AAMI Health Insurance

AAMI offers a wide choice of Hospital and Extras plans, so you can get exactly the level of cover you need.

You can choose from five levels of Hospital cover and four levels of Extras cover for singles, couples, single parents and families. AAMI Health Insurance is issued by nib health funds limited.

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Why should I consider AAMI when looking for private health?

  • 60-70% back on Extras not typically covered by Medicare
  • Unlimited emergency ambulance cover
  • No new waiting periods on Extras when switching from another fund
  • Simple, 24/7 claiming (just upload a photo of your receipt).

What Hospital and Extras cover options are available?

You can purchase hospital or extras cover individually to get the right level of cover, or combine them for a more comprehensive health care package.

AAMI’s five levels of Hospital cover are as follows:

  • Starter Hospital. This is for the young and healthy or for families on a budget. It covers the basics including accidental injury, emergency ambulance, appendix removal, colonoscopies, dental surgery, gastroscopies, grommets in ears, gynaecological services, hernia repair, joint investigations, joint reconstructions, tonsils and adenoids removal, rehabilitation (MBP), palliative care (MBP) and psychiatric treatment (MBP).
  • Starter Boost Hospital. This plan is for healthy young singles and couples not yet planning a family. It includes everything in the Starter Hospital plan plus treatment for brain surgery, cancer surgery and in-hospital treatment or stroke treatment.
  • Everyday Hospital. This is mid-level cover for older singles and couples as well as for completed families. It includes everything in the Starter Boost Hospital plan plus rehabilitation, palliative care, back surgery and heart-related procedures and surgery as well as cochlear implant surgery and bone anchored hearing devices.
  • Everyday Boost Hospital. This is for singles as well as for couples not planning a family or having completed families. It includes everything in the Everyday Hospital plan plus eye treatments and surgery, joint replacements and renal dialysis.
  • Premium Hospital. This is comprehensive cover designed for those wanting ultimate peace of mind or planning to have children. It includes everything in the Everyday Boost Hospital plan plus pregnancy and birth-related services, infertility investigations, assisted reproductive services, obesity/weight loss surgery and psychiatric treatment (with a Benefit Limitation Period).

AAMI also includes a choice of four different levels of Extras cover:

  • Starter Extras. This is budget-friendly cover that lets you claim up to 60% back on commonly used healthcare services including chiropractic/osteopathy, physiotherapy, preventative dental, general dental, ambulance, pharmaceutical prescriptions and optical.
  • Starter Boost Extras. This lets you claim up to 60% back on a wider range of healthcare services. It includes everything in the Starter Extras plan with higher annual limits plus major dental, natural therapies and remedial massage.
  • Everyday Active Extras. This lets you claim up to 60% back on a wider range of healthcare services. It includes everything in the Starter Boost Extras plan with higher annual limits plus orthodontics, podiatry/orthotics, dietary advice, top health aids, psychology, speech pathology (speech therapy), occupational therapy, healthier lifestyle expenses and preventative tests.
  • Premium Active Extras. This lets you claim up to 70% back on the cost of an extensive range of services including everything in the Everyday Active Extras plan with higher annual limits plus antenatal and postnatal services, hearing aids/speech processors, eye therapy (orthoptics) and exercise physiology.

What exclusions are there?

Just like any private health fund, AAMI Health Insurance will not pay a benefit under some circumstances. The following will not be covered:

Hospital cover
  • Any procedure performed during a waiting period
  • In-hospital treatment not recognised by Medicare
  • Any cosmetic procedure to enhance appearance
  • Any hospital treatment not related to patient care
  • Hospital or specialist admission or booking fees
  • Pharmaceuticals that are available under the PBS
  • Oral contraceptives
  • Any service rendered in a nursing home
  • Private room accommodation for a procedure performed the same day
  • Respite care
  • Any take-home items
  • Any outpatient service performed by a doctor or specialist
Extras cover
  • Any service provided during a waiting period
  • A service provided after an annual benefit limit has been reached
  • Any service by a provider not recognised by AAMI
  • A service for treatment where compensation is available from another source
  • Any service such as a life insurance exam or health screen required by an employer
  • Any consultation covered by a Medicare Primary Health Care Plan (ie, psychology or dental plans)
  • Any service provided outside Australia

What waiting periods apply?

When you join AAMI Health Insurance, there is a two-month waiting period before you will be eligible to receive most Hospital and Extras benefits. But if you switch to AAMI from another provider and purchase the same level of Extras cover, you will not have to re-serve any waiting periods you have already served.

Standard waiting periods that apply include the following:

Hospital cover
  • 12 months. This wait period applies to pregnancy and birth-related services as well as to pre-existing conditions (apart from psychiatric, rehabilitation or palliative care).
  • 2 months. This wait period applies to psychiatric, rehabilitation or palliative care (regardless of whether it’s a pre-existing condition) plus other conditions needing hospitalisation that are not pre-existing conditions.
  • 1 day. This wait period applies to emergency ambulance and accidental injury.
Extras cover
  • 36 months. This wait period is for hearing aids and cochlear speech processors.
  • 12 months. This wait period applies to artificial aids, non-specialty orthodontia, dental specialty services, dental prosthetic services, inlays, onlays, facings, orthodontics, periodontics, endodontics and oral surgery, dentures, denture maintenance/repairs and other prosthodontic services, periodontal surgery, root therapy and endodontic services by a dentist not registered as a specialist.
  • 6 months. This wait period applies to healthier lifestyle expenses as well as to optical appliances and repairs.
  • 2 months. This wait period applies to all services and items apart from those listed above.

Do I have to pay an excess?

Many Hospital products require the payment of an excess before you can be admitted to hospital. The AAMI Starter Hospital, Starter Boost Hospital and Everyday Hospital plans all include a $500 excess, while the Everyday Boost Hospital and Premium Hospital plans allow you to choose between a $250 and $500 excess.

How can I claim on my health insurance?

Making a claim on your AAMI Health Insurance is easy. You can claim at any time simply by filling out an online claim form and uploading a copy of your receipt from your mobile device. You can also call between 8am and 6.30pm weekdays on 13 22 44.

Questions you might have about AAMI

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