Private Hospital and Specialist Cover

Private Hospital and Specialist Cover is our most comprehensive cover, taking care of specialist consultations, diagnostics, surgery, and treatments in recognised private hospitals. Even if you're fit and healthy, it's important to have a plan in place for unexpected medical expenses to help you get access to the right support you when you need it most.

Specialist Consultations**
Obstetrics Benefit up to $2,000 per pregnancy**
Cover for many pre-existing conditions after three years
$300,000 surgical cover per person each year
$200,000 medical and cancer cover per person each year
Your choice of nil, $500, or $1,000 excess options
5% AA Member discount available if you provide a valid AA Membership number for you or someone named on your policy*

Apply for yourself and your family through our quick online application, at an AA Centre or over the phone with our New Zealand based team.

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non-PHARMAC Plus

non-PHARMAC funded drugs can be lifesaving, but could possibly cost up to hundreds of thousands of dollars. The non-PHARMAC Plus option can be added to Private Hospital or Private Hospital and Specialist Cover, and helps you cover the cost of some drugs that are Medsafe approved and prescribed under the Medsafe guidelines, but aren’t funded by PHARMAC^#.

With non-PHARMAC Plus, you may have access to wider treatment options and cover for approved drugs used to treat cancer and other types of health conditions.

Find out more

Be confident knowing what your policy covers

We want to make sure you're confident knowing what you are and aren't covered for. That means reading your Policy Wording to understand the benefits as well as your responsibilities, and the cover limits and exclusions of your policy.

Hospital Surgical Benefit

We will pay up to a total maximum of $300,000 for each insured person every policy year, less any excess for any of the surgery related benefits under this cover.

Hospital Medical Benefit (non surgical hospitalisation)

We will pay up to a total maximum of $200,000 for each insured person every policy year, less any excess for the non-surgical (non-medical) and cancer related benefits under this cover. Individual limits may apply to each of the benefits.

Specialist Consultation Benefit

We will cover all eligible claims for specialist consultations during the cancer treatment phase (chemotherapy, brachytherapy, radiotherapy or surgery) and up to twelve registered specialist consultations for other treatments (including pre- and post- cancer treatment phase) per insured person every policy year.

AA Health Insurance Private Hospital and Specialist	Annual Benefit limits
Standalone benefits
Surgery in a recognised private hospital (Hospital Surgical Benefit)	$300,000^
Non-surgical hospitalisation (Hospital Medical Benefit)	$200,000^
Included under standalone benefits***
Cancer treatments	$300,000 for cancer surgery; $200,000 for cancer treatment (including up to $10,000 for cancer treatment at home)
Diagnostics investigations	$15,000
Non-PHARMAC cancer treatment	$10,000
Registered specialist skin lesion surgery	$6,000
CT, MRI and PET scans	$5,000
Intravitreal eye injections	$3,000
Travel and accommodation- Cancer	Up to $5,000 for travel and accommodation
Travel and accommodation- Surgery or Medical	Up to $2,000 for travel and $3,000 for accommodation
Follow-up investigation for cancer	$3,000 each year, for up to five years
Parent accommodation	$200 per night, up to $3,000
Obstetrics	$2,000 for each pregnancy
GP surgery	$750
Post-hospital physiotherapy	$750
Post-hospital therapeutic care	$250
Post-hospital home nursing care	$150 per day, up to $6,000
ACC Top Up	Covers the difference in costs between what ACC pays for an injury and the costs incurred
ACC Treatment Injury	Cover for reparative treatment for any injury that occurs during treatment
Road ambulance transfer	Cover for cost of road ambulance transfer from a public or private hospital to the closest private hospital
Oral surgery	Cover for oral surgery performed by an oral surgeon / maxilla-facial surgeon, including wisdom teeth extraction.
Specialist consultations	Unlimited number for cancer related consultations, up to 12 for others
Varicose veins surgery	Cover for varicose vein treatment on recommendation from a GP or registered specialist
Other benefits
Premium Waiver	Up to 2 years
Suspension of cover after one year	You may choose to suspend the cover for overseas travel, parental leave and unemployment
Pre-existing cover for newborns	Pre-existing conditions are covered when a child is added within 4 months of birth
Loyalty benefit- sterilisation after two years	$1,000 (lifetime limit)
Optional add-on
non-PHARMAC Plus	Four different cover levels to suit your needs: $50,000, $100,000, $200,000 or $300,000^

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Things you should know

Benefit limits and excesses apply per person and refresh each policy year.
100% of your eligible cover amount can be claimed if you select a provider from the nib First Choice Network. You can still choose a provider outside of the network; you will just need to make a 'gap-payment', as these provider rates aren't standardised and regulated through the group.
There's a 14-day cooling off period that gives you peace of mind in knowing that if you change your mind in this time, we'll refund 100% of premiums paid.
Waiting periods apply before you can access some benefits under your policy. See the above table and Policy Wording for more information.
Most pre-existing conditions are covered after a 3 year waiting period. Some pre-existing conditions are never covered. Please check the Policy Wording for full details.
We won't change your premiums on an individual basis (unless you change your smoking status), however it's possible for all premiums to increase in the future. We will always give you 30 days' written notice if that happens.
For more information on non-PHARMAC Plus, see the non-PHARMAC Plus Policy Wording.

Private Hospital and Specialist Cover