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Review AHM Health Insurance Hospital and Extras

Anneke Van Aswegen Updated: 11 May 2020
Types of Health Insurance

Whether you’re seeking private health insurance because you’re getting a bit older and need more medical care or you already have AHM health insurance and recently received your renewal email or notice of a premium increase, it’s always a good idea to review your policy options before making an informed decision regarding purchasing or switching policies.

AHM offers a wide range of policy options, including Hospital cover, Extras cover, and combined packages designed to suit you and your family at various stages of your life.

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Who is AHM?

Australian Health Management (AHM) is a 100% Australian-owned business that was founded in 1971 and forms part of Medibank Private Ltd after it was acquired in 2009. With over 40 years’ experience and more than 700,000 members, AHM’s black and white marketing campaigns have become well known in Australia. They also offer their members some additional perks, like 2 for 1 movie tickets at HOYTS every Thursday night after 5 pm.

AHM health insurance review

Products available from AHM includes Hospital and Extras policies, as well as several package options combining Hospital and Extras to suit your unique requirements. However, from 1 April 2019, all package options will exclude pregnancy and birth-related services, assisted reproductive services and weight loss surgery.

The health fund strives to make private health insurance as easy as possible by delivering a digital-first experience so that you can manage your cover online.

Combined Hospital and Extras Packages

Black + White starter flexi

Combines Hospital cover for accidents and routine Extras with a $550 flexi limit.

The cover might be better suited to young and healthy singles or couples looking for a budget-friendly policy that includes Entry-level coverage.

Black + White lite flexi

Affordable cover that provides basic in-hospital treatments, combined with a $700 flexi limit on Extras.

Black + White boost flexi

Combines a broader range of hospital procedures with a $800 flexi limit.

Black + White classic flexi

Provides more than just the basics for Hospital cover, and Extras with a $900 flexi limit.

Black + White deluxe flexi

Top cover with $1,100 Flexi limit for Extras. Might be best suited to people needing more medical care, as this is the only package option that includes:

Important: For a complete list of procedures and treatments included in each plan, please request a quote or visit the AHM website. Also, all service providers for Hospital and Extras must be recognised by AHM before they can pay a benefit.

What is AHM Flexi limit?

With Flexi Extras you choose your preferred services from the range that’s available on your specific policy type, up to the benefit amount specified. The amount of services you can choose will also depend on the policy you have. Flexi Extras allows you to tailor your cover to suit your requirements and it will start to increase after you’ve been an AHM member for one full financial year, capped at 5years.

AHM Hospital cover

If you want coverage for in-hospital treatments, or just want private health insurance to avoid the Lifetime Health Cover (LHC) loading and Medicare Levy Surcharge (MLS), then you need a Hospital policy. With AHM Hospital cover options you generally only have the choice of a $500 excess amount. However, no hospital excess is required for kids going to the hospital.

Take note: As of 1 April 2020, all health insurers are required to adopt the standard clinical Hospital categories (Gold, Silver, Bronze and Basic).

AHM Hospital cover options available for purchase include:

Health Insurance Quotes

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  • Keep your family healthy
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Want to talk to a specialist? Call 1300 743 254

AHM Extras cover

You can choose from a wide range of Extras and buy them as either a stand-alone policy or mix and match them with your choice of Hospital policy. The type of general treatments you’ll be covered for, and the benefit percentage you can claim back depends on which Extras policy you choose.

Important: The percentage you can claim back on your AHM Extras generally have an annual benefit limit. Carefully review the policy Standard Information Statement (SIS) before deciding. Also, your out-of-pocket costs will depend on what the provider charges.

There are 3 AHM Extras options that include loyalty limits, rewarding you for remaining a member by increasing the benefit amounts you can claim back on your policy.

Your loyalty limits are calculated on the number of financial years the primary member continues their coverage.

Lifestyle Extras

No waiting periods on general dental, optical, non-PBS pharmaceuticals, physiotherapy and chiropractic, psychology or remedial massage.

Includes coverage for orthodontics and there’s no annual limit for emergency ambulance transport. You’ll also have access to AHM Health Improvement Benefits.

Family Extras

Extras cover specifically designed for families and includes cover for speech therapy, occupational therapy, and eye therapy. This policy might also suit couples wanting to start a family as it covers pre and post-natal services and birthing courses.

Super Extras

This is the health fund’s most comprehensive Extras policy and might suit people requiring more medical care, especially senior Australians, as it pays benefits towards audiology, outpatient procedure rooms fees and post-operative aids and medical aids (e.g. braces and non-surgical prosthesis).

Take note: From 1 April 2019, as part of the government reforms, benefits for natural therapies will no longer be provided. For example, homoeopathy, kinesiology, reflexology, and aromatherapy.

AHM Benefits

AHM provides members with Health Improvement Benefits, which encourages you to improve your health and lifestyle by enabling you to claim money back on specific programs. If you have a valid Extras policy (Lifestyle, Family or Super extras) AHM might pay benefits towards:

  • Health checks
  • Weight loss and exercise classes
  • Stress management courses
  • Stop smoking courses and replacement therapies
  • Disease management association fees
  • Preventative tests, scans and screenings
  • Cancer Counsel UV products
  • Swimming lessons

Does AHM cover ambulance?

Yes, when purchasing an AHM Hospital policy, you’ll receive coverage for medically necessary ambulance transportation. However, how much you can claim for ambulance services is dependent on the Hospital policy you choose. If you only have an Extras policy, the health insurer will pay benefits towards emergency ambulance services when provided by an AHM approved ambulance provider.

Waiting periods

The amount of time you must wait before claiming on a benefit after your policy commences will depend on the level of cover you hold and the treatment or service you want to claim on.

Waiting period Treatment or Service
1 Day Emergency ambulance
2 Months
  • Ambulance services
  • Hospital treatments needed because of an accident
  • Travel and accommodation
2 Months
  • All in-hospital treatments for conditions that did not exist before starting your policy
  • Healthy heart checks and Doctor’s health checks
  • Psychiatric, rehabilitation and palliative care
  • General dental
  • Physiotherapy and chiropractic
  • Podiatry
  • Acupuncture, naturopathy and remedial massage
6 Months Optical
12 Months
  • Pre-existing conditions
  • Pregnancy and birth-related services
  • Insulin pump replacements
  • Disease management appliances
  • Speech processors
  • Major dental and orthodontics
  • Hearing aids
  • Pre and post-natal services
24 Months Laser eye surgery for sigh correction

How do I claim AHM health insurance?

You can claim benefit on the spot using your AHM member card at any recognised Extras providers who usne HICAPS. Alternatively, you can use the AHM app to make most Extras claims. You can also log in to your AHM account online and make a claim that way. If you prefer going old school, you can download the claim form from the AHM website and email or post it the health fund.

To claim travel and accommodation, you’ll need to complete a claim form and include your invoice, which should contain a statement from your attending doctor or a copy of your medical statement or bulk billing statement.

Frequently asked questions

  • Is AHM health insurance good?

    Whether or not a private health insurer is a good option for you and your family, depends on your specific requirements and what you can afford. You might want to get an AHM quote and compare their offering and premium against similar products from other major Australian health insurance companies.
  • When does health insurance reset?

    AHM Extras limits generally reset on the 1st of July, at the start of the financial year. However, some Extras limits are based on a rolling year and are renewed 12 months after your policy starts. Be sure to read the SIS of your chosen policy for specifics.
  • Is AHM not for profit?

    No, AHM forms part of the Medibank group and is thus a for-profit health fund, meaning the insurer aims to return a profit to its shareholders and/or owners.
  • Can AHM assist with Overseas Student Health Cover (OSHC)?

    Yes, AHM does offer health insurance for overseas students. The Australian Health Management OSHC is a business of Medibank Private Ltd.

Health Insurance Quotes

  • Reduce out-of-pocket expenses
  • Keep your family healthy
  • Easy and convenient
  • Free to use

Want to talk to a specialist? Call 1300 743 254

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