a full cast is applied to the injured limb
  •  Ambulance (unlimited emergency)

      Ambulance (unlimited emergency)

    Waiting Period: 1 day

    If you need immediate medical attention and your condition means that you cannot be transported in another way, you are covered for:

    • Emergency Ambulance transport to hospital provided by a State or Territory Ambulance service anywhere in Australia
    • Emergency Ambulance call out fees (where the customer is treated at the scene by paramedics and it is determinded that transport to hospital is not required)
    • Transport between hospitals when the transfer is required as a result of the existing hospital not specialising in the treatment required

    Disclaimer: Emergency Ambulance transport is paid at 100% of the cost. No hospital excess is applicable for this service.

  •  Assisted Reproductive Services

      Assisted Reproductive Services

    Under all Apia covers no benefits are payable towards Inpatient services relating to egg retrieval and implantation. This includes:

    • IVF
    • GIFT
  •  Back Surgery

      Back Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to treat back abnormality or injury. This includes:

    • spinal fusion
    • discectomy (surgical removal of a herniated disc)
  •  Brain Surgery

      Brain Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to treat conditions of the brain or skull. This may include:

    • removing a brain tumour
    • bleeding (haemorrhage) in the brain
    • blood clots (hematomas) in the brain
    • weaknesses in blood vessels (brain aneurysm repair)
    • craniotomy
  •  Cancer Treatment

      Cancer Treatment

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to remove cancer and cancer treatments which are PBS approved for the specific type of cancer being treated (dependent on your level of cover). This may include:

    • surgery
    • radiation (radiotherapy)
    • chemotherapy
  •  Colonoscopies

      Colonoscopies

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Medical procedure to examine the large intestine (colon) and/or to diagnose and investigate:

    • cancer of the colon (bowel cancer)
    • colon polyps)
    • unexplained abdominal pain
  •  Cosmetic Surgery

      Cosmetic Surgery

    Under all Apia covers, no benefits are payable towards procedures or hospital costs associated with cosmetic surgery to enhance appearance.

  •  Dental Surgery

      Dental Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Teeth extractions where a hospital admission is required for a general anaesthetic. This may include:

    • surgical removal of impacted wisdom teeth
  •  Eye Treatment

      Eye Treatment

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery and treatment relating to the eye. This may include:

    • cataract removal
    • lens-related services
  •  Gastroscopies

      Gastroscopies

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Medical procedure to examine the oesophagus (throat), stomach and duodenum (first part of the small intestine). Gastroscopies can be used to diagnose and investigate:

    • difficult or painful swallowing
    • pain in the stomach
    • bleeding
    • ulcers
    • cancers
  •  Gynaecological Services

      Gynaecological Services

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Procedures dealing with the health of the female reproductive system (uterus, vagina and ovaries) where not related to infertility. This may include:

    • abdominal or vaginal hysterectomy
    • endometriosis
  •  Heart Procedures

      Heart Procedures

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    The medical treatment or surgical procedure for cardiac conditions such as heart disease, arrhythmias, congenital defects. This may include:

    • surgical insertion of pacemakers and defibrillators
    • stent insertion
    • coronary angioplasty and artery bypass grafts
    • heart transplants
    • operations for congenital defects and heart valve defects
  •  Hernia Repair

      Hernia Repair

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to repair a hernia. A hernia is the protrusion of organs, such as intestines, through a weakened section of the abdominal wall. The most common sites are:

    • in the groin
    • abdominal areas such as the navel
  •  Infertility Investigations

      Infertility Investigations

    Under all Apia covers no benefits are payable towards surgery to investigate a female's fallopian tubes and the condition of uterus and ovaries in relation to infertility. It can also treat conditions effecting fertility such as:

    • Endometriosis
    • tubal microsurgery
    • removal of fibroids
    • correction of uterine abnormalities
  •  Joint Investigations

      Joint Investigations

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to examine the inside of a joint for accurate diagnosis and removal of loose bodies. This may include the investigation of the:

    • knee
    • shoulder
    • elbow
    • ankle
  •  Joint Reconstructions

      Joint Reconstructions

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to reconstruct damaged ligaments. This may include the reconstruction of the:

    • knee
    • shoulder
  •  Joint Replacement

      Joint Replacement

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to replace a joint in the body with an artificial prosthesis. This can be the replacement of the entire joint or a component of it. This may include the replacement of the:

    • hip
    • knee
    • shoulder
  •  Obesity Surgery

      Obesity Surgery

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Surgery to reduce the capacity of the stomach as a treatment for morbid obesity. This may include:

    • gastric banding surgery
    • stomach bypass
  •  Palliative Care

      Palliative Care

    Waiting Period: 2 months

    The care of patients with serious illness to relieve pain. Palliative Care:

    • provides relief from pain and other distressing symptoms
    • does not hasten or postpone death
    • supports people to live as actively as possible until death
  •  Pregnancy & Birth

      Pregnancy & Birth

    Under all Apia covers no benefits are payable towards childbirth or complications during pregnancy. This may include:

    • child birth
    • early labour
    • pregnancy induced diabetes
    • hypertension
  •  Psychiatric Treatment

     Psychiatric Treatment

    Waiting Period: 2 months

    Treatment of mental illness or addiction in a psychiatric facility. This may include treatment for:

    • depression
    • eating disorders
    • drug and alcohol rehabilitation
  •  Rehabilitation

      Rehabilitation

    Waiting Period: 2 months

    Physical therapy and exercise treatment at a rehabilitation facility following an inpatient admission. This may include:

    • stroke recovery
    • strengthening of joints and limbs
    • cardiac rehabilitation
  •  Renal Dialysis

      Renal Dialysis

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Treatment to replace the function of the kidneys. Primarily used by people with temporary or permanent renal failure.

  •  Stroke Treatments

      Stroke Treatments

    Waiting Period: 12 months (2 months for ailments / conditions that are not pre-existing)

    Treatment for a stroke. A stroke or CVA is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to lack of blood flow (ischemia) caused by a:

    • blockage (thrombosis, arterial embolism)
    • haemorrhage
  • Hospital Excess
    $250 $500

    The amount you agree to pay toward your hospital admission, before we pay a benefit. Choosing a higher excess will reduce the cost of your premiums.

    Each adult on the policy will only pay one excess per calendar year if they go to hospital, no matter how many admissions they may need. There is no hospital excess for dependent children under 21 years of age.

    The amount you agree to pay toward your hospital admission, before we pay a benefit.

    Read More
      Choose Extras Cover 
     

    Extras Cover

    Select your extras, customise with advanced options or choose Premium cover

     

    6 Extras

  •  Ambulance

     Ambulance

    Waiting Period: 1 day

    If you need immediate medical attention and your condition means that you cannot be transported in another way, you are covered for:

    • Emergency Ambulance transport to hospital provided by a State or Territory Ambulance service anywhere in Australia
    • Emergency Ambulance call out fees (where the customer is treated at the scene by paramedics and it is determinded that transport to hospital is not required)
    • Transport between hospitals when the transfer is required as a result of the existing hospital not specialising in the treatment required

    Disclaimer: Emergency Ambulance transport is paid at 100% of the cost. No annual limit is applicable for this service.

  • no limit
  •  General Dental

     General Dental

    Waiting Period: 2 months

    Diagnostic and other preventative procedures (not covered under Preventative dental) completed to help you keep on top of your oral health. This is routine dental that includes:

    • fillings
    • basic extractions (excluding wisdom teeth)
    • x-rays

    Disclaimer: Doesn't include more complex treatments or procedures such as orthodontic work, endodontic treatment (root canal therapy), crowns or bridges. See Dental (Major).

  • $600
  •  Major Dental

     Major Dental

    Waiting Period: 12 months

    Complex dentistry procedures such as:

    • crowns and bridges
    • root canal therapy
    • removal of wisdom teeth
    • dentures
    • implants
  • $600
  •  Optical

     Optical

    Waiting Period: 6 months

    Correction of visual impairment such as long or short sightedness. Examples of treatment include:

    • prescription glasses
    • contact lenses
  • $250
  •  Physiotherapy

     Physiotherapy

    Waiting Period: 2 months

    Treatment by a physiotherapist which uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to normal activities of daily living.

    Disclaimer: Benefits are only payable for consultations with a physiotherapist.

  • $350
  •  Preventative Dental

     Preventative Dental

    Waiting Period: 2 months

    Preventative dental treatment to help you maintain your oral health with no annual limits. This includes selected:

    • examinations
    • scale and clean
    • fluoride treatments

    Disclaimer: No annual limit is applicable for this service. For more diagnostic and preventative dental procedures see Dental (General).

  • no limit

    + Higher Limits

  •  Ambulance

     Ambulance

    Waiting Period: 1 day

    If you need immediate medical attention and your condition means that you cannot be transported in another way, you are covered for:

    • Emergency Ambulance transport to hospital provided by a State or Territory Ambulance service anywhere in Australia
    • Emergency Ambulance call out fees (where the customer is treated at the scene by paramedics and it is determinded that transport to hospital is not required)
    • Transport between hospitals when the transfer is required as a result of the existing hospital not specialising in the treatment required

    Disclaimer: Emergency Ambulance transport is paid at 100% of the cost. No annual limit is applicable for this service.

  • no limit
  •  General Dental

     General Dental

    Waiting Period: 2 months

    Diagnostic and other preventative procedures (not covered under Preventative dental) completed to help you keep on top of your oral health. This is routine dental that includes:

    • fillings
    • basic extractions (excluding wisdom teeth)
    • x-rays

    Disclaimer: Doesn't include more complex treatments or procedures such as orthodontic work, endodontic treatment (root canal therapy), crowns or bridges. See Dental (Major).

  • $700
  •  Major Dental

     Major Dental

    Waiting Period: 12 months

    Complex dentistry procedures such as:

    • crowns and bridges
    • root canal therapy
    • removal of wisdom teeth
    • dentures
    • implants
  • $1300
  •  Optical

     Optical

    Waiting Period: 6 months

    Correction of visual impairment such as long or short sightedness. Examples of treatment include:

    • prescription glasses
    • contact lenses
  • $300
  •  Physiotherapy

     Physiotherapy

    Waiting Period: 2 months

    Treatment by a physiotherapist which uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to normal activities of daily living.

    Disclaimer: Benefits are only payable for consultations with a physiotherapist.

  • $450
  •  Preventative Dental

     Preventative Dental

    Waiting Period: 2 months

    Preventative dental treatment to help you maintain your oral health with no annual limits. This includes selected:

    • examinations
    • scale and clean
    • fluoride treatments

    Disclaimer: No annual limit is applicable for this service. For more diagnostic and preventative dental procedures see Dental (General).

  • no limit

    22 Extras

  •  Ambulance

     Ambulance

    Waiting Period: 1 day

    If you need immediate medical attention and your condition means that you cannot be transported in another way, you are covered for:

    • Emergency Ambulance transport to hospital provided by a State or Territory Ambulance service anywhere in Australia
    • Emergency Ambulance call out fees (where the customer is treated at the scene by paramedics and it is determinded that transport to hospital is not required)
    • Transport between hospitals when the transfer is required as a result of the existing hospital not specialising in the treatment required

    Disclaimer: Emergency Ambulance transport is paid at 100% of the cost. No annual limit is applicable for this service.

  • no limit
  •  General Dental

     General Dental

    Waiting Period: 2 months

    Diagnostic and other preventative procedures (not covered under Preventative dental) completed to help you keep on top of your oral health. This is routine dental that includes:

    • fillings
    • basic extractions (excluding wisdom teeth)
    • x-rays

    Disclaimer: Doesn't include more complex treatments or procedures such as orthodontic work, endodontic treatment (root canal therapy), crowns or bridges. See Dental (Major).

  • $1000
  •  Major Dental

     Major Dental

    Waiting Period: 12 months

    Complex dentistry procedures such as:

    • crowns and bridges
    • root canal therapy
    • removal of wisdom teeth
    • dentures
    • implants
  • $1300
  •  Optical

     Optical

    Waiting Period: 6 months

    Correction of visual impairment such as long or short sightedness. Examples of treatment include:

    • prescription glasses
    • contact lenses
  • $350
  •  Physiotherapy

     Physiotherapy

    Waiting Period: 2 months

    Treatment by a physiotherapist which uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to normal activities of daily living.

    Disclaimer: Benefits are only payable for consultations with a physiotherapist.

  • $600
  •  Preventative Dental

     Preventative Dental

    Waiting Period: 2 months

    Preventative dental treatment to help you maintain your oral health with no annual limits. This includes selected:

    • examinations
    • scale and clean
    • fluoride treatments

    Disclaimer: No annual limit is applicable for this service. For more diagnostic and preventative dental procedures see Dental (General).

  • no limit
     
     

    6 Extras

  •  
    Chiropractic Osteopathy

     Chiropractic Osteopathy

    Waiting Period: 2 months

    Chiropractic treatment involves manipulation based therapy to treat conditions related to the nerves, skeleton and muscles. Ostepathic treatment includes manipulation of the body to promote mobility and balance. Chiropractors and osteopaths are useful for:

    • back and neck pain
    • sciatica
    • frequent headaches
    • joint pains and muscle strains
    • work-related, repetitive strain and sports-related injuries

    Disclaimer: Benefits are only payable for consultations with a chiropractor or osteopath.

    $300
  •  
    Eye Therapy (orthoptics)

     Eye Therapy (orthoptics)

    Waiting Period: 2 months

    Eye therapy involves detecting, assessing, diagnosing and performing non-surgical (and non-medical) management of eye movement disorders and abnormalities. Orthoptists exclusively specialise in treating conditions such as:

    • lazy or turned eyes
    • double vision
    • vision impairments caused by trauma

    Disclaimer: Benefits are only payable for consultations with an orthoptist.

    $200
  •  
    Health Aids

     Health Aids

    Waiting Period: 12 months

    A range of artificial and health aids that may assist in everyday living. Examples include:

    • blood pressure monitor and coagulation checks (blood clots)
    • hip, knee, ankle, foot and ankle-foot orthoses finger, hand, arm & elbow orthoses/splints nebuliser and spacers (asthma)
    $300
  •  
    Healthier Lifestyle

     Healthier Lifestyle

    Waiting Period: 6 months

    This benefit is designed to allow you to claim on items that assist your health and wellbeing as prescribed by your GP or nib recognised provider. Benefits are payable for the following services:

    • gym memberships
    • yoga and pilates classes
    • personal training
    • weight management programs (Jenny Craig, Weight Watchers)

    Disclaimer: To claim on health management items, you'll need your GP or nib registered provider to sign a Health Management Program Supporting Evidence form. This cover is for consultations only (food or supplementary items are not covered).

    $250
  •  
    Hearing Aids

     Hearing Aids

    Waiting Period: 36 months

    A battery powered, electronic device that makes listening easier for people with hearing loss.

    $800
  •  
    Pharmaceutical

     Pharmaceutical

    Waiting Period: 2 months

    This benefit only covers nib approved items that are not part of the Pharmaceutical Benefits Scheme.

    $250
  •  
    Podiatry Orthotics

     Podiatry Orthotics

    Waiting Period: 2 months

    Podiatrists specialise in the prevention, diagnosis and treatment of disorders and conditions of the feet and lower limbs. Orthotics are devices prescribed by a podiatrist that are placed into the shoe to control or correct abnormal lower limb motions and alignment. Conditions treated by a podiatrist include:

    • complications with arthritis affecting the legs and feet
    • skin and nail disorders
    • corns and calluses
    • ingrown toenails

    Disclaimer: This cover is for podiatrist consultations and prescribed devices only. Benefits are not payable for surgery in a doctor's or podiatrist's rooms.

    $250
  •  
    Preventative Tests

     Preventative Tests

    Waiting Period: 6 months

    Screening tests to help with the early detection of health conditions. These tests can include:

    • thin prep (additional testing following a pap smear)
    • bowel screening
    • bone density testing
    $200
  •  Chiropractic Osteopathy
    $500

     Chiropractic Osteopathy

    Waiting Period: 2 months

    Chiropractic treatment involves manipulation based therapy to treat conditions related to the nerves, skeleton and muscles. Ostepathic treatment includes manipulation of the body to promote mobility and balance. Chiropractors and osteopaths are useful for:

    • back and neck pain
    • sciatica
    • frequent headaches
    • joint pains and muscle strains
    • work-related, repetitive strain and sports-related injuries

    Disclaimer: Benefits are only payable for consultations with a chiropractor or osteopath.

  •  Dietary Advice
    $600

     Dietary Advice

    Waiting Period: 2 months

    Dietitians and Nutritionists educate people on appropriate diet, menu planning and preparation of food to enhance and maintain optimum health.

    Disclaimer: Benefits are only payable for consultations with a dietitian or nutritionist. Food items are not covered.

  •  Exercise Physiology
    $300

     Exercise Physiology

    Waiting Period: 2 months

    The use of exercise (as prescribed by an Exercise Physiologist) as a treatment strategy in the physical rehabilitation of a patient. Exercise physiologists assist with:

    • disease prevention
    • injury rehabilitation
    • establishing and maintaining functional independence

    Disclaimer: Benefits are only payable for consultations with an exercise physiologist.

  •  Eye Therapy (orthoptics)
    $200

     Eye Therapy (orthoptics)

    Waiting Period: 2 months

    Eye therapy involves detecting, assessing, diagnosing and performing non-surgical (and non-medical) management of eye movement disorders and abnormalities. Orthoptists exclusively specialise in treating conditions such as:

    • lazy or turned eyes
    • double vision
    • vision impairments caused by trauma

    Disclaimer: Benefits are only payable for consultations with an orthoptist.

  •  Health Aids
    $500

     Health Aids

    Waiting Period: 12 months

    A range of artificial and health aids that may assist in everyday living. Examples include:

    • blood pressure monitor and coagulation checks (blood clots)
    • hip, knee, ankle, foot and ankle-foot orthoses finger, hand, arm & elbow orthoses/splints nebuliser and spacers (asthma)
  •  Healthier Lifestyle
    $400

     Healthier Lifestyle

    Waiting Period: 6 months

    This benefit is designed to allow you to claim on items that assist your health and wellbeing as prescribed by your GP or nib recognised provider. Benefits are payable for the following services:

    • gym memberships
    • yoga and pilates classes
    • personal training
    • weight management programs (Jenny Craig, Weight Watchers)

    Disclaimer: To claim on health management items, you'll need your GP or nib registered provider to sign a Health Management Program Supporting Evidence form. This cover is for consultations only (food or supplementary items are not covered).

  •  Hearing Aids & Speech Processors
    $1200

     Hearing Aids & Speech Processors

    Waiting Period: 36 months

    A hearing aid is a battery-powered, electronic device that makes listening easier for people with hearing loss. Benefits are payable for speech processors (the external component of a cochlear implant) when the processor is replaced as part of an out-patient procedure.

  •  Home Nursing Services
    $200

     Home Nursing Services

    Waiting Period: 2 months

    Services provided by a registered nurse in private practice for the treatment of illness, disease, incapacity or disability. This service includes:

    • wound management
    • removal of sutures
    • pain management

    Disclaimer: Benefits are not payable for services such as a nurse-housekeeper during recovery after illness.

  •  Natural Therapies
    $400

     Natural Therapies

    Waiting Period: 2 months

    Treatments that work on the physical and emotional body to relieve pain and improve health and wellbeing. Services include:

    • remedial massage
    • acupuncture
    • naturopathy
    • herbalism
    • myotherapy and shiatsu

    Disclaimer: Benefits are only payable for consultations with your natural therapy practitioner.

  •  Occupational Therapy
    $450

     Occupational Therapy

    Waiting Period: 2 months

    Therapy which assists people to overcome limitations caused by injury or illness, emotional or psychological difficulties, developmental delay or the effects of aging. This can include:

    • rehabilitation in skills of self care
    • physical rehabilitation
    • cognitive and memory assessment
    • stress management and relaxation

    Disclaimer: Benefits are only payable for consultations with an occupational therapist.

  •  Orthodontia
    $800

     Orthodontia

    Waiting Period: 12 months

    A form of specialty dentistry focusing on realigning teeth and bites. Examples include:

    • braces
    • plates

    Disclaimer: The annual limit on this service starts at $800 and increases by $100 per calendar year to $2,600 lifetime limit.

  •  Pharmaceutical
    $500

     Pharmaceutical

    Waiting Period: 2 months

    This benefit only covers nib approved items that are not part of the Pharmaceutical Benefits Scheme.

  •  Podiatry Orthotics
    $400

     Podiatry Orthotics

    Waiting Period: 2 months

    Podiatrists specialise in the prevention, diagnosis and treatment of disorders and conditions of the feet and lower limbs. Orthotics are devices prescribed by a podiatrist that are placed into the shoe to control or correct abnormal lower limb motions and alignment. Conditions treated by a podiatrist include:

    • complications with arthritis affecting the legs and feet
    • skin and nail disorders
    • corns and calluses
    • ingrown toenails

    Disclaimer: This cover is for podiatrist consultations and prescribed devices only. Benefits are not payable for surgery in a doctor's or podiatrist's rooms.

  •  Preventative Tests
    $200

     Preventative Tests

    Waiting Period: 6 months

    Screening tests to help with the early detection of health conditions. These tests can include:

    • thin prep (additional testing following a pap smear)
    • bowel screening
    • bone density testing
  •  Psychology
    $500

     Psychology

    Waiting Period: 2 months

    Group or individual consultations with a psychologist. Psychology services are commonly sought for:

    • marital, family or relationship problems
    • stress or pain
    • fears, phobias, anxiety and panic attacks
    • sexual difficulties
    • eating and weight control problems

    Disclaimer: A benefit is not payable for tests (e.g. psychometric testing).

  •  Speech Pathology
    $450

     Speech Pathology

    Waiting Period: 2 months

    The diagnosis, management and treatment of people who are unable to effectively communicate or who have difficulty with feeding and swallowing. Speech pathologists help a range of people, including:

    • kids who have difficulty making themselves understood verbally
    • those who stutter
    • stroke sufferers

    Disclaimer: Benefits are only payable for consultations with a speech pathologist.

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      Choose Hospital Cover 
     

    Your Cover

    Your estimate summary

     

     

     

    More Information

    Everything else you will need to know.

    What is private health insurance?

    An overview

    In Australia, Medicare provides health care for citizens and permanent residents. By taking out private health insurance you can get more health care options, peace of mind an it may even help you avoid tax.

    More on Australia's health care system

    Hopital & Extras

    Hospital cover gives you access to private hospitals and choice of doctor, while Extras cover helps with the costs of services not normally covered by Medicare, such as dental and physiotherapy.

    Compare our Hospital and Extras cover

    Lifetime health cover

    Under Lifetime Health Cover(LHC), you'll pay a 2% loading on top of the normal premiums for each year you don't have hospital cover, over age 31.

    The loading only applies for 10 years of continuous hospital cover. This isn't just with Apia health insurance, but every health fund.

    For more information, call us on 13 50 50 or visit the department of Health and Ageing website at www.health.gov.au

    The Australian Government Rebate on Private Health Insurance

    The Australian Government Rebate on private health insurance.

    More Information

    Medicare Levy Surcharge

    If your taxable income is above the Medicare Levy Surcharge thresholds, and you don’t have an appropriate level of private hospital cover, you may have to pay the Medicare Levy surcharge.

    More Information

    • This hospital cover includes additional services  


      As well as hospital stays for these commonly claimed procedures, there is also the provision of Hospital cover for all other Medicare recognised services that aren't listed as an exclusion on this product.

    • Waiting periods  


      Before you can start claiming, you must be in your chosen cover for a set period of time (known as a waiting period). Customers can only claim benefits after they have served the specified waiting period. For more information, see the waiting periods page or call us on 13 50 50. An annual limit applies on how much you can claim and/or the number of times you can claim for Extras. At the beginning of each year, your benefit limits are renewed allowing you to claim benefits again. Annual limits are calculated per person, per calendar year. For more information, click here, or call us on 13 50 50.

      Switching from another fund?

      Waiting periods already served with your current fund, will be recognised so you can claim straight away. However, you may be required to serve a waiting period for benefits on your new health insurance policy that aren't covered by your existing fund. Any benefit limits already used with your current health fund will apply to your Apia health insurance policy. For more information call Apia on 13 50 50 or read the Policy Booklet here

    • What will I be covered for during my stay in hospital?  


      You're covered for the below services as an admitted private patient in our Agreement Public or Private Hospital. Out-of-pocket expenses may be incurred, however, for some services. Please see the Policy Booklet for more information.

      Accommodation

      Cover for private or shared accommodation includes:

      • day surgery
      • overnight accommodation
      • special care unit accommodation (intensive care, coronary care or neonatal care)
      Operating Theatre

      Fees and charges associated with use of the operating theatre for surgery. Doctor's surgical fees and in-hospital consultations.

      Consultations with a doctor while you are in hospital. This includes all costs for:

      • surgical fees
      • in-hospital consultations
      Prostheses (Surgically implanted)

      Equipment or a device that is surgically implanted by a medical practitioner to improve health outcomes (e.g. an artificial hip or knee). You are able to receive a benefit for surgically implanted prostheses, when the following applies:

      • the prosthesis is on the approved Federal Government Prosthesis Schedule
      • you are covered for the related procedure/surgery. For example, if you are covered for heart, then you will be covered for the implant of a pacemaker or stent
      • you are admitted to hospital as an in-patient

      Some out-of-pocket expenses may be incurred.

      Allied health services

      Allied health services that are received in hospital include:

      • physiotherapy
      • hydrotherapy
      • occupational therapy

      Some out-of-pocket expenses may be incurred.

      Prescriptions

      Prescription medications required for specific treatment when in hospital. Some medications that aren't on the Pharmaceutical Benefits Scheme (PBS) may not be covered.

      Ward-drugs and sundry medical supplies

      Pharmaceuticals and medical supplies used throughout your stay in a hospital ward including:

      • bandages
      • pain killers
      Nursing care

      Care from nurses throughout your stay in hospital.

    • What won't I be covered for during my stay?  


      Hospital excess

      A hospital excess is the amount you elect to pay towards the cost of a hospital stay before any benefits are payable. You only pay an excess if you or someone on your policy goes to hospital. There is no hospital excess for dependant children under 21 years of age. The excess applies once per person per calendar year and is payable directly to the hospital prior to your admission.

      Extra fees & charges

      Additional fees may be charged by the hospital for care and treatment associated with your stay. These are not covered and may include:

      • private hospital emergency or out-patients fees
      • admission or booking fees charged by a specialist or the hospital
      • private room accommodation for a same day procedure
      Services listed as policy exclusions

      Any service listed as excluded on a customer's policy is not covered. This includes:

      • procedures within waiting periods
      • cosmetic procedures to enhance appearance
      Additional or specialised nursing care

      If you require additional or specialised nursing care, extra charges may apply. Examples of such care includes:

      • special nursing
      • services provided exclusively or primarily for the care or treatment of a mentally disabled person who is not a private patient in a hospital
      • services rendered in a nursing home
      • respite care
      Additional medications & procedures

      If you require additional medications or procedures, extra charges may apply. These include:

      • pharmaceuticals that are not available under the Pharmaceuticals Benefits Scheme (PBS)
      • oral contraceptives
      • autologous blood collection and storage
      • procedures performed in a doctor's surgery
      Extra services

      Services that aren't directly related to your treatment and care. These include:

      • beauty services
      • phone calls
      • TV hire
      • car parking
      • luxury rooms
      • take-home items e.g. crutches
      Services not recognised by Medicare

      Services, drugs or disposable items which may be used in a hospital but that are not recognised by Medicare. These are considered experimental and are not covered e.g. some items associated with robotic surgery

    • Code of Conduct  


      nib proudly supports and complies with the Private Health Insurance Code of Conduct. A copy of the Code of Conduct brochure is available here.

    • Privacy Policy  

    • Switching from another fund  


      Waiting periods already served with your current fund will be recognised, so you can claim straight away. However, you may be required to serve a waiting period for benefits on your new health insurance policy that aren't covered by your existing fund. Any benefit limits already used with your current health fund will apply to your Apia health insurance policy. For more information call us on 13 50 50 or read the Policy Booklet here

    • Pre-existing Conditions  


      A pre-existing condition is an ailment, illness or condition where, in the opinion of a medical practitioner appointed by the insurer (not your own doctor), the signs or symptoms of a condition existed during the six months before you first joined hospital cover or upgraded to a higher level of hospital cover. If your condition or illness is determined to have met the pre-existing condition definition, a 12 month waiting period applies from the date of joining or upgrading your level of hospital cover.

    • Policy Booklet  


      Please click here to view the Policy Booklet. Information should be read carefully and retained.

    • nib Underwriting & Commission  


      About the insurer

      This health cover is underwritten by nib health funds limited ABN 83 000 124 381 (nib) a registered private health insurer.

      About the agent

      nib has appointed Australian Pensioners Insurance Agency Pty Ltd (Apia) ABN 14 099 650 996 as its authorised agent to promote and distribute this health cover on nib's behalf, for which Apia receives a commission.

    • Agreement Private Hospitals  


      nib have agreements with approximately 80% of Australia's private hospitals. These agreements help nib keep hospital costs and therefore your premiums down. They also mean nib reduce or eliminate out-of-pocket expenses when you need treatment.

      Refer to the Policy Booklet for more information

     

    Important Information

    !Waiver of 2 month waiting period applies to new customers on a combined Hospital & Extras product, for Extras normally requiring a 2 month waiting period. Longer waiting periods apply for some services including optical, pre-existing conditions and major dental. Read the policy booklet before purchasing. Conditions apply.

    *Price calculated on: a single living in NSW, an Australian Government Rebate Tier of 0, assumed Lifetime Health Cover loading of 0% for hospital cover, $500 Excess for hospital cover, paying by direct debit and receiving up to 4% discount and a cover start date of today. Advanced Extras cannot be purchased as a standalone cover.

    nib health fund limited ABN 83 000 124 381 (nib) has appointed Australian Pensioners Insurance Agency Pty Ltd (Apia) ABN 14 099 650 996 as its authorised agent to promote and distribute this health cover on nib's behalf, for which Apia receives a commission.