Apia Health Insurance

Find health insurance well-suited for people over 50 at Apia.

Apia aims to provide quality health care to individuals with a lot of experience living. They only offer two mid-level hospital plans, but these are designed to cover what older Australians need without weighing them down with unnecessary services.

finder.com.au does not currently have access to this health insurance brand. You may wish to compare options available on the health insurance homepage.
Top 3 features:
  1. Good for seniors. Apia keeps premiums down by not offering cover for treatments you won't need, such as pregnancy and birth .
  2. Good for customisable extras.Essential and Classics Extras keep premiums low by covering only a basic spread of services.
  3. Beware of expensive plans. Apia's Premium Extras is roughly $25/week, which is more expensive than other extras with similar benefits and coverage.

Who is Apia?

Apia is a member of the Suncorp Group, specialising in insurance for seniors and over 50s. They serve over 700,000 Australians with products tailored towards people with a good deal of experience in living life.

What health insurance options are available?

Hospital cover

There's a range of cover levels when it comes to private hospital services:

  • Silver Essentials Hospital Plus. This is a mid-level hospital cover, where Apia will cover the costs for most common treatments you'll undergo in hospital. They will generally pay the full costs of hospital accommodation, theatre fees, intensive care costs, and more. Excess for this is flexible: $250, $500, or $750.
  • Silver Premium Hospital Plus. A slightly upgraded version of the Silver Essentials plan, including cover for cataracts, weight loss surgery, and dialysis for chronic kidney failure. Flexible excess of $250, $500, or $750.
BenefitSilver Essential Hospital PlusSilver Premium Hospital Plus
Back, neck and spine
  • Yes
  • Yes
Blood
  • Yes
  • Yes
Bone, joint and muscle
  • Yes
  • Yes
Brain and nervous system
  • Yes
  • Yes
Breast surgery (medically necessary)
  • Yes
  • Yes
Cataracts
  • No
  • Yes
Chemotherapy, radiotherapy and immunotherapy for cancer
  • Yes
  • Yes
Dental surgery
  • Yes
  • Yes
Diabetes management (excluding insulin pumps)
  • Yes
  • Yes
Dialysis for chronic kidney failure
  • No
  • Yes
Digestive system
  • Yes
  • Yes
Ear, nose and throat
  • Yes
  • Yes
Eye (not cataracts)
  • Yes
  • Yes
Gastrointestinal endoscopy
  • Yes
  • Yes
Gynaecology
  • Yes
  • Yes
Heart and vascular system
  • Yes
  • Yes
Hernia and appendix
  • Yes
  • Yes
Hospital psychiatric services
  • Yes Minimum Benefit Payable
  • Yes
Implantation of hearing devices
  • Yes
  • Yes
Insulin pumps
  • Yes
  • Yes
Joint reconstructions
  • Yes
  • Yes
Joint replacements
  • Yes
  • Yes
Kidney and bladder
  • Yes
  • Yes
Lung and chest
  • Yes
  • Yes
Male reproductive system
  • Yes
  • Yes
Miscarriage and termination of pregnancy
  • Yes
  • Yes
Pain management
  • Yes
  • Yes
Pain management with device
  • Yes
  • Yes
Palliative care
  • Yes
  • Yes
Plastic and reconstructive surgery (medically necessary)
  • Yes
  • Yes
Podiatric surgery (provided by a registered podiatric surgeon)
  • Yes
  • Yes
Rehabilitation
  • Yes
  • Yes
Skin
  • Yes
  • Yes
Sleep studies
  • Yes
  • Yes
Tonsils, adenoids and grommets
  • Yes
  • Yes
Weight loss surgery
  • No
  • Yes

Extras cover

These can be purchased separately, or combined with one of the two hospital covers above.

  • Essential Extras. Provides a 60% benefit for a small range of services, including general and major dental treatment, optical appliances, and physiotherapy. No annual limit on preventative dental work. Additional extras, including pharmaceuticals, hearing aids and more, can be added on for a higher premium.
  • Classic Extras. Provides a 60% benefit for the same range of services as Essential Extras, but with a higher annual limit. The same additional extras can be added on for a higher premium, as with Essential Extras.
  • Premium Extras. Apia's most comprehensive extras plan. Provides a 75% benefit on everything Classic Extras offers, but also for orthodontics, exercise physiology, a range of natural therapies, speech, eye, and occupational therapy, podiatry and more. Also includes a $400 'healthier lifestyle' benefit for things like weight management and health management programs.

Information on tiers

Private health insurance has been reformed by the government in an attempt to make it more flexible and easy to navigate for consumers. As of April this year, hospital plans have been reorganized into four tiers (Basic, Bronze, Silver and Gold), with each tier having a minimum set of requirements a plan must offer to qualify. Along with the 'plus' options, this allows insurers like Apia to tailor their plans to suit their customers.

Member offers

As a member of the Suncorp Group, Apia members have access to Suncorp Rewards - giving them up to 15% savings on eGift cards for everyday items at over 100 retailers.

How to make a claim

If you're claiming for a particular health service, you can present your membership card at the time of service and claim your benefit immediately. Otherwise, you can make your claim online by uploading the relevant policy documents, or contact Apia by phone or email for help with lodging your claim.

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6 Responses

  1. Default Gravatar
    CharlesApril 4, 2018

    I am a member of Apia, could you tell me whether, I am covered for:Optometrists

    • finder Customer Care
      NikkiApril 4, 2018Staff

      Hi Charles!

      Thanks for your message and for visiting finder – the leading comparison website & general information service built to give you advice in your buying decision needs. How are you doing today?

      APIA Health Insurance covers optical however it would vary according to the plan you have. Essential Plan covers $250, Essential Plus covers, $300 and Premium covers $350.

      Hope this helps!

      Cheers,
      Nikki

  2. Default Gravatar
    JJApril 28, 2017

    I am a provider of medical services. Do I need to register as a provider with you? Unable to get anything on the web to do claims, etc – like fees schedule.

    Please let me know.

    • finder Customer Care
      ZubairMay 1, 2017Staff

      Hi JJ,

      Thank you for your question.

      You have contacted finder.com.au, a comparison and information service and not actually Apia Health Fund. You will need to contact Apia Health Fund directly about this matter.

      Cheers,
      Zubair

  3. Default Gravatar
    KerryOctober 12, 2016

    Dose APIA have an Eye Surgery option and if this maybe something
    that will be considered in the near future?

    • finder Customer Care
      RichardOctober 13, 2016Staff

      Hi Kerry,

      Thanks for getting in touch. Apia does provide cover for eye surgery on its Premium Hospital Cover option.

      Unfortunately, Apia is not currently one of the funds in our comparison panel. If you would like to compare cover options from the funds in our panel, you can do so by heading over to our health insurance for over 65s page and either comparing you options online or by completing a contact form to speak with an adviser.

      All the best,
      Richard

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