Jeffrey Wade
AIA is one of the largest life insurers in the world, with a presence in 18 markets across the Asia Pacific. AIA Health Insurance is partnered with the Australian Health Service Alliance Ltd (AHSA), which provides its members with access to most private hospitals and day surgeries in Australia. AIA Health members are encouraged to seek medical treatment and services within the AIA Health network to limit any gap payments. AIA New Zealand Limited is part of the AIA Group and has been providing insurance to New Zealanders since 1981. Here is a step-by-step guide on how to claim medical insurance with AIA:
| Characteristics | Values |
|---|---|
| Company | AIA Australia, AIA New Zealand |
| Claim process | Submit medical invoices (paid or unpaid) to Medicare, fill out a Medical Claim Form and a Medicare Two-way claim form. |
| Claim portal | MyAIA, Online Member Services portal |
| Claim via email | [email protected] |
| Claim via phone | 1800 333 004 |
| Claim via card | HICAPs card |
| Claim status | Assessed within five business days |
| Excess | $500 or $750, with potential for a refund if you hold an AIA Vitality status of Silver or above |
| Excess refund exclusions | Cataracts, joint replacements, dialysis for chronic kidney disease, pregnancy and birth, assisted reproductive services, weight loss surgery, insulin pumps, pain management, sleep studies |
| Pre-existing conditions | Two-month waiting period for palliative care, psychiatric and rehabilitation services |
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What You'll Learn
Claiming medical insurance with AIA Australia
AIA Australia provides health insurance to its customers, and there are several ways to make a claim. Firstly, it is important to understand what you are covered for and any associated out-of-pocket costs. AIA Health members are encouraged to seek medical treatment and services within the AIA Health network to limit any gap payments.
When visiting a General Practitioner (GP) or Specialist, you will need to pay for the service upfront and in full on the day of your visit. Once you have received your invoice, you can submit this as a claim through the Online Member Service Portal. If you have any issues, you can email [email protected]. You can also use your HICAPs card at your registered provider or log in to the Online Member Services portal.
If you are an inpatient, which means you have been admitted to the hospital for a medical service, Medicare will cover the MBS portion of the procedure and issue a Statement of Benefits form as confirmation. This will then be forwarded to AIA Health to complete the Private Health Insurance portion. If there are any outstanding costs, this is considered an out-of-pocket expense for the member.
For Extras claims, your claim will be assessed within five business days of the date it is received. All AIA Health Insurance products have a $500 or $750 excess, but you may be eligible for a refund if you hold an AIA Vitality status of Silver or above. There are no excesses for dependents.
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Claiming medical insurance with AIA New Zealand
AIA New Zealand has been providing insurance to New Zealanders since 1981 and is part of the AIA Group, one of the largest life insurers in the world. AIA New Zealand is committed to helping build a healthier, cleaner, and more sustainable New Zealand.
To make a health insurance claim with AIA New Zealand, you can visit their corporate site to learn more and submit your claim online. The online form must be read and accepted by the policy owner and the claimant (or their parent/guardian if the claimant is under 16). The single file size cannot exceed 3MB, and only files of type PDF, DOC/DOCX, JPG/JPEG, or PNG are allowed as attachments.
If you are an AIA Health member, it is recommended that you seek medical treatment and services within the AIA Health network to limit any gap payments. Before beginning treatment, it is important to understand and consent to any additional costs not covered by your insurer. You can ask your doctor or medical service provider for informed financial consent.
For visa types 188, 400, 403, 407, 408, 417, 462, 476, 482, 485, and 489, you can make a claim to cover some or all of the costs of your treatment. Your healthcare provider may be able to process your claim immediately, or you may need to make an upfront payment and then submit a claim for reimbursement.
If you are having trouble lodging your claim on the member portal, you can email [email protected] for assistance.
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Claiming medical insurance with AIA Vitality
AIA Health Insurance is partnered with the Australian Health Service Alliance Ltd (AHSA), which provides its members with access to most Private Hospitals and Day Surgeries in Australia. When you are treated for a service included under your policy in an agreement hospital, AIA will cover the associated hospital costs less any excesses.
All AIA Health Insurance products have a $500 or $750 excess, however, you may be eligible to have your full excess refunded if you hold an AIA Vitality status of Silver or above. There are no excesses for dependents.
If you are seeing a General Practitioner (GP) or a Specialist, you’ll need to pay for the service in full on the day of your visit. Once you have received your invoice receipt, and where covered under your policy, you’ll be able to submit this as a claim through AIA's Online Member Service Portal. If you have any difficulties, you can also email this to [email protected].
If you are claiming medical insurance with AIA Vitality, you can start earning points for getting to know and improving your health. You can learn more about the benefits, discounts, and rewards you will have access to with AIA Vitality. You can also earn up to 15,000 points and $260 a year in Active Rewards, as well as 25 Airpoints Dollars or $25 Woolworths vouchers.
If you are a corporate health insurance member, you can claim by using one of the following methods:
- Using your HICAPs card at your registered provider
- Online, by logging in to the Online Member Services portal
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Claiming medical insurance with AIA online
AIA Australia
If you are a corporate health insurance member with AIA Australia, you can claim online by logging in to the Online Member Services portal. You will need to factor in up to five working days to complete the assessment.
AIA New Zealand
AIA New Zealand strives for a simple and fast claims process. You can lodge your health insurance claim via the MyAIA customer portal, which also gives you visibility of your online health claim history. The quickest way to submit a claim is online, and it should take about 10 minutes. Once received, AIA will assess the claim within 3 to 5 working days.
AIA Philippines
AIA Philippines has a hassle-free claims process. You can file your claim online by filling out the form, submitting your requirements, and getting a reference number for status tracking. You can also submit your claim via eSubmission by scanning your documents and submitting the requirements online.
AIA Malaysia
Although I could not find specific information on online medical insurance claims with AIA Malaysia, the website does mention a hassle-free claims process and high-touch customer service experience. You can find claims-related information and guides on the website, as well as a form library.
Important Information for AIA Australia and New Zealand
When claiming with AIA, you will need your medical invoices (paid or unpaid) and a completed Medical Claim Form. If you go ahead with hospital admission without confirming your entitlements, and AIA subsequently determines your condition to be pre-existing, you will have to pay all outstanding hospital and medical charges not covered by Medicare.
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Claiming medical insurance with AIA via email
AIA Health Insurance is partnered with the Australian Health Service Alliance Ltd (AHSA), which provides its members with access to most Private Hospitals and Day Surgeries in Australia. When you are treated for a service included under your policy in an agreement hospital, AIA will cover the associated hospital costs less any excesses.
If you are having trouble lodging your claim on the member portal, you can email [email protected] with the required documentation. This includes your medical invoices (paid or unpaid), Medicare Two-way claim form, and Statement of Benefits form.
When seeing a General Practitioner (GP) or Specialist, you’ll need to pay for the service in full on the day of your visit. Once you have received your invoice receipt, you can submit this as a claim by email. Depending on the reason for your visit, you may need to pay your private health insurance excess before, at the time of, or after your visit to the hospital.
If you have less than 12 months of membership on your current hospital cover, you’ll need to contact AIA by phone or email before being admitted so they can determine whether the waiting period for pre-existing conditions applies. This assessment can take up to five working days.
It is important to understand any additional costs not covered by your insurer before beginning treatment. You can ask your doctor or medical service provider for informed financial consent prior to receiving care.
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Frequently asked questions
You can submit your claim through the Online Member Service Portal. You will need to submit your invoice receipt, and where covered under your policy, you will be able to submit this as a claim.
You can email your claim to [email protected].
AIA has a team that will guide you through the claim process. You can get in touch with them via phone, email, or live chat during business hours.
AIA Health Insurance covers the associated hospital costs, less any excesses. All AIA Health Insurance products have a $500 or $750 excess.
Health funds are unable to provide cover for outpatient services. AIA Health Insurance also does not cover excess refunds for services within clinical categories such as cataracts, joint replacements, dialysis for chronic kidney disease, and pregnancy and birth.
