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AHM Health Insurance Review: Understanding Your Coverage Options

Megan Fraser Fact Checked Updated: 21 November 2023
Types of Health Insurance

AHM Health Insurance is a company that has assisted Australian residents for the last 40 years by providing straightforward health insurance policies that match various needs. Currently, AHM assists around 950,000 members and is one of the key figureheads that assisted in creating the Private Health Insurance Code of Conduct.

This comprehensive guide will discuss AHM’s history, the policies they offer, the pros and cons of partnering with AHM, the costs, claim processes, and any relevant information you may need to know before deciding on a policy. Having all the necessary information about a health insurance provider is important because it ensures you make a perfect and suitable choice that matches your lifestyle.

Key facts

  • AHM offers Hospital, Extras and Combined cover for singles, couples, families, and overseas students.
  • Members can choose the extras they require if the predesigned policies do not match their personal requirements.
  • AHM offers a youth-based discount to those who apply for a hospital policy before 30.

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About AHM

Originally established in the 1980s and known as ‘The Club’ or ‘the Government Employees Medical & Hospital Fund’, the group grounded itself in 1986 as a solid alternative to the private health insurance industry and grew to over 80,000 members.

During this time, The Club expanded and acquired other brands, such as Illawarra Health Fund, Senior Advantage Mutual Health, and Australian Country Health. These brands were then consolidated under one branch known as the Australian Health Management Group Ltd, or AHMG for short.

In 2009, the members of AHMG voted to merge the company with Medibank Private Limited. Even though AHM is part of one of the largest health insurers in Australia, the group still aims to provide a strong alternative that meets customer’s and member’s expectations. AHM was also a strong contributor to creating the Health Insurance Code of Conduct.

Types of Health Insurance Policies

AHM offers an array of Health Insurance policies that aim to meet the personal requirements of singles, couples, families, and single parents. They offer hospital, extras, and combined cover that follows the same tier structure as many other Private Health Insurance companies.

AHM also offers no-gap dental cover and age-based discounts for youth who sign up for a policy with AHM. The company attempts to ensure that the policies and coverage types offered are as simple and straightforward as possible.

Hospital Cover

The hospital coverage that AHM provides can range from the barebone necessities, which is often chosen by those who do not require a lot of coverage, or to extremely comprehensive. The coverage that one receives will be solely dependent on the policy that has been taken out. In total, AHM offers 9 total tiers of coverage, which range from basic (accidents only) to the completely comprehensive advanced hospital gold.

These hospital policies can be taken out by singles, couples, and families. As mentioned before, AHM offers a youth-based discount for anyone between 18 and 29. The discounted percentage for young members is:

The youth-based discount will apply until the age of 41 and incentivise members who apply for a hospital policy before 30. This is a great opportunity to receive cover and save on additional expenses.

Extras Cover

AHM offers 8 Extras policies that potential members can choose from. If the 8 predesigned policies AHM offers do not match the expectations of potential members, there is an option to select specific extras. This is a great way to maximise the coverage one may receive while also maximising the policy itself. Selecting your own extras means you do not have to spend extra money on extras you may not require.

Depending on the Extras policy chosen, members will also receive a specific percentage back up to the annual limit of the policy. These form a part of the more affordable Extras policies and are known as the Black 50, 60, and 70 packages. Dental is provided across all policies, and AHM rewards members with no-gap coverage when using selected dentists. AHM is also partnered with Specsavers and Goodlife Health Clubs to provide discounts and benefits to members who may require or are interested in utilising these services.

Combined Cover

Combined cover is a policy that provides coverage for hospitals and extras. Combined policies is a good way to ensure that members receive an all-encompassing policy that provides coverage for the many different personal requirements that a member may require in their day-to-day life. AHM offers these combined packages, known as the AHM hospital and extras packages. The coverage that a member will receive for both hospital and extras will depend solely on the chosen package.

AHM offers 5 different combined packages that are tailor-made for different personal requirements. The downside to the combined packages is that members cannot select the extras they specifically require. Each package is rigid, and the extras provided in the policy are the only extras a member will have access to. The positive side to this feature is that the combined packages are often easier to maintain and cheaper in the long run.

Pros and Cons

As with every health insurance provider, one should consider a range of pros and cons before selecting the policy they require. Let’s have a look at some of the pros and cons of AHM health insurance.

Advantages of AHM health insurance:

Disadvantages of AHM health insurance:

How much does cover cost

Now that we have discussed the history of AHM, the different policies offered, and the advantages and disadvantages of partnering with AHM, let’s have a closer look at the average costs of taking out a policy with AHM. The cost of a policy will vary based on the lifestyle, needs, tier type, and policy type taken out by the member. The policy cost and coverage may also vary based on the member’s geographical location. It is important to always confirm the extent of the coverage with the health insurance provider before deciding to select a policy.

Compare AHM policies

Hospital CoverHospital PremiumExtras CoverExtras Premium
Starter Basic$106.55 – $110.45Choosable 50 – Teeth$16.55
Essentials Basic Plus$111.55 – $121.55Black 50 Saver$18.80
Simple Bronze Plus$119.70 – $128.70Black 50$23.05
Starter Bronze$117.65 – $125.95Value Extras$43.50
Core Bronze Plus$149.20 – $157.00Choosable 60 – Teeth / Eyes$47.40
Starter Silver$152.70 – $163.00Black 60$53.80
Classic Saver Silver Plus$159.50Classic ExtrasElevate Silver Plus
Advanced Hospital Gold$160.80 – $169.15Lifestyle Extras$74.55
Deluxe Saver Silver Plus$195.00Black 70$75.65
Super Silver Plus$219.65 – $229.90Family Extras$80.60
Advanced Hospital Gold$330.70 – $362.20Super Extras$120.50

Source: Privatehealth.gov.au (November 2023; Premium estimates for a single individual living in NSW)

Joining AHM

Joining AHM is a simple process that can be completed through their online website. To join AHM, a potential member should first browse the different policies offered. When the decision is made on what policy is required, the member can click through the link on the policy and fill out the required form. The only information a potential member will need when signing up for the policy is the member’s Medicare card and the banking details of the account that will be charged monthly.

Once this process is done, the member is then signed up with AHM and will have to wait through the required period before having access to the necessary coverage. The AHM app can also be downloaded to monitor the entire process and the policy. The process is very simple and takes only three minutes to complete.

Staying on a Family Policy

The family policy offered by AHM allows for adult children to be covered by the policy up until the age of 21. Adult dependants who are full-time students will also receive coverage for free by the AHM family health insurance policy until the age of 31. Adult children who are not full-time students can still be covered by the AHM family health insurance policy up until the age of 31 at an extra cost.

How to Claim

There are three main ways that a member can claim with AHM health insurance. These three methods are through the online website, the app, or email.

To claim on the online website, a member simply needs to use the AHM member login portal on the online website and navigate to the ‘claims’ tab. The member should ensure that if they are claiming an extra service, they have the receipt on hand. To make a claim, the member simply needs to select the service used and then enter the provider name or number, who went, the service date, the item number and the amount paid.

To claim on the mobile app, the member must log in through the AHM member login portal and then navigate to the ‘claims’ tab. The member will need to select who claimed for the service and then enter the required information in the empty spaces provided.

To make a claim through the email channel, a member can download a claims form from the AHM website, fill out the necessary information and email it to the official AHM email channel.

Common Mistakes to Avoid

Choosing a health insurance policy that directly matches your personal requirements can be daunting. To assist you in making your decision, here are some common mistakes you should avoid:

Frequently Asked Questions and Answers

  • What distinguishes AHM’s policies in the market?

    What makes AHM unique is that they have attempted to create policies that directly meet the personal requirements of their members. AHM states that its services are customer-centric and aim to maintain a good level of customer satisfaction. The policies are mostly flexible and appeal to a wide array of different lifestyles. The policies are also very simple to understand and are often more straightforward than some health insurance providers.
  • How do AHM’s costs compare with other insurers?

    AHM offers packages that are very competitive within the health insurance industry. The combined hospital and extras policies are designed to maximise the cost a member may have while not forsaking the coverage needed. The extras policy allows members to be more flexible and choose the specific services that they require. This means that the extras chosen will directly match the member’s personal needs and lower the risk of paying for extras that will never be used.
  • What are the steps to get started with AHM?

    The AHM application process is a simple, quick, and easy process that can take around three minutes to complete. To get started with AHM, a potential member simply needs to navigate to their online website, decide on a policy they want, and fill out the online form provided after selecting the desired policy. Once this process is completed, a member can claim their policy coverage after the designated waiting period has elapsed.
  • How long can dependents stay on a family policy with AHM?

    A dependant can remain on the family policy up until the age of 21. If the adult dependant is a full-time student, they can remain on the AHM family policy until 31. If the adult dependant is not a full-time student, they can remain on the policy until the age of 31 but at an extra cost.
  • How to choose the right AHM policy for my needs?

    To choose the right policy for any health insurance policy, it is essential first to identify all the personal needs that you or your family may have. When these needs are identified, it becomes easier to select the policies that you need and push aside the policies that may not meet your personal requirements. The next step is to compare each policy and health insurance provider. The chosen policy and provider should directly match your health requirements, financial limits and desired coverage level.

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