Private Health Funds: AHM
AHM has been around for over 40 years, having started out as a small club in 1971. It was set up in Wollongong and had a strong NSW focus. These days, it is one of the most well-known Australian health funds with members across the country, caring for the health and wellbeing of over 500,000 people Australia wide. AHM is a wholly-owned subsidiary of Medibank Private, which gives their members the security of being part of Australia’s largest health fund. The Medibank Board are in charge of overseeing AHM and its corporate governance.
AHM was voted Best Health Insurer in 2011 in the Australian Financial Review’s Smart Investor SMILES Survey 2011/12.
AHM’s mission is based on member care and ongoing wellness. To this end, they also offer health management programs. This includes coaching to achieve health goals, pregnancy and parenting support, and support for chronic and complex health conditions.
- ahm offer a comprehensive range of Hospital and Extras cover which can be mixed and matched to suit a range of budgets and needs.
- with selected ahm Health Insurance packages, you can combine extras limits into a single annual limit to use however you want on the included extras
- ahm have abolished all 2 and 6 month waiting periods on Extras covers.
- ahm will contact their members if they notice that they haven’t claimed on their Extras.
- ahm understands that individual health needs change over time. Their friendly cover specialists contact members to review whether the cover they have now is the cover they need now.
Like most health funds, AHM offers hospital cover, extras cover and a combination of both.
All AHM Hospital packages include the standard benefits of having hospital cover. They currently have five options for hospital cover:
Budget Hospital – ahm’s most basic level of hospital cover includes a $500 excess. There are a lot of exclusions but it does include joint reconstructions, cancer treatment, bowel surgery and colonoscopies.
Basic Hospital – ahm’s Basic Hospital cover includes a $250 copayment. Unlike Budget Hospital, it includes palliative care, back surgery and joint replacements (excluding hip and knee).
Classic Hospital – ahm’s mid range hospital cover also includes cardiac-related procedures and rehabilitation.
Family Hospital – For couples and families who want to be covered for pregnancy and birth related services, Family Hospital is similar to Classic Hospital but also includes these types of services.
Essential Hospital -ahm’s slightly more extensive mid range hospital cover is aimed at older singles, couples and families and includes a $250 copayment. It covers eye surgery and dialysis.
Top Hospital – ahm’s broadest level of hospital cover includes pregnancy-related services, assisted reproductive services, hip and knee replacements, gastric banding surgery and psychiatric services.
ahm offers four levels of Extras cover to suit a range of budgets and needs:
Basic Extras cover includes routine dental, optical, pharmacy, physio, chiropractic, osteopathy and alternative therapies. For the most part, there are low limits attached to included extras – with the exception of emergency ambulance (which has no limit).
Lifestyle Extras is more comprehensive and also covers major dental, orthodontics, refractive sight correcting laser eye surgery, psychology, hypnotherapy and 17 alternative/complementary therapies. Annual limits are slightly more generous than Basic Extras and go up after 5, 10, 15 and 20 continuous years of membership.
Family Extras also covers pre and post natal services, speech therapy, podiatry, occupational therapy and eye therapy.
Super Extras is the broadest option and has no limits for routine dental.
Hospital and extras cover
Want to combine hospital and extras cover? AHM has packages designed to suit different life stages and budgets. This can help you to find cover that is appropriate for you. There are packages to suit families, younger singles and couples, and older singles and couples and options range from the very basic Lite Cover to the broader Mid Cover packages. The First Steps package combines basic hospital with a generous 70 per cent back on extras.
This is included in AHM hospital cover for policyholders who live in NT, SA, VIC or WA. If, however, you live in NSW or ACT then you may want to think about getting stand-alone ambulance cover as it is not included in those states. Bear in mind that you have state-provided cover if you live in QLD or TAS.
There are several ways that members can make claims. For extras, you can claim online. There is also the option to print off a claim form and return it to AHM (by free post) or to claim by phone.
AHM also offers HICAPS for members. Not familiar with this? It stands for Health Industry Claims and Payments Service. It is electronic and works in real time. Claims are processed there and then at your health care provider, so it is a quick and easy way to claim.
Assuming that you have an eligible policy, AHM members can take advantage of AHM Dental and Eyecare Practices. Benefits include regular check-ups and cleaning, and discounts on dental and eyecare products.
Members can also access rewards from AHM’s partners. These rewards may vary, but they usually relate to health, fitness and lifestyle.