Offer Ends 31 October 2018.
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Compare AAMI Health Insurance Hospital Cover
What are the benefits of Hospital Cover?
Our five Hospital Cover products are designed to help singles, couples, single parents and families meet the cost of private treatment in a hospital, avoid public hospital waiting lists and choose the specialist that treats you, when and where.
Use our Health Insurance comparison table to see the complete list of included and excluded services to help you decide which Hospital Cover product is right for you.
Are there any waiting periods before I can make a claim?
Yes, before you can make a claim, a waiting period may apply. These vary from 1 day to 12 months depending on the treatment you’re claiming for.
However, if you’re switching to AAMI Health Insurance from another health fund, not only is it easy but you won’t have to restart waiting periods you’ve already served with your old fund when you sign up for the same level of cover with us.
Does AAMI cover pre-existing conditions?
Yes. A waiting period of 12 months will apply before you can claim for treatment.
A condition is considered pre-existing if you’ve experienced symptoms at any time up to 6 months before joining this health fund or upgrading your cover. A medical practitioner will determine if a condition is pre-existing after reviewing information from your doctor.
What’s included with AAMI Health Insurance Hospital Cover?
It depends on the type of Hospital Cover you choose from.
Starter Hospital covers just the basics and is designed for the young and fit. Concerned about tax? You won't pay the Medicare Levy Surcharge, if applicable, with this product, or any of our other Hospital products.
Starter Boost Hospital covers a little more than the basics, including brain surgery, stroke treatment, plus cancer surgery and in-hospital cancer treatment.
Everyday Hospital is our mid-level product with everything in Starter Boost Hospital plus heart procedures, back surgery and full benefits payable for palliative care and rehabilitation.
Everyday Boost Hospital builds on Everyday Hospital with inclusions such as joint replacements, eye treatments and renal dialysis.
Premium Hospital is our most comprehensive Hospital product with cover for pregnancy and birth services, infertility investigations and assisted reproductive services.
AAMI Health Insurance Comparison Table
Use our Health Insurance comparison to see the complete list of included services to help you decide which Hospital Cover product is right for you.
Cancer treatment in hospital: It is important to be aware that health insurance will only cover the portion of costs that relate to an admission to hospital. Specialist fees outside of hospital or other outpatient fees in relation to chemotherapy or radiotherapy aren’t covered.
High cost drugs are sometimes requested for the Treatment of some cancers. Typically high-cost drugs are for newer Treatments that are not recognised by the Pharmaceutical Benefit Scheme (PBS) because the PBS considers them to be still under clinical trial and therefore experimental Treatments. Health insurance will not Cover high cost drugs for the same reasons (or may only Cover a small portion of the cost). It is the responsibility of the treating doctor, and Hospital, to inform Patients about the potential for large out-of-pockets as a result of high cost drugs.
Customers without full cover for Psychiatric Treatment are able to use a one-off waiver to upgrade their cover and have immediate access to applicable in-hospital mental health services. This waiver is only available to customers who have held hospital cover for at least the previous two months and have a valid referral from a consulting psychiatrist. To find out more, call us on 13 22 44.
Benefit Limitation Period - Minimum Benefits Payable (BLP - MBP) means that unless you're transferring from a Complying Health Insurance Product (see Policy Booklet), there will be significant out-of-pocket costs if you go to hospital for this treatment in the first 12 months of your policy. After serving the 2 month Waiting Period, your benefit will be limited to "Minimum Benefits Payable" for the following 10 months. After this period of time you are entitled to the full benefit claimable for the treatment
Minimum Benefits Payable (MBP) means that we will pay the minimum amount of benefits that 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. If you’re attending a Private Hospital for these services, there will be significant out-of-pocket costs. If a treatment important to you is listed as MBP, we recommend you consider a higher level of cover
What isn't covered?
Hospital excess
A hospital excess is a charge that applies when you, or someone on your policy, are admitted to hospital. Depending on the Hospital Cover you have this will be $250 or $500. It only applies once per person, per calendar year, and is paid directly to the hospital before your admission. There’s no hospital excess for dependent children under 21.
Extra fees and charges
Some hospitals charge additional fees for care and treatment associated with your stay. These may include:
- private hospital emergency or out-patient fees
- admission or booking fees charged by a specialist or the hospital
- private room accommodation for a same day procedure
Call us on 13 22 44 before choosing a hospital to find out what charges may apply.
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 surgery
Additional or specialised nursing care
If you require additional or specialised nursing care, extra charges may apply. Examples of such care include:
- 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
You may be liable for extra charges if you require:
- autologous blood collection and storage
- drugs that aren’t available under the Pharmaceuticals Benefits Scheme (PBS)
- oral contraceptives
- 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.
New hospital and extras policy
