Looking for health insurance that promotes flexibility, choice and added value? Then ahm may be the right fund for you.
With 40 years in the business, ahm Health Insurance is trusted by over 500,000 Australians nationwide to protect their healthcare needs and is backed by Medibank, one of the largest private health funds in the country.
Offering a range of hospital, extras and combined cover, ahm Health Insurance has policies to suit any need or budget.
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Compare ahm's complete range of policies side-by-side
What policy options are available?
- Top Hospital. Made for those who want complete peace of mind, this policy covers all hospital treatments that Medicare pays a benefit for, as well as specialised services including pregnancy, labour ward fees, reproductive services, sterility reversal and weight loss surgery.
- White Deluxe. A good choice if you are looking for a comprehensive policy without pregnancy. It covers all the services included in Top Hospital except for obstetrics, reproductive services and weight loss surgery, which are excluded. A partial benefit also applies to psychiatric services.
- White Classic. An intermediate policy that covers a wide range of hospital services including cancer treatment, heart procedures, brain surgery, joint reconstruction and more. Specialised treatments such as dialysis, spinal fusion, pregnancy and major eye surgery are excluded.
- White Boost. This policy allows you to claim for a number of hospital treatments including surgery to remove wisdom teeth, joint reconstruction, colonoscopies and tonsil removal. Pregnancy, psychology, palliative care and rehabilitation are partially covered.
- White Lite. Designed for the budget-conscious, this policy covers essential hospital services including injury relating to accidents, emergency ambulance transport, tonsil removal and more. Be aware that a large number of treatments are excluded from this policy.
- White Starter. If you are young, healthy and wanting to avoid the Medicare Levy Surcharge, this policy is a solid option. It provides full cover for accident treatment and emergency ambulance as well as partial cover for rehabilitation, palliative care and psychiatric services.
- Super Extras. A premium extras policy that covers you for 28 services including major dental, orthodontics, optical and pharmacy prescriptions. Super Extras also boasts the highest annual benefit limits and no limit is applied to routine dental.
- Family Extras. This policy covers a range of out-of-hospital treatments including pre and postnatal services and birthing courses. While annual benefit limits are not as high as Super Extras, they are still generous and waiting periods are waived for common services your children may need, such as routine dental and optical.
- Lifestyle Extras. Focusing on the wellbeing of the body and the mind, this extras policy covers up to 17 alternative and complementary therapies including acupuncture, naturopathy and herbalism. Other services are not neglected either, as you are also covered for major dental, optical, laser eye surgery and more.
- Black 60. Covering you for a range of essential extras services without breaking the bank, this policy pays up to 60% towards the cost of treatments including major dental, physiotherapy and remedial massage. Optical and emergency ambulance transport costs are fully covered. Annual benefit limits are shared between certain services.
- Black 50 Saver. An inexpensive entry-level policy that covers 50% of the costs relating to routine dental, physiotherapy, chiropractic and osteopathic care. Emergency ambulance transport is also included and fully covered. Annual benefit limits are shared between certain services.
- Deluxe Flexi. Combining all the services included in White Deluxe plus a generous amount of extras, this policy ensures that you are fully covered both inside and outside of hospital. Be aware that psychiatric care has a partial benefit applied, while obstetrics, reproductive services and weight loss surgery are excluded.
- Classic Flexi. A solid option if you are looking for a comprehensive combined policy without the additional cost of insuring for specialised services. The hospital cover is identical to White Classic with the same exclusions and restrictions. All the extras services covered by Deluxe Flexi are also included with the exception of major dental.
- Boost Flexi. The middle ground option between the comprehensive and budget packages, Boost Flexi provides the same level of hospital cover as the White Boost policy while including a large number of extras services such as routine and complex dental, optical, physiotherapy, natural therapies, prescription medications and more.
- Lite Flexi. Affordable without compromising on protection, this policy includes all the hospital services covered by White Lite along with a range of extras. Rehabilitation, palliative care and psychiatric care are partially covered, while major dental, podiatry, orthotics and natural therapies are excluded.
- Starter Flexi. Suitable for those who only require the bare essentials, this policy covers you for vital hospital services and general treatments that are not eligible for a Medicare benefit (such as dental) and it allows the policyholder to avoid the Medicare Levy Surcharge and the Lifetime Health Cover loading.
Are there any bonus benefits?
ahm offer a range of benefits to it's members:
- Choose your own provider. ahm Health Insurance does not penalise you if you visit a non-preferred provider for any extras services.
- Excess and co-payment options. You can access a range of excess and co-payment (daily charge) to help reduce the cost of your premiums.
- Flexible extras limits. If you choose the Deluxe Flexi, Classic Flexi, Lite Flexi or Starter Flexi combined policies, the annual benefit limit is applied as a lump sum for you to spend however you wish, without shared limits.
- Loyalty rewards. Annual benefit limits on some extras services increase every year that you maintain your cover. Combined policies cap at five years and standalone extras policies cap at 20 years.
Paying your ahm health insurance premiums
ahm health insurance premiums can be paid:
Premiums can be paid in the following ways
- By direct debit from your nominated bank account or credit card
- By BPAY from your bank account
- Over the phone using your credit car
How many hospital agreements does ahm have in my state and in total?
The benefit you receive for hospital treatment is influenced not only by the level of cover you have in place, but also by whether or not your health fund has an agreement with the hospital where you are treated. Check out the table below for details of the number of hospital agreements ahm and Medibank Private have in place in your state or territory compared to the maximum of any health fund across the industry:
|Private hospital agreements||Day hospital agreements|
|NSW||87 (industry maximum: 101)||76 (industry maximum: 96)|
|ACT||5 (industry maximum: 7)||4 (industry maximum: 9)|
|VIC||56 (industry maximum: 84)||68 (industry maximum: 75)|
|QLD||53 (industry maximum: 57)||37 (industry maximum: 51)|
|SA||27 (industry maximum: 29)||19 (industry maximum: 27)|
|WA||20 (industry maximum: 23)||17 (industry maximum: 26)|
|TAS||5 (industry maximum: 8)||3 (industry maximum: 5)|
|NT||1 (industry maximum: 2)||1 (industry maximum: 1)|
Is there anything I cannot claim for?
Australian health funds typically exclude some procedures and items from cover, which is why you should always check your policy's rules and exclusions carefully. ahm's general exclusions can be found below:
- Charges above the minimum benefit for surgically implanted prostheses
- The full cost of accommodation or theatre fees if treated at a non-agreement hospital
- Treatment that is currently subject to a waiting period
- Personal items in hospital such as phone calls, TV, faxes, internet and newspapers
- Take-home bandages and dressings
- Costs for services not covered by Medicare
- Any medical, hospital or ambulance services received overseas
- Cosmetic surgery
- The full cost of restricted or excluded services
- Podiatric surgery
How do I make a claim?
Once you’ve received treatment or purchased an item covered by your policy, you’ll need to make a claim. You can lodge a health insurance claim with ahm in the following ways:
- On the spot. You can swipe your ahm membership card at almost 20,000 health care providers that support the HICAPS electronic claims system. This allows you to have your claim processed immediately.
- Via a mobile app. You can lodge a claim using the ahm mobile app by taking a photo of your receipt using your smartphone and then submitting it to ahm.
- Online. You can log into your online account through the ahm website and lodge your account by providing the details included on your receipt. You’ll also need your bank details handy to arrange an immediate transfer of the benefit into your account.
- By post. You can fill out a claim form and submit it along with your receipt from the provider to:
- AHM Health Insurance
- Locked Bag 1006
- Matraville, NSW, 2036
Benefits can be paid by bank transfer or cheque.
Coming to Australia on a student visa?
ahm Health Insurance offers Overseas Student Health Cover (OSHC) for international students who are planning to study in Australia. The policy is fully compliant with student visa conditions and includes the following benefits:
- Broad protection. Cover for hospital treatment, visits to the doctor, emergency ambulance transport and medications.
- Fast payment on claims. Benefits are paid to you within two working days and claims can be lodged online or by phone.
- Interpreter. A free interpreter service is available to use.
- 24-hour helpline. Can be called for emergency medical assistance and advice.
- Stress and trauma counselling. All members have free access to counselling if they require it.
Want to know more about ahm?
Below are some useful info to help you decide whether ahm is the health fund for you:
How many members does ahm service?
ahm provides health insurance cover to more than 500,000 people. Its parent fund, Medibank, boasts a 27.6% market share, making Medibank the largest health fund in Australia.
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