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2023 Review of AIA Health Insurance

Megan Fraser Fact Checked Updated: 16 November 2023
Types of Health Insurance

Health insurance is an extremely important necessity. Choosing the right policy that matches your needs is how you effectively prepare for the future. Health insurance is there to save you money, time and stress. This blog will closely examine the Private Health Insurer AIA.

This will be an Ultimate Guide to AIA Health Insurance. We will comprehensively review gap cover, hospital agreements, AIA Vitality, discounts, ambulance cover, family policies, and online claims.

Key facts

  • AIA Health insurance assists 3,8 million Australians with health and life insurance.
  • The business offers a rewards programme, AIA Vitality, that grants members benefits, discounts, and more.
  • AIA does not provide extras-only cover but does provide Hospital and Combined cover.
  • In 2021 – 2022 , AIA offered 85% of their policyholders with ‘no-gap’, meaning that the policyholder’s service was fully covered by health insurance and Medicare.

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Who is AIA?

The AIA group is the largest independent publicly listed pan-Asian life and health insurance group. Originally established just over 100 years ago in 1919, AIA expanded and, in 1972,  opened its first Australian office in Melbourne. As of 2023, AIA has since expanded nationwide and currently assists 3,8 million Australians with health and life insurance.

AIA is a for-profit health insurance that offers coverage of varying levels. Like other Health Insurance Providers, clients can choose policies matching their personal requirements and providing different coverage levels. 

AIA is different to other service providers because it utilises the operating philosophy that Health Insurance should help you every day – not just when things go wrong. Through their rewards system known as AIA Vitality, the business aims to reward policyholders daily through benefits such as up to $500 each year in retail shopping vouchers, discounted HOYTS movie vouchers, discounted gym memberships with Fitness First, Virgin Active and Goodlife, and other benefits.

Features of AIA Health Insurance

AIA Health insurance offers varying coverage levels. AIA does not provide Extras-only cover. Instead, policy holders will need to buy a combined hospital and extras policy if they require any extras cover. AIA provides eight main hospital coverage types:

These health insurance products can cater for:

Extras can be taken out as a combined hospital and extras policy. Policyholders that are a part of and interact with AIA vitality can get increased Extras claim levels and lowered premiums on their policies.

Guide To Switching Private Health Insurance in Australia 1

Cost and Affordability

Now that we understand who AIA is, what they offer, and who they cater to, let’s have a closer look at each policy type, the general costs, the excess amounts, and what it covers.

Basic Accident Only Hospital

The Basic Accident Only Hospital policy is an entry-level basic policy that only provides coverage for accidental injury and emergency ambulence. This policy has an excess of $500 and grants the policyholder access to Vitality Starter. The average monthly premium for this policy is $194.91.

Basic Plus Hospital

The Basic Plus Hospital policy is another plicy that provides basic hospital coverage. This policy includes coverage for the previously mentioned policy as well as::

This policy has an excess of $750 and grants the policy holder with access to Vitality Starter. The average monthly premium for this policy is $112.96.

Bronze Hospital (750 and 500)

The Bronze Hospital plan has 2 policy types, the 750 and the 500. These policies include coverage mentioned in the previous policies as well as some of the following:

The policy has an excess of $750 for the Bronze Hospital 750 policy, and $500 for the Bronze Hospital 500 policy. Both of these policies, and every policy after this  grants you full access to AIA Vitality. The average monthly premium for the Bronze Hospital 500 policy is $123,68 and $117,52 for the Bronze Hospital 750 policy.

Bronze Plus Hospital (750 and 500)

The Bronze Plus Hospital policy is the higher-end version of the bronze policies from AIA.These policies include coverage mentioned in the previous policies as well as some of the following:

This policy has an excess of $500 for the Bronze Plus Hospital 500 policy, and $750 for the Bronze Plus Hospital 750 policy. The average monthly premium for the Bronze Plus Hospital 500 policy is $137,65 and $130,78 for the Bronze Plus Hospital 750 policy.

Silver Hospital (750 and 500)

The Silver Hospital policy offers more comprehensive Hospital coverage. These policies include coverage mentioned in the previous policies as well as some of the following:

This policy follows the same excess type of the previous 750 and 500 policy types. The average monthly premium for the Silver Hospital 750 policy is $157,23, and $165,50 for the Silver Hospital 500 policy.

Silver Plus Hospital

The Silver Plus Hospital policy offers slightly more coverage than the Silver Hospital policy. This policy includes coverage mentioned in the previous policies as well as some of the following:

This policy has an excess of $750. The average monthly premium for the Silver Plus Hospital policy is $167,51.

Silver Plus Advanced Hospital (750 and 500)

The Silver Plus Advanced Hospital 500 and 750l policies provide advanced hospital coverage. These policies include coverage mentioned in the previous policies as well as some of the following:

These policies follow the same excess structure as the previous 750 and 500 policies. The average monthly premium of the Silver Plus Advanced Hospital 750 policy is $236.66, and $249.08 for the Silver Plus Advanced Hospital policy.

Silver Plus Family Hospital

The Silver Plus Family Hospital policy is a comprehensive health insurance policy that provides advanced hospital coverage for families. This policy includes coverage mentioned in the previous policies as well as some of the following:

This policy has an excess of $750. The average monthly premium of the Silver Plus Family Hospital policy is $297.

Compare AIA Health Insurance Policies

Hospital PolicyAverage Premium per MonthCombined PolicyAverage Premium per Month
Basic Plus Hospital Starter 750$112.96Basic Plus Hospital 750 and Good 50% Back Extras$171.65
Bronze Hospital 500$123.68Basic Plus Hospital 750 and Base 50% Back Extras$146.98
Bronze Hospital 750$117.52Bronze Hospital 500 and Good 50% Back Extras$182.37
Bronze Plus Hospital 500$137.65Bronze Hospital 750 and Better 60% Back Extras$205.50
Bronze Plus Hospital 750$130.78Silver Hospital 500 and Base 50% Back Extras$199.52
Silver Hospital 500$165.55Silver Plus Hospital Advantage 750 and Active Saver Extras$215.92
Silver Hospital 750$157.23Silver Plus Advanced Hospital 500 and Good 50% Back Extras$307.77
Silver Plus Hospital 750$167.51Silver Plus Advanced Hospital 750 and Better 60% Back Extras$324.64
Silver Plus Advanced Hospital 500$249.08Silver Plus Family Hospital 750 and Good 50% Back Extras$355.69
Silver Plus Advanced Hospital 750$236.66Silver Plus Family Hospital 750 and Base 50% Back Extras$331.02
Silver Plus Family Hospital 750$297.00Silver Plus Advanced Hospital 750 and Best 70% Back Extras$358.69

Source: Privatehealth.gov.au (November 2023; Premium estimates for a single individual living in NSW)

Health Insurance options

What Makes AIA Different to Other Insurers

Each health insurance provider offers their policyholders distinct benefits, rewards, no-gap coverage, and premium structures. This section of the guide will explore some of these distinct differences.

AIA Health’s Access Gap Cover

‘No-Gap’ refers to a structure put in place by a health insurance company to assist in lowering the overall out-of-pocket cost that a policyholder may have. ‘Known-Gap’ is when the health insurance provider tells you about the possible out-of-pocket cost you may have after your service.

In The State of Health Reports for 2021 – 2022 provided by the Office of the Commonwealth Ombudsman, AIA offered 85% of their policyholders with ‘no-gap’, meaning that the policyholder’s service was fully covered by health insurance and Medicare. 10,5% of policyholders were also offered a ‘known-gap’. 

AIA Vitality

AIA Vitality is a scientifically designed programme that aims to improve the health and well-being of its policyholders. The AIA Vitality programme can be accessed through the AIA Vitality app. Completing tasks and going for check-ups will earn you vitality points. There is a ranking system within the app for active members. The ranks include Bronze, Silver, Gold and Platinum. Moving up through the ranks will grant you more benefits.

Members that are a part of this programme also receive additional rewards when actively utilising the programme. Some of these rewards include a lowered monthly premium, up to $500 in vouchers to use at partnered retailers yearly, and cashback on eligible international and domestic flights.

Discounts and Rewards

In your first year of signing up with AIA, if you choose a policy that includes AIA Vitality and reach silver status, you will receive 5% off your premiums for that year. AIA extras also provides policyholders up to 80% claimback on essential extras like optical and dental services.

Some other member benefits include:

How to Make a Claim

There are a few methods that members can use to make a claim with AIA. Due to the numerous avenues that AIA has made available, it is a simple and transparent process to make a claim. A claim can be made in one of the following ways:

  • By completing a claim form and posting it to their office in Melbourne.
  • Emailing a completed health insurance form to their official email.
  • By using their Online Members Services Portal.
  • Using your HICAPs card at registered providers.

AIA Health insurance for families

AIA Health Insurance provides comprehensive family policies. These policies apply to family members who live in the same household. The coverage includes children who may not be your biological children.

A child-dependant can remain on the policy until the age of 25. They must live within the same household as the policyholder and not married for the coverage to remain. When a child dependant is removed from a policy, they have 2 months to register for their own policy to avoid re-serving waiting periods.

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Frequently Asked Questions and Answers

  • How does AIA handle member complaints?

    Member complaints can be made through email, mailing the Melbourne office, contacting your financial advisor or Superannuation fund directly, or completing a complaints form on their website. A representative or advocate can speak on your behalf. When one of these steps is taken, a member of the AIA team will either email you back or they will schedule a callback with you to discuss the complaint and the complaint process.
  • What is AIA’s gap cover like?

    AIA provides ‘no-gap’ and ‘known gap’ coverage for their members. In the 2021 – 2022 financial year, AIA offered 85% of their policyholders with ‘no-gap’ meaning that the the policyholder’s service was fully covered by the health insurance and Medicare. 10,5% of policyholders were also offered a ‘known-gap’. The known gap and no-gap coverage will vary based on your policy type.
  • Does AIA offer any discounts?

    By participating in the AIA Vitality programme, members can receive discounts, cashback, rewards, and other features AIA offers. The business has also partnered with amile.com.au to provide discounts on dental services. Members will also receive a discount on optical services at Specsavers and OPSM.
  • What ambulance cover does AIA provide?

    AIA’s ambulance cover will cover you in a necessary emergency. The coverage is for ambulances that will take you directly to the Hospital or perform on-site treatment. AIA describes a necessary emergency as ‘when an immediate hospital or on-site treatment is required for a serious and acute injury or condition where the viability of function of an organ or body part is threatened’. If it is not an emergency, your coverage type will provide varying ambulance coverage.
  • How does AIA’s family policy work?

    These policies apply to family members who live in the same household. The coverage includes children who may not be your biological children. Coverage for child dependants will remain until the age of 25, provided they still stay at home and are not married.

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