For palliative care
Silver Hospital covers palliative care. Check the hospital cover for exclusions and restricted benefits before choosing.
Apia health insurance
Is it a good health insurer?
Apia has 4 hospital and 5 extras policies in our comparison, from $122.17 a month for hospital cover (Single · NSW · $500 hospital excess, after rebate).
Issued by nib Health Funds Ltd. Hospital, extras or both.
Explore 4 hospital and 5 extras products, or find cover by treatment. Sources for Apia
Reviewed, Edited and Designed by
Grace Connolly
Created with AI assistance
Page updated 26 October 2026 · Prices effective 17 September 2026
I need cover for…
Apia cover: the main choices.
Compare hospital inclusions
If you claim major dental every year
Classic Extras has a $1,300 major dental limit. Check the extras benefits for shared pools and claim conditions.
Before you pay for Silver
Silver Hospital adds back, neck and spine treatment and other categories compared with Bronze Hospital Plus. What the hospital cover step costs depends on your household, state and excess.
Apia policies and example prices.
The profile you choose updates the Apia price tables, hospital shortlist and alternative-policy comparison below.
Single · NSW · $500 hospital excess · example premiums after rebate.
Monthly examples include the 24.118% government rebate, the maximum for adults under 65. Your rebate and final quote may differ.
Need an Apia price for your circumstances? Compare Apia with cover across all Australian health funds.
Compare my optionsHospital cover
4 product lines
$53.15 more per month for Silver Hospital Plus versus Silver Hospital after rebate for the selected example profile.
Cataracts is an additional inclusion, not the complete list of differences.
Extras cover
5 product lines
Also considering nib?
Related insurer
Apia and nib-branded health cover share an issuer, but their policy benefits, prices and joining offers can differ.
A nib-branded policy is not an Apia policy. Check the exact product and terms before joining.
Explore nib-branded coverWhat does Apia hospital insurance cover?
2 Apia hospital policies fully cover cataracts
Single · NSW · $500 hospital excess. Only policies that fully include cataracts are shown. How we read hospital categories
Compare selected treatment categories across all 4 hospital policies
Selected Apia treatment categories.
More premium does not mean more back on everything.
Apia extras limits per 12 months unless the statement says otherwise
Single-policy examples. Each links to its policy statement.
Essential Extras → Premium Extras
The optical limits move from $250 to $350 for the Single-policy examples. Premium Extras raises the physio limit from $350 to $600. It also raises the major dental limit from $600 to $1,300 and adds psychology.
Premium Extras: higher benefit examples
The optical examples move from 60% on Essential Extras to 75%, with a $350 optical limit and $600 physio limit for the Single-policy example.Weigh those increases against the premium.
Why Apia's shared limits and waiting periods matter
Every optical benefit shown has a standard waiting period of 6 months.
Apia vs. ahm vs. Westfund
How Apia compares with similar hospital policies.
These are selected Silver Plus examples from ahm and Westfund, not identical policies or a search for the cheapest cover across the market.
Comparing Apia Silver Hospital Plus with ahm Core Silver Plus and Westfund Silver Plus Advantage Hospital. Single · NSW · $500 hospital excess · Silver Plus hospital cover
Apia and selected alternatives: monthly prices and verified coverage differences.
What the differences mean for you
Both alternatives have lower example premiums for this profile. That does not make their cover identical. A lower premium can come with different treatment benefits. Check whether these differences matter for the cover you need.
Pain management with a device: included with Westfund; not included with Apia and ahm.
Sleep studies: included with ahm and Westfund; not included with Apia.
These alternatives match Apia Silver Hospital Plus on tier, cataracts and joint replacements. How we choose alternatives
Compare all 38 hospital treatment categories
Apia and the alternatives: all 38 treatment categories, policy information as at 26 October 2026.
Compare Apia with cover from every Australian health fund.
Apia against the industry.
These figures describe nib Health Funds Ltd, which issues Apia health cover, not Apia customers alone.
nib members had no gap on 88.8% of in-hospital medical services in the 2024-25 financial year, against 87.1% across the industry. State of the Health Funds Report 2024-25 · accessed 26 October 2026
nib paid 58% of members' extras (general treatment) charges in the 2024-25 financial year, against 50.7% across the industry. State of the Health Funds Report 2024-25 · accessed 26 October 2026
nib increased premiums by an average of 5.47% in 2026, against 4.41% across the industry. Government premium-increase figures · accessed 23 October 2026
ProductReview
1.8 / 5
801 ProductReview reviews
Voluntary customer reviews · nib
Snapshot: 26 October 2026. This is nib's listing, not an Apia-only rating or a representative survey.
Complaint share is close to market share, but investigated complaints are lower
Share of all complaints, 2024-259.6%
Market share, 30 June 20259.8%
0%12%
State of the Health Funds Report 2024-25 · checked 26 October 2026
nib's share of complaints the Ombudsman received in 2024-25 is close to its market share at 30 June 2025. Its share of complaints the Ombudsman investigated that year is 6.4%, below its market share.
Latest quarter, January to March 2026. The Ombudsman referred 70 complaints about nib Health Funds Ltd to it to resolve, 10.5% of those it referred about all insurers. It also investigated 1 complaint about nib Health Funds Ltd, 33.3% of those it investigated about all insurers. Ombudsman Quarterly Update · checked 26 October 2026
Check the practical details.
Check your provider
Confirm that Apia recognises your provider. Ask for a treatment plan and item numbers so Apia can estimate your benefits and out-of-pocket costs.
Make or track a claim
Use Apia's health claims guidance and member login for receipts, claim tracking and remaining benefits.
Contact Apia
For sales and customer service, call 13 50 50. Monday to Friday, 8am to 6pm AEST/AEDT. Closed weekends and national public holidays.Contact details checked 22 October 2026.Official contact details and messaging options
Before you choose Apia.
Who provides Apia health insurance?
Apia health insurance is issued by nib Health Funds Ltd. An Apia policy is not necessarily identical to a policy sold under another nib brand, so compare the actual policy terms and price.
Source: Government insurer profile, checked 23 October 2026.
What is the cheapest Apia hospital policy?
Bronze Hospital Plus is the cheapest Apia hospital policy for a single person in NSW with a $500 hospital excess, at $122.17 a month after the 24.118% government rebate for adults under 65 (prices effective 17 September 2026). This compares all 4 Apia hospital policies, not the whole market. Check what it excludes before choosing on price.
Source: How we compare prices, checked 26 October 2026.
What changes if I move from Bronze Hospital Plus to Silver Hospital?
Apia Silver Hospital adds full cover for heart and vascular system, implantation of hearing devices and 4 more categories compared with Bronze Hospital Plus. For the Single / NSW / $500 excess example it costs $37.68 more a month, so check what each policy covers before you upgrade.
Source: Private Health Information Statements, checked 26 October 2026.
Sources for Apia.
Policy information retrieved 26 October 2026. Prices effective 17 September 2026.
Private Health Information Statements · Apia · checked 26 October 2026
State of the Health Funds Report 2024-25 · nib · checked 26 October 2026
Government insurer profile · nib · checked 23 October 2026
Government premium-increase figures · nib · checked 23 October 2026
Government rebate rates and eligibility · Australian Government · checked 26 October 2026
ProductReview listing · nib · checked 26 October 2026
Official contact details · Apia · checked 22 October 2026
I need cover for...