ahm Health Insurance
ahm Health Insurance
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Long story short
Excess options that work for you
Choose an excess between $0 and $750. In most cases, the higher your excess, the lower your premiums and vice versa.
Lower out of pocket costs with GapCover
ahm’s GapCover helps reduce your medical bills by covering a portion of the difference between Medicare’s fee and what your specialist charges.
Ambulance cover included
All policies include some coverage for ambulance use, so you’re protected in an emergency.
Perks for younger members
If you’re 18–29, ahm offers youth discounts on hospital cover, plus perks like gym discounts and savings on eyewear at Specsavers and OPSM.
What makes ahm different?
The team at ahm wants to take the worry out of your wellbeing and keep your health insurance simple and stress free.
Fixed payouts = more savings
Don’t let your health budget go to the wind. Know exactly how much you’ll get back for selected claims with ahm’s fixed percentage returns (subject to waiting periods and annual limits).
Keep your health insurance in your back pocket
Want to check in on your current extras allowances? Or make a claim? No need to put it on the to-do list for later; find all your health insurance details in the palm of your hand with the ahm app.
Get support from Aussies who understand
Talk to someone who knows your area. ahm’s Wollongong team of in-house experts can find suitable cover for all types of Aussie lifestyles.
Join a fund known for keeping its customers happy
The ahm team works hard to make sure each customer gets the coverage they want, and their list of customer satisfaction awards are just proof of this.
What types of policies does ahm health insurance offer?
ahm health insurance has a range of cover options to keep you sorted, no matter what you’re after:
Hospital cover: This is for when you need treatment in hospital. It helps you get the care you need from the doctor you choose, with potentially shorter wait times, and possibly in a private room (perfect for a more comfortable recovery).
Extras cover: If you’re all about extras (without hospital cover), this one’s for you. It covers stuff that Medicare won’t, like dental, optical, physio, and more. The extras included depend on the policy you choose.
Hospital and extras: Think of this as your hospital cover but with all the extras bundled in. It’s kind of like the cherry on top of your base hospital coverage.
Ambulance cover: Most hospital and combined policies come with ambulance cover, but it’s worth double checking what your state offers. For Queenslanders and Tasmanians, the state government has you covered for most emergency ambulance services either within your state or Australia-wide. But for the rest of us, we can benefit from ahm’s ambulance coverage.
ahm helpful tip
Before heading to the hospital or seeing a specialist, give ahm a call to see what and who is covered under your policy. Have all your membership and treatment details ready and a rough idea of the cost you’ll have to pay out of pocket.
Also, double-check if the hospital is in ahm’s network. Going out of network could mean higher costs, so get those details in writing!
How will I know which hospitals and specialists have an agreement with ahm?
Knowing which in-hospital specialists are partnered with ahm could help lower your out-of-pocket costs, which is what anyone would want.
Once you’ve seen your doc in the hospital, then comes the not so fun part; paying. The difference between what Medicare covers and what your specialist charges is known as the gap. But if your hospital or specialist has an agreement with ahm, they’ll cover part (or all) of that gap, which means less out of pocket for you. At ahm, it’s known as GapCover.
When it comes to extras, things work a little differently. Extras like dental aren’t covered by Medicare, so GapCover doesn’t apply. But good news: ahm has no-gap dental. That means for dental care, eligible ahm extras policies could take care of your out-of-pocket costs too! You could get up to two dental check-ups per financial year with no out-of-pocket costs at selected dentists (excluding specialists), subject to annual limits.
So, if you want to try and lower your out-of-pocket costs even just a little, it’s worth checking who has an agreement with ahm. To see if your favourite doctor or nearest private hospital works with your policy, use the ahm find a provider tool to get the most from your health insurance.
Frequently asked questions
Does ahm health insurance cover pre-existing medical conditions?
For ahm policies, it’s less about if and more about when you’ll be able to use your health insurance with a pre-existing condition. A pre-existing condition is considered an ailment or illness that has impacted you for more than 6 months before being insured.
If you’re looking at ahm policies and have a pre-existing condition (professionally determined or not), an ahm medical practitioner will have to do their own assessment to decide whether your illness is pre-existing. This means you’ll need to submit some information from your doctor, then ahm will come back to you within 10 working days with a decision.
Once you’re insured, you won’t be able to make any claims towards your treatments until the 12-month waiting period is over. This will be the same for those who have upgraded their coverage. But good news – if you’ve served these waiting periods with another fund, by law they must transfer across with you, so you won’t have to re-serve them after switching.
How can I manage my cover with ahm?
Managing your ahm health insurance cover online is a breeze. Once you’ve made an account, you can make or view most extras claims, to find tax statements, check out waiting periods, order replacement cards, and even search for partner private hospitals all from your laptop.
How do excesses work with ahm?
You can customise ahm’s excesses to your own needs. With the choice to pay an excess that suits you (within a certain range) you can make sure your policy is providing exactly what you need. In simple terms, the higher your excess, the lower your premium, and vice versa.
Like other types of insurance, when you claim private hospital for treatment on your hospital cover, there’s an excess that needs to be paid. This excess is the amount you’ll need to pay before Medicare and your insurers come in.
At ahm, you’ll be able to choose an excess that ranges from $750 to nothing at all – yes, you heard that right! But of course, depending on the excess you choose, you’ll have to pay more or less in premiums.
So, if you know hospital treatments will be a regular occurrence or if you consider yourself a pretty healthy person, picking the right excess can make a big difference in your coverage.
How can I pay my premium?
Paying your health insurance premium is super simple. You can pay by direct debit (perfect for anyone who want to sit back and forget about monthly bills), or one off payments (which can be made with Vias or Mastercard, with a 0.21% surcharge). If you want to explore other options, once you’ve signed up, you can check out the ahm app.
How do I make a claim with ahm?
There are a number of options available to you when making a claim with ahm health insurance.
How to claim for extras
- On the spot. Use your ahm membership card to instantly claim your treatment at selected ahm providers with HICAPS.
- Via a mobile app. Log in to the ahm app and add your claim details in under the claims tab, and you’ll be done in minutes.
- Online. Login to your account, go to ‘make a claim’ and select the service you want. Then just add all the details and lodge your claim; just make sure to keep your receipts on hand in case you need to upload them.
How to claim for hospital treatments
If you need to make a hospital claim there are two ways to do so:
- Once you’ve got a bill from your specialist fill in a Medicare claim form, then a Two-way claim form. Once Medicare processes these they’ll send them to ahm.
- If you have a Medicare statement of benefits, fill in an ahm claim form and send it through with the statement of benefits.
Does ahm health insurance offer any discounts or additional perks to members?
They sure do. Many health insurance funds, including ahm, want to make sure everyone’s covered. If you’re between 18 and 29, you might be able to get a discount on your hospital cover with ahm’s youth discount.
There’s also a range of perks available to ahm health insurance members, including:
- GoodLife Health Club discounts for new selected memberships.
- Up to 25% off glasses and lenses at Specsavers.
- Up to 20% off lenses, non-prescription sunglasses and contact lenses at OPSM.
Ready to explore ahm health insurance options?
Are you curious which ahm policy could suit you best? Compare from a range of ahm policies alongside other providers online with iSelect. Whether you’re looking for a simple solution to your healthcare cover or want all the bells and whistles, our comparison experts are here to help. Call our health comparison experts at 1800 784 772 to find what you need from someone who understands the ins and outs of all things health insurance.