Our verdict: Apia Health Insurance is tailored to seniors, so it doesn't cover treatments like pregnancy. Otherwise, its coverage options are all quite comprehensive.
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Pros
Apia is tailor made for seniors. It keeps premiums down by not offering cover for treatments including assisted reproductive services, pregnancy and cosmetic surgery.
Essential and Classics Extras keep premiums low by covering only a basic spread of services. Other extras you might need can be added on for an increase in your premium.
Cons
It doesn't offer a lot of choice, it only has 3 hospital insurance policies.
It doesn't offer basic hospital cover.
Good value Apia policies
These are some good value hospital policies from Apia, all from the Silver tier.
Silver Hospital. This comes with 29 claimable services and cover for the likes of heart and vascular system, back, neck and spine, implantation of hearing devices, lung and chest, blood, dental surgery and more.
Silver Hospital Plus. This includes everything covered in Silver Hospital as well as cataracts and joint replacements.
Silver Premium Hospital Plus. Another upgraded version of the Silver plan, this also covers dialysis for chronic kidney failure, weight loss surgery, pain management with device, insulin pumps and sleep studies. In total, Silver Premium Hospital Plus comes with 36 claimable services.
Extras coverage
These can be purchased separately, or combined with either of the 2 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. This also comes with 60% back on 6 claimable services but has higher annual limits, for example $1,300 for major dental compared to $600 with Essential Extras.
Premium Extras. The most comprehensive extras policy available with Apia, you'll get 75% back on 22 claimable services, up to your annual limit.
Ambulance coverage
Both Apia Health Insurance hospital and extras policies include Ambulance Cover. This includes:
Emergency Ambulance transport to a hospital provided by a state or territory ambulance service.
Ambulance call out fees (if you're treated at the scene and don't need to go to hospital).
Transport between hospitals when transfer is required.
Apia Health Insurance complaints
We looked at the 2021 Ombudsman health insurance complaints to see how good Apia's customer service is (it's underwritten by nib).
Apia/nib had a lower complaints ratio than its market share.
Apia/nib had a larger complaints ratio than some other big insurers like Bupa, Medibank and HBF.
This chart shows the weighted volume of complaints received by each health fund, according to the Commonwealth Ombudsman. The lower the number, the better. Only non-restricted funds with a national market share of at least 0.1% are included here. Apia/nib is 12th overall in this ranking. The weighting ensures that funds are compared fairly; larger funds serve more customers so can potentially get more complaints.
Apia frequently asked questions
No, Apia is not a not-for-profit health fund. It's part of the Suncorp Group. Apia's health insurance product is underwitten by nib.
Apia is a member of the Suncorp Group, so members have access to Suncorp Rewards, giving them up to 15% savings on eGift cards for everyday items at over 100 retailers. You may also be able to benefit from a 10% premium discount if you hold 2 or more eligible policies with Apia.
Apia offers a 24/7 claims service. 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 on your Apia account, or contact Apia by phone on 13 50 50.
Gary Hunter is a writer at Finder, specialising in insurance. He’s been writing about life, health, travel, home and pet insurance for over three years, has pored over hundreds of product disclosure statements and written more than 500 insurance articles. Gary holds a Tier 1 General Insurance (General Advice) certification and is passionate about helping Aussies understand their policies so that they can get better value for their money.
Travel insurance is an essential expense for anyone planning a trip overseas, though sometimes it can be difficult to find cover if you are over 80 years of age.
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