Apia Health Insurance for Over 50s: 2019 Review

Apia Health Insurance for over 50s aims to fill the gap by offering an insurance plan specially tailored for older Australians.

As you get older, your health insurance needs change. So it makes sense to have an insurance policy that caters to those needs. After all, you don’t want to pay for unnecessary services!

And that’s why we feel it’s one of the best options available.

Apia Health Insurance Plans

If you decide to apply for Apia Health Insurance, then there are two mid-level hospital plans to choose from. That might not seem so generous at first. But remember: both of them are designed with the needs of older Australians in mind!

So, what are the two options?

First, there’s the Silver Essentials Hospital Plus plan. With this plan, your insurance pays for the basic expenses for most of the common hospital treatments. This usually means that your policy pays the full cost of your hospital accommodation, intensive care, and theater fees. There are a few others too, but we’ll look at them in our next section.

Your other option is the Silver Premium Hospital Plus plan. This type of policy is a slight upgrade from Silver Essentials, so it includes a few extra benefits. Some of those benefits are covering cataracts, dialysis for chronic kidney failure, and even weight-loss surgery. We’ll take a look at all of the extra benefits a little later.

Both plans have flexible excesses. So depending on which option you choose, you might pay $250, $500, or $750 in excess.

Remember that the higher your excess is, the lower your premiums will be. But that also means you’ll be paying more money out-of-pocket any time you make a claim. So always think very carefully before making your decision.

What Benefits Are Included With the Silver Essential Hospital Plan?

To make things easier, we’re first taking a look at all of the benefits that come with the Silver Essential Hospital Plan by Apia Health Insurance. That way, you can easily see what extra benefits you’ll get with the Silver Premium Hospital plan afterward.

So, these are the benefits that you get with both options:

  • Adenoids, grommets, and tonsils
  • Back, neck, and spine treatments
  • Blood tests and treatments
  • Bone, joint, and muscle treatments
  • Brain and nervous system treatments
  • Breast surgery (but only if it’s a medical necessity – so no cosmetic surgery)
  • Chemotherapy, immunotherapy, and radiotherapy for cancer treatment
  • Dental surgery
  • Diabetes management (however, this doesn’t include insulin pumps – that’s separate)
  • Digestive system treatments
  • Ear, nose, and throat tests and treatments
  • Eye exams and treatment (but this doesn’t include cataract treatment)
  • Gastrointestinal endoscopy
  • Gynecology (but this doesn’t include pregnancy, births, or any assisted reproductive services)
  • Heart and cardiovascular system treatments
  • Hernia and appendix treatments
  • Hospital psychiatric services (however, for the Silver Essentials Hospital plan, this is only with the minimum benefits payable)
  • Implanting hearing devices
  • Insulin pumps (remember, this is separate to diabetes management!)
  • Joint reconstruction and replacement surgery
  • Kidney and bladder treatments
  • Lung and chest treatments
  • Male reproductive system treatments
  • Miscarriages and other terminations of pregnancy
  • Pain management, with or without a device
  • Palliative care
  • Plastic and reconstructive surgeries (but this is only if it’s for medical reasons)
  • Podiatric surgeries (but this is only if you go to a registered podiatric surgeon. And the policy doesn’t cover in-hospital podiatric services either)
  • Rehabilitation
  • Skin
  • Sleep studies

What Extra Benefits Do You Get With the Silver Premium Hospital Plan

Apia Health Insurance

Okay, so there are also a few extra benefits that you get here.

Remember, even though it’s a shorter list, you’re getting more benefits!

  • Cataracts treatment
  • Dialysis for chronic kidney failure treatment
  • Hospital psychiatric services don’t have to be with the minimum benefits payable anymore
  • Weight-loss surgery

Apia Health Insurance Extras

There are also a few extras options for you to choose from. You can decide whether you want to buy them separately or if you want to add one or more of them to your Apia Health Insurance plan.

Essential Extras

With the Essential Extras addon, you’ll get 60% paybacks for a few small services. But you also need to remember that there are some limits to that benefit.

For ambulances and preventative dental treatments, there are no annual limits at all. But for general dental treatments, there’s a limit of $600 a year.

Major dentist treatments have a separate limit, which is also $600 a year. Optical appliances have a limit of $250 a year, and physiotherapy has a limit of $350 a year.

Classic Extras

The Classic Extras addon has the same 60% benefits for the same list of services as the Essential Extras. But the limits are a little higher.

Ambulances and preventative dental treatments still have no annual limits. But general dentist treatments have a limit of $700 a year. And the major dentist treatment limit goes up to $1,300.

Optical appliances have a limit of $300 a year, while the limits for physiotherapy goes up to $450.

Premium Extras

Apia Health Insurance’s Premium Extras addon is definitely the best. Instead of only 60% benefits, you get 75%. And while Essential and Classic Extras only have 6 available services, Premium has 22!

To make things easier, let’s look at them in a list.

  1. Ambulances still have no annual limits, of course.
  2. General dentist treatments go up to $1,000 a year.
  3. Major dentist treatments go up to $1,300 a year.
  4. Optical appliances enjoy a higher limit of $350 a year.
  5. Physiotherapy goes up to an annual limit of $600.
  6. Preventative dentist treatments also have no annual limits, just like with the Essential and Classic Extras addons.
  7. Orthodontia has a starting annual limit of $800.
  8. Exercise physiology has a limit of $300 a year.
  9. Chiropractic osteopathy has a limit of $500 a year.
  10. Natural therapy enjoys an annual limit of $200.
  11. You can get speech therapy benefits for a maximum of $450 a year.
  12. Podiatry consultations and foot orthodontic appliances share a limit of $400.
  13. Eye therapy has an annual limit of $200.
  14. Dietary advice consultations have a yearly limit of $600.
  15. You can get a maximum of $200 a year of benefits for home nursing services.
  16. Occupational therapy has a limit of $450 a year.
  17. $500 a year for pharmaceutical prescriptions.
  18. Psychology also has a limit of $500 a year.
  19. Speech processors and hearing aid appliances share a $1,200 annual limit.
  20. Health aid appliances have a total limit of $500 a year.
  21. Preventative tests are eligible for a $200 payback maximum each year.
  22. You can also get a $500 payback bonus for having a healthier lifestyle.

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