Review AHM Health Insurance Hospital and Extras

Published: March 7, 2019

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_logo

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.

Request an AHM Quote

Save Time & Money Save Time & Money
100% Free Service 100% Free Service
Simple & Convenient Simple & Convenient
REQUEST QUOTE

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.

  • In-hospital treatment as a private patient in a public or private hospital
  • 1 Ambulance service per year for singles and 2 for couples

Black + White lite flexi

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

  • Joint reconstructions & investigations
  • Surgical removal of wisdom teeth
  • Removal of tonsils, adenoids, grommets & appendix
  • Minor gynaecological procedures
  • General dental & endodontic
  • Optical
  • Physiotherapy and chiropractic
  • Remedial massage

Black + White boost flexi

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

  • Brain surgery
  • Bowel surgery
  • Cancer therapies
  • Colonoscopies
  • Transcutaneous electrical nerve stimulation (TENS) for pain relief
  • Non-PBS pharmaceuticals

Black + White classic flexi

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

  • Palliative care
  • Heart-related procedures
  • Implantation of hearing devices
  • Insulin pumps & diabetes management
  • Podiatric surgery
  • Orthotics & Orthopaedic shoes

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:

  • Major dental
  • Cataract surgery
  • Hip and knee replacements
  • Dialysis for chronic kidney failure

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:

White starter: Only covers the costs of hospital treatments and procedures required as a result of an accident. Might be suited to young and healthy singles and couples on a tight budget.

White lite: A cheap option for those wanting coverage for essential procedures, including joint reconstruction and investigations and the removal of tonsils, adenoids, grommets and appendix.

White boost: Provides a broader range of in-hospital treatments, for example, brain surgery and colonoscopies, but still excludes certain services to keep your premiums affordable.

Classic silver plus: Previously known as the White classic, includes rehabilitation, palliative care, pain management, and implantation of hearing devices.

Deluxe silver plus: Formerly called White deluxe, offers comprehensive cover for procedures like major eye surgery, heart and vascular procedures, renal dialysis, and spinal fusion surgery.

Top Hospital Gold: This hospital policy is AHM's most comprehensive cover option and is generally suited to people wanting to start a family as it includes obstetrics and pregnancy-related services, assisted reproductive services, and midwife assisted home births.

Request and compare health insurance policies

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.

Black 50 saver: Get 50% back on Extras, including general dental, physiotherapy and chiropractic.

Black 60: Claim 60% back on included Extras, such as major dental, optical, ambulance services and remedial massage.

Black 70: Includes the same benefits as the Black 60, but you claim 70% back up to your annual limits.

Black 70 plus: Get 70% back on general treatments, including Non-PBS pharmaceuticals, podiatry, psychology, and acupuncture.

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.

medal
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
  • Cancel 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 and answers

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.

Request an AHM health insurance quote

Ask an Expert?

6 Comments

  • Jen |

    Hello, I am an overseas student. I was wondering if I upgrade my AHM health insurance to couple policy how much would it cost me? Thank you so much, God Bless.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Jen, we need a bit more information from you, for example where in Australia you live and if you want Extras only, Hospital only or Combined hospital and extras cover. Please fill in the form above and a consultant will give you a call to go through your options. Alternatively, you can call 1300 795 560 for immediate assistance.

  • John |

    Hi, At present, my wife and I are on the top cover. Could I remain in top cover if I were able to reduce my costs by
    1. Removing weight loss
    2. Obstetrics-related services
    3. Services not covered by Medicare.

    Also, we are pensioners with concession cards do we need to also pay the Ambulance levy. Would we still be covered for all services including emergencies in all states in Australia? Cheers John

    • SPECIALIST
      Anneke Van Aswegen |

      Hello John.

      You’ll have to contact the health fund directly concerning the status of you cover when removing specific services.

      As concession card holders, you might not need additional ambulance coverage. However, this depends on the state you live in.

      Please give our specialists a call on 1300 795 560 for assistance.

  • lyn nelson |

    Would like a quote on silver extras and hospital. Thanks

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Lyn.

      Because I do not know where in Australia you live and your specific requirements, i.e. your family dynamic etc. I cannot provide you with a quote. Please fill in the quote form above or call 1300 795 560 for immediate assistance.