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.
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.
Apia Health Insurance: Our verdict
Apia Health Insurance is underwritten by nib and tailored to seniors. It offers 3 hospital options and 3 extras cover policies.
Apia is good if:
You're an older Australian and don't need coverage for reproductive services, pregnancy or cosmetic surgery.
You want a mid-range policy.
Apia is not great if:
You want a Gold policy.
You still need cover for pregnancy or medically necessary cosmetic surgery.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
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 2023 Ombudsman health insurance complaints to see how good Apia's customer service is (it's underwritten by nib).
Apia (nib) had a higher complaints ratio than its market share.
Apia (nib) had a larger complaints ratio than some other big insurers like Bupa, Medibank and HBF.
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 Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
Gary Ross's expertise
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
