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If you have been affected by the recent storms, we're here to help 24/7. Make a claim online or call us on 13 50 50
Our operating hours vary across our insurance products, please check which apply to you.
Our operating hours vary across our insurance products, please check which apply to you.
Skip 2 & 6 month waits on Extras with any new combined Hospital and Extras cover^.
Ends 30 June 2021. T&Cs apply.
Select or combine Hospital cover and extras to suit you
29 claimable services
Cover that includes many commonly claimed services.
31 claimable services
Includes all cover from Silver Hospital, plus Cataracts and Joint replacements.
36 claimable services
The best Apia hospital cover for peace of mind.
Select or combine Hospital cover and extras to suit you
6 claimable services
Cover for extras people use most, with 60% back of the cost back to you, up to your annual limit.
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No Limit |
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$600 |
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$600 |
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$250 |
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$350 |
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No Limit |
Advanced Extras
You can add additional extras like chiropractic and osteopathy to suit an active lifestyle.
6 claimable services
Get 60% of the cost back every time you claim, with higher annual limits.
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No Limit |
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$700 |
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$1300 |
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$300 |
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$450 |
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No Limit |
Advanced Extras
You can add additional extras like chiropractic and osteopathy to suit an active lifestyle.
22 claimable services
The best level of Apia Extras cover with 75% back, up to your annual limit.
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No Limit |
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$1000 |
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$1300 |
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$350 |
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$600 |
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No Limit |
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Starting limit of $800 |
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$300 |
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$500 |
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$400 |
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$450 |
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$400 |
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$200 |
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$600 |
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$200 |
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$450 |
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$500 |
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$500 |
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$1,200 |
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$500 |
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$400 |
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$200 |
Everything else you will need to know.
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$300 |
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$200 |
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$300 |
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$250 |
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$800 |
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$250 |
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$250 |
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$200 |
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 and it may even help avoid tax.
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.
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 by July 1 following your 31st birthday.
LHC increases by 2% for every year you don't join, up to a maximum of 70%, and can only be removed after 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 ATO website at www.ato.gov.au
The Medicare levy surcharge (MLS) is levied on Australian taxpayers who do not have an appropriate level of private hospital cover and earn above a certain income.
The base income threshold (under which you are not liable to pay the MLS) is $90,000 for singles and $180,000 for families.
If your taxable income is above the MLS thresholds and you don't have an appropriate level of private hospital cover, you may have to pay the MLS.
Find more information, including how to calculate your income for MLS purposes, visit the ATO website at www.ato.gov.au
^This Offer is only available to new members who take out a combined Apia Health Insurance Hospital & Extras policy by 11:59pm (AEST) 30 June 2021. Not available to existing health insurance policyholders with AAMI, Apia, Suncorp, nib, GU Health or Qantas, or to previous policyholders who have held health insurance with any of these brands and cancelled their policy 6 months before or during the Offer Period.
The Offer consists of waiving 2 & 6 month waiting periods for Eligible Members on all Extras services that normally require a 2 or 6 month waiting period under the Eligible Product. The Waiver will be fulfilled at the time the Eligible Member takes out the Eligible Product. Longer waiting periods may apply for some services.
See full terms and conditions. Apia Health Insurance is issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer, and is marketed by Platform CoVentures Pty Ltd ABN 82 626 829 623 (PC), a Suncorp Group company. PC is an authorised agent of nib and receives commission from nib. nib is not a part of the Suncorp Group. Read the policy booklet before buying this insurance.
Accidental injury benefit
The immediate necessary treatment required as a result of an accident. To be covered for the Accidental Injury Benefit, you must provide documented proof that you have sought treatment at a hospital emergency department or by a medical practitioner within 72 hours of the Accident. The Emergency Department attendance is classed by the Australian Department of Health as an outpatient service, not a hospital admission, and therefore it is not payable by the Fund. The Accidental Injury Benefit covers further treatment in hospital as an admitted patient, where you are re-admitted to a hospital within 90 days of the initial visit.
For example:
Waiting Period: 1 Day
Ambulance
Emergency ambulance transport.
Assisted Reproductive Services
Under all Apia covers, no benefits are payable towards hospital treatment for fertility treatments or procedures.
For example:
Back, neck and spine
Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Bone, joint and muscle
Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Blood
Hospital treatment for the investigation and treatment of blood and blood-related conditions.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Brain and nervous system
Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Breast surgery (medically necessary)
Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Chemotherapy, radiotherapy and immunotherapy for cancer
Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours. Surgical treatment of cancer is listed separately under each body system.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Cosmetic Surgery
Under all Apia covers, no benefits are payable towards procedures or hospital costs associated with cosmetic surgery to enhance appearance.
Dental Surgery
Hospital treatment for surgery to the teeth and gums.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Diabetes management (excluding insulin pumps)
Hospital treatment for the investigation and management of diabetes.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Digestive system
Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Eye (not cataracts)
Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Ear, nose and throat
Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Gastrointestinal endoscopy
Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
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:
Gynaecology
Hospital treatment for the investigation and treatment of the female reproductive system.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Heart and vascular system
Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Implantation of hearing devices
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
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:
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
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:
Joint reconstructions
Hospital treatment for surgery for joint reconstructions.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Joint Replacement
Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Lung and chest
Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Male reproductive system
Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Pain management
Hospital treatment for pain management that does not require the insertion or surgical management of a device.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Palliative care
Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.
Waiting Period: 2 Months
Pain management with device
Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Pregnancy and Birth
Under all Apia covers, no benefits are payable towards hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Hospital psychiatric services
Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.
For example:
Waiting Period: 2 Months
Rehabilitation
Hospital treatment for physical rehabilitation for a patient related to surgery or illness.
For example:
Waiting Period: 2 Months
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
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:
Ambulance
Emergency ambulance transport paid at 100% of the cost.
Waiting period: 1 day.
General Dental Treatment
e.g. fillings, basic extractions, x-rays.
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Major Dental Treatment
Includes root canal therapy, crowns, bridges, dentures, oral surgery.
Waiting period: 12 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Preventative Dental Treatment
Includes selected examinations, scale and cleans and fluoride treatments.
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Optical Appliances
e.g. prescription glasses and contact lenses
Waiting period: 6 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Physiotherapy
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Chiropractic Osteopathy
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Dietary Advice
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Exercise Physiology
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Eye Therapy (orthoptics)
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Health aids (appliance limits apply)
Surgical stockings, CPAP Machine, CPAP parts, pressure garment, walking frame, blood pressure monitor, hip protector, blood coagulation device, erectile dysfunction pump, macular degeneration aid.
Waiting period: 12 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Healthier lifestyle benefit
Approved: weight management, quit smoking and health management programs (gym, personal trainer).
Waiting period: 6 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Hearing aids & speech processors (appliance limits apply)
Waiting period: 36 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
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
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Kidney and bladder
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Natural Therapies
Remedial massage, acupuncture, Chinese herbalism and myotherapy.
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Natural Therapies
Remedial massage, acupuncture, Chinese herbalism and myotherapy.
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Occupational Therapy
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Orthodontia
Increasing by $100 per calendar year to lifetime limit of $2,600.
Waiting period: 12 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Palliative care
Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.
Waiting Period: 2 Months
Pharmaceutical prescriptions
Benefits only payable for non PBS items. Benefits do not apply to prescriptions dispensed to hospital in-patients.
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Podiatry (consultations only) Foot orthotics (appliance limits apply)
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Plastic and reconstructive surgery (medically necessary)
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident, or congenital.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Preventative tests (service limits apply)
Thin prep, bone density tests, bowel screening.
Waiting period: 6 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Psychology
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Skin
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example:
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Hospital psychiatric services
Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.
For example:
Waiting Period: 2 Months
Speech Pathology (Speech therapy)
Waiting period: 2 months (Applies if you are new to health insurance or if you have recently increased your level of Extras cover).
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
Waiting Period: 12 months (2 Months for ailments / conditions that are not pre-existing)
Podiatric surgery (provided by a registered podiatric surgeon)
Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon.
Limited to cover for: accommodation; and the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.
Waiting Period: 12 Months (2 Month for ailments / conditions that are not pre-existing)
2 Disclaimer: It is important to be aware that Podiatric Surgeon fees for services performed in Hospital besides the hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon are not Covered. We will not pay benefits for theatre fees and services performed by the Podiatric Surgeon, any medical practitioner, specialist, radiologist, radiographer, sonographer, or pathologist that may be provided during or associated with Podiatric Surgery (provided by a registered podiatric surgeon).
Upcoming changes to health insurance premium and health cover
Each year we review our health covers to ensure they continue to provide our customers with value for money health insurance that meets their needs. As a result of this review, we'll be making adjustments to our available health cover options.
This year we are also implementing the Australian Government's Private Health Insurance Reforms which we believe will deliver more value to our customers. These Reforms are effective 1 April 2019. A summary of these changes are provided below.
A Basic/Bronze/Silver/Gold tiering system is being introduced to make it easier to understand how comprehensive your level of cover is. To be categorised in a certain tier, each cover must include a minimum set of treatments, as set by the Australian Government.
Did you know that by increasing your excess level, you can pay less in premium, but a little more if you need to go to hospital?
From 1 April 2019, a $750 excess will be available on hospital cover to help you save on your premium.
From 1 April 2019, health funds are no longer permitted to pay benefits for selected Natural Therapies as part of a complying health insurance policy. This change is a result of a review conducted by the Government that found there is no clear evidence demonstrating the clinical effectiveness of the therapies being removed.
The affected Natural Therapies are:
To help you understand the hospital treatments you are covered for, the Australian Government has introduced new Clinical Categories that are uniform across the health insurance industry. These categories group related treatments together. This is a different approach to how we have described your hospital inclusions in the past, where we have listed treatments individually.
You would have recently been contacted by us in relation to changes to your current cover and what this means for you. The reference table below provides a summary of changes to hospital cover.
Pre-1 April 2019 Apia Health Insurance Hospital cover
Essential Hospital
Premium Hospital
Apia Health Insurance Hospital cover from 1 April 2019
Apia Health Insurance call back
Apia Health Insurance call back
Cookie and Data Policy
We use cookies and other related technologies to improve and tailor your website experience. See our Cookie and Data Policy. This policy provides information about how Apia collects and uses data related to your online activity, and how you can choose to remain anonymous.
AAI Limited
Australian Pensioners Insurance Agency Pty Ltd (Apia) ABN 14 099 650 996 AR 239591 is an authorised representative of AAI Limited ABN 48 005 297 807 AFSL 230859 (AAI), the issuer of Home, Landlord, Car, Motorcycle, Caravan, Motorhome, Boat, Travel, Compulsory Third Party Personal Injury (CTP) Insurance and Motor Accident Injuries Insurance (MAI Insurance). Registered Office: Level 28, 266 George Street, Brisbane QLD 4000.
You should read and consider the Product Disclosure Statement (and any related documents) on this website before making any decisions about general insurance. Any advice provided is general advice only and has been prepared without taking into account any person's particular objectives, financial situation or needs, so you should consider whether it is appropriate for you before acting on it.
Health Insurance
Apia Health Insurance is issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer, and is marketed by Platform CoVentures Pty Ltd ABN 82 626 829 623 (PC), a Suncorp Group company. PC is an authorised agent of nib and receives commission from nib.
Life Products
Any advice on this page in connection with the Life products is general in nature and is provided by Platform Ventures Pty Ltd ABN 35 626 745 177 AFS Representative Number 001266101 (PV). PV is part of the Suncorp Group and an authorised representative of TAL Direct Pty Limited ABN 39 084 666 017, AFSL 243260 (TAL Direct).
Funeral Insurance
Apia Funeral Insurance is issued by either Asteron Life & Superannuation Limited ABN 87 073 979 530, AFSL 229880 (Asteron) or by TAL Life Limited ABN 70 050 109 450 AFSL 237848 (TAL Life), which are part of the TAL Dai-ichi Life Australia Pty Limited ABN 97 150 070 483 group of companies (TAL). TAL companies use the Apia brand under license. TAL companies are not part of the Suncorp Group. TAL Direct Pty Limited ABN 39 084 666 017 AFSL 243260 (TAL Direct) has been authorised under an arrangement with the insurers to enter into, vary or cancel insurance cover and manage, administer and settle claims on behalf of the insurer as if it were the insurer.
Asteron and TAL Life support and adhere to the Life Insurance Code of Practice (Code). The Code has been developed voluntarily by the Life Insurance industry through the Financial Services Council to promote high standards of service to consumers, provide a benchmark of consistency within the industry, and establish a framework for professional behaviour and responsibilities. Download the Code here. For more information contact the Financial Services Council on (02) 9299 3022 (local call cost), email info@fsc.org.au or visit www.fsc.org.au.
Rewards and Recognition
The Reward and Recognition program ("Suncorp Benefits") is being operated by EONX Services Pty Ltd ABN 39 615 958 873. To register for Suncorp Benefits you must hold a current eligible personal policy or an eligible personal product or service from one of the brands in the Suncorp Network brand. Purchase limits apply to each individual retailer. See full Terms and Conditions. Use of Suncorp Benefits is subject to the operator's privacy policy.
This content is current for Home and Contents, Home and Contents Extra, Village Style Residence, Apartment Style Residence, Assisted Living Residence, Landlord, Car Advantage, Motorcycle, Caravan, Motorhome and Boat Insurance policies commenced or renewed on or after 23 March 2021.
