AHM Health Insurance Review

Published: July 20, 2017

When looking for health cover from a private health fund, like AHM Health Insurance, you want to find the best option for your requirements. Discover what AHM private health insurance offers, how much their policies cost, and what you won’t be covered for.

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Hospital cover

  • White Starter
  • White Boost
  • Top Hospital

Extras cover

  • Black 50 Saver
  • Lifestyle Extras
  • Family Extras

Combined cover

  • Starter Flexi
  • Boost Flexi
  • Deluxe Flexi

Many people don’t know what they are covered for and might not realise that there are other, more affordable or relevant options available. We aim to provide you with the information needed for you to find the best value for your premium and avoid nasty surprises, like hidden costs.

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About AHM Private Health Insurance

AHM was founded in 1971 in Wollongong. It was acquired in 2009 by Medibank, one of Australia’s largest health insurers. With over 40 years of experience, AHM offers a range of policies and now has more than 500,000 members.

AHM Health Insurance cover options

AHM offers 6 Hospital Cover, 5 Extras Cover and 5 Combined Cover options to suit many different types of people and at various price points.

Review AHM Hospital Cover

AHM Hospital Cover policies will cover you for the cost of hospital treatments and many specialised services, depending on the level of cover that you choose.

AHM offers 6 Hospital Cover plans, including:

White Starter is the right product for you if you’re looking to cover the costs of treatments needed when you’ve been in an accident.

White Lite is aptly described as “lite on your pocket” because it’s one of their cheaper options, covering a minimal number of procedures.

White Boost gives you more cover so that you can claim for thousands of procedures in a private or public hospital.

White Classic is perfect if you need more peace of mind providing cover for a variety of procedures that aren’t included in the first three options, like heart-related procedures.

White Deluxe is a much more expensive, but comprehensive cover option, providing coverage for procedures like major eye surgery, renal dialysis, and spinal fusion surgery.

Top Hospital is the most expensive policy, but you get cover for literally thousands of procedures, most notably obstetrics-related surgery, weight loss programs, and brain surgery.

Comparing hospital cover options

Services covered White Starter White Lite White Boost White Classic White Deluxe Top Hospital
Accidents
All joint replacements
All joint reconstructions & investigations
Ambulance services
Limited cover
Limited cover
Unlimited cover
Unlimited cover
Unlimited cover
Unlimited cover
Assisted reproductive services (Including In Vitro Fertilisation and Gamete intrafallopian transfer)
Brain surgery
Cancer treatment (Including chemotherapy and radiotherapy)
Colonoscopies
Gynaecological procedures
Minor procedures
Minor procedures
Heart-related procedures (Including angiograms, stents, open heart, and bypass surgery)
Major eye surgery (Including cataracts)
Obstetrics-related services
Partial cover
Psychiatric care
Partial cover
Partial cover
Partial cover
Rehabilitation care
Partial cover
Partial cover
Partial cover
Removal of appendicitis
Renal dialysis
Spinal fusion surgery
Weight loss surgery
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Compare & Review AHM Extras Cover options

You can get quality Extras Cover and have the freedom to mix and match their different Extras policies with your Hospital policy. You can even purchase your choice of Extras Cover as a standalone policy. There are 5 options to choose from:

  • Black 50 Saver
  • Black 60
  • Lifestyle Extras
  • Family Extras
  • Super Extras

Black 50 Saver

From $3.10 per week, it’s most affordable, and you get 50% back on extras, like physiotherapy, osteopathy, and chiropractic.

  • You can choose which providers you want to claim services from.
  • Unlimited emergency ambulance cover, excluding transport covered by a state scheme or ambulance subscription or non-emergency transport.
  • 2 month waiting periods apply, which means you must wait 60 days before you can use this service and claim for it unless you’ve switched from another provider or an AHM plan and have already served a waiting period

Black 60 

From $7.00 per week, it’s all about the teeth and eyes. You get 60% back on a selection of services, including Black 50 extras, optical, natural therapies, and comprehensive dental services: Routine dental, complex dental, and major dental.

  • This plan gives you 100% back on optical services, like frames, prescription lenses, and contact lenses.
  • You can choose which providers you want to claim services from.
  • Unlimited emergency ambulance cover with just a 1 day waiting period, excluding transport covered by a state scheme or ambulance subscription or non-emergency transport.
  • Unless you’ve switched from another provider or from a different AHM plan and have already served a waiting period, there are different waiting periods for different treatments, including 2 months of routine dental, remedial massage, physiotherapy, chiropractic, and osteopathy, 6 months for optical, and 12 months for complex and major dental.

Lifestyle Extras 

From $11.25 weekly, AHM Lifestyle Extras includes optical, physiotherapy, chiropractic, osteopathy, natural therapies, and routine + complex + major dental services, orthodontics, pharmacy, psychology and hypnotherapy, dietitian and nutritionist, weight loss, and health improvement benefits, like disease management and stress management courses.

  • You also get loyalty rewards in the form of increased annual claiming limits for some services after you’ve been with them for 5, 10 and 20 continuous financial years.
  • Unlimited emergency ambulance cover with just a 1 day waiting period, excluding transport covered by a state scheme or ambulance subscription or non-emergency transport.
  • No waiting periods on most services, but for complex dental, major dental, and orthodontics there are 12-month waiting periods, and for laser eye surgery there is a 2-year waiting period.

Family Extras 

From $11.95 a week, there are no family limits, irrespective of your family size and focuses on all the things that a family would need cover for like braces and speech therapy.

  • Includes optical, physiotherapy, chiropractic, osteopathy, natural therapies, and routine + complex + major dental services, orthodontics, pharmacy, psychology and hypnotherapy, speech therapy, occupational therapy, orthoptics, podiatry (including orthotics and orthopaedic shoes), pharmacy, prenatal and postnatal services, birthing courses, dietitian and nutritionist, weight loss, health improvement benefits (stress management courses, health checks, children’s swimming lessons, and more), hearing aids, and more.
  • Loyalty rewards in the form of increased annual claiming limits for some services after you’ve been with us for 5, 10 and 20 continuous financial years.
  • Unlimited emergency ambulance cover, excluding transport covered by a state scheme or ambulance subscription or non-emergency transport.
  • No waiting periods on most services, but for complex dental, major dental, orthodontics, orthotics & orthopaedic shoes, hearing aids, medical gases, and joint fluid replacement injections there are 12-month waiting periods.

Super Extras 

From $18.10 weekly, AHM Super Extras is their most expensive policy with the highest level of extras cover.

  • Includes optical, physiotherapy, chiropractic, osteopathy, natural therapies, and comprehensive dental, orthodontics, pharmacy, psychology and hypnotherapy, speech therapy, occupational therapy, orthoptics, podiatry (including orthotics and orthopaedic shoes), pharmacy, prenatal and postnatal services, birthing courses, dietary services, weight loss, health improvement benefits (like health checks and children’s swimming lessons), hearing aids, and more.
  • Unlimited routine dental, with some dental items including a maximum number of times you can claim from per year.
  • Loyalty rewards in the form of increased annual claiming limits for some services after you’ve been with us for 5, 10 and 20 continuous financial years.
  • Unlimited emergency ambulance cover, excluding transport covered by a state scheme or ambulance subscription or non-emergency transport.
  • There is a 12 month waiting periods for complex dental, major dental, orthodontics, orthotics & orthopaedic shoes, hearing aids, medical gases, and joint fluid replacement injections, 2-year waiting period for laser eye surgery, and no waiting periods for a wide range of services, including optical, physiotherapy, chiropractic, podiatry, eye therapy, pre- and post-natal services and birthing courses, and many more.

AHM Combined Cover options reviewed

If you prefer to bundle your Hospital and Extras Cover together into one policy, then this might be a viable option for you. You can tailor your own cover by mixing and matching Extras and Hospital policies, but it is often simpler to take out one of their pre-packaged cover options. There are 5 combined cover plans to choose from:

  1. Starter Flexi
  2. Lite Flexi
  3. Boost Flexi
  4. Classic Flexi
  5. Deluxe Flexi
Combined policyWhat’s Included
Starter Flexi: From $17.50 weekly
  • The most affordable with $550 flexi limit on included extras every year, as well as basic cover for vital hospital services and general treatments that aren’t eligible for a Medicare benefit, like dental.
  • Includes full cover for accidents and partial cover for rehabilitation, palliative care, and psychiatric care.
  • This policy lets you avoid the Medicare Levy Surcharge (levied on Australian taxpayers who do not have an appropriate level of private hospital insurance and who earn above a certain income) and the Lifetime Health Cover loading (a Government initiative designed to encourage people to take out hospital insurance earlier in life and to maintain their cover).
Lite Flexi: From $21.35 weekly
  • Covers a range of Extras and all the hospital services from White Lite Hospital, with the same exclusions and restrictions.
  • Excluded Extras services: major dental, podiatry, orthotics, and natural therapies.
  • You get $700 on extras, like routine dental, physiotherapy, and osteopathy, as well as $200 as a separate limit for optical.
Boost Flexi: From $25.60 weekly
  • This level of cover is between the comprehensive and budget packages.
  • Includes the same level of hospital cover as the White Boost policy, with the same restrictions and exclusions, including no excess for children.
  • You get $800 on extras, like routine and complex dental, optical, physiotherapy, natural therapies, prescription medications, and more, as well as $200 as a separate limit for optical.
Classic Flexi: From $31.45 weekly
  • Comprehensive combined policy without the additional cost of insuring for specialised services.
  • Includes White Classic hospital cover, with the same exclusions and restrictions, including the benefit of no excess for children.
  • You get $900 on all the extras services covered by Deluxe Flexi, including $250 as a separate limit for optical.
  • Major dental is not included.
Deluxe Flexi: From $39.40 weekly
  • The second most expensive option, with seriously comprehensive cover, Deluxe Flexi combines all the services included in White Deluxe, with the same exclusions and restrictions, as well as a generous number of extras.
  • hile you get full cover both inside and outside of hospital, you only get partial cover for psychiatric care and obstetrics, reproductive services and weight loss surgery are excluded.
  • This plan includes $1100 to spend on included extras every year and $300 as a separate optical limit with 100% back.

Exclusions: What’s not covered? 

  • If you claim for treatment that is excluded from your AHM policy.
  • If you claim for treatments/services performed during the waiting period on your policy.
  • If you claim for personal items in hospital, like newspapers, phone calls, and Internet usage.
  • If you claim for accommodation or theatre fees at a non-agreement hospital.
  • If treatment is subject to a waiting period at the time, you received it.
  • If you claim for take-home bandages and dressings.
  • If you are claiming for cosmetic surgery.
  • If you are claiming for restricted or excluded services.
  • If you are claiming for podiatric (foot) surgery.
  • If you claim for costs of services that aren’t covered by Medicare.
  • If it’s for a treatment/service that hasn’t been received
  • If your claim is not lodged within two years of the date of service.
  • If you claim for charges above the minimum benefit for surgically implanted prostheses.
  • If you claim for services/treatments performed outside of Australia.

AHM Pros and Cons

Even though there are many benefits to having private health insurance, it’s important to examine all the features, benefits, and exclusions to make sure you choose the best option for your needs.

ProsCons
AHM comes with the security and backing of a trusted national brand, Medicare, and they are the only brand with no individual limits on Extras, helping you claim more and waste less.Even with their most comprehensive Combined Cover policies, you can end up with partial cover for psychiatric services and exclusions for obstetrics-related services.
You get loyalty rewards, which means that the annual benefit limits on some Extras services will increase every year that you maintain your cover with AHM.Ambulance services for Tasmania and Queensland residents aren’t covered by AHM Health Insurance. These members must claim from state schemes.
Choose your own provider: No penalties if you visit a non-preferred provider for any extras services. You receive full cover no matter where you are treated.Not all policies give you unlimited cover for medically necessary ambulance trips to the nearest hospital able to provide the level of care you require.
Each hospital and combined policy offer multiple excesses and co-payment options that can assist in reducing the cost of your premiums.The lump sum benefit for extras in the combined package policies won’t apply, and you will be subject to the sub-limits and shared limits of the extras policy you choose.
No daily charge applies to dependent children, students, or adults on your policy, and the daily charge is waived if you’re hospitalised due to an accident.You get what you pay for. If you decide to go for the cheapest option, you might not have the level of cover you need and if you decide to go for more cover, your premium will be higher.

Frequently asked questions about AHM Health Insurance

What is AHM OSHC?

AHM OSHC (Overseas Student Health Cover) provides affordable student health insurance for people travelling from abroad to study in Australia. When you apply for OSHC through AHM, you are provided with access to an interpreter service, a 24-hour helpline for emergency medical assistance and counselling for both stress and trauma.

What is the difference between AHM and Medibank?

AHM is a business of and owned by Medibank Private Ltd. With the backing of its parent company, AHM and Medibank operate as two separate brands. While both offer a comprehensive range of private health insurance cover options, each has their own branding, their own unique way of offering their products, and their own terms and conditions.

Can I get dental cover with AHM health insurance?

Yes. You can get access to AHM dental cover with their Extras Cover and Hospital & Extras Cover, as both these cover options include a dental benefit. The complexity and cost of the dental procedures you would like to have covered depends on the level of cover you choose.

If you want to find the best health insurance cover, you can compare similar products from a variety of companies to see which offers, benefits and price best suit your needs.

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