Take a look through our frequently asked questions below.
The Australian Government has introduced a range of changes to how private health insurance operates to make it simpler and more affordable. The main changes are: the introduction of Gold, Silver, Bronze and Basic levels of cover; standard clinical definitions of what is included in your cover; higher excess options to make your premium lower; the exclusion of some natural therapies from cover and the option to offer a discount of up to 10% for people who are aged 18-29. These changes will make it easier to compare cover across different health funds and in some cases make cover more affordable.
One of the recent reforms that Australian Government made to health insurance is for all covers to be grouped into tiers: Gold, Silver, Bronze and Basic. The tier the cover is in must be included in its name, which is why our product names are changing. This means that is now easier for you to compare covers across different health funds as all Gold covers (for example) must meet a minimum set of requirements.
One of the recent reforms that Australian Government made to health insurance is standardise the clinical definitions used to describe the services that are included or excluded from a cover. Because this will be uniform across all health funds, it'll be easier for you to know what is and isn't included in your cover and compare this across different health funds.
Where your policy includes a Dental Gap Refund, it means that if you have served your general dental waiting periods and hold AIA Vitality Silver status or above, myOwn will refund 100% of your dental gap payment on eligible preventative dental treatments. You will need to pay your provider at the time of service. After validating your eligibility, myOwn will reimburse any gap payment made on the eligible claim. To be eligible for this you must hold AIA Vitality Silver status or above at the time of service. There is nothing more for you to do. myOwn will make a direct deposit into the nominated bank account on your membership.
If you are making a manual (non-HICAPS) dental claim, you will still need to make the claim, but you won’t need to do anything different to how you claim today to receive the refund. We will process all refunds within five business days of receiving the claim.
Preventative dental treatments refer to the following dental treatments: comprehensive oral examinations, periodic oral examinations, removal of plaque or stains, removal of calculus (first and subsequent visit) and the provision of a mouthguard.
This benefit is limited to one service per treatment group per year for each person listed on the policy. Eligible Dental Gap Refund item numbers for each treatment group are:
Comprehensive oral examination
- 011 (comprehensive oral examination) or
- 012 (periodic oral examination)
Scale and Clean
- 111 (removal of plaque and/or stain), or
- 114 (Removal of calculus – first visit), or
- 115 (Removal of calculus – subsequent visit)
- 151 (Provision of a mouthguard).
Dental Gap Refund cannot be used where the service limit for preventative dental has already been reached.
Yes – provided you are on an eligible policy and at least one of the adult members on the policy have attained AIA Vitality Silver status or above.
We will process Dental Gap Refunds within five business days of receiving your claim – whether that is lodged through HICAPS at your dentist or through you lodging an eligible claim with us. The refund will be paid as a Direct Debit to your nominated bank account.
I have Silver AIA Vitality status, but my partner doesn’t – are they eligible for Dental Gap Refund?
No. To be eligible for Dental Gap Refund the person the claim is for must have AIA Vitality Silver status or above. (Dependents on a family policy will have access to Dental Gap Refund when at least one policy holder or partner/ spouse achieves AIA Vitality Silver status or above.).
Where your policy includes a travel and accommodation benefit this can be used to claim towards the travel and accommodation costs of either yourself or a carer (if applicable) while you’re in hospital.
Benefits are only eligible where the round trip is at least 200km within Australia. Benefits are capped at $50 per day for accommodation and 15 cents/km for travel for you and your carer.