AHM Health Insurance Review
Chris Quinn
Chris Quinn
General ManagerKey Points
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Backed by Medibank for broad access to 500+ private hospitals.
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40+ years of experience serving 950,000 Australians.
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Flexible cover tiers (Basic, Bronze, Silver, Gold) to suit any budget.
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Youth discounts for 18–29-year-olds on hospital policies.
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Flexi-limits for extras, letting you allocate benefits your way.
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Easy digital claims via a simple app and online portal.
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Government rebates may lower premiums based on age and income.
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Financial year extras reset (from July 1) for earlier benefit access.
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Ambulance cover included in most policies (waiting periods apply).
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Extra member perks like 10% off AHM income, travel, and life insurance, plus discounts at Specsavers & OPSM
AHM Health Insurance Review
AHM Health Insurance is well-regarded for its simple, affordable, and flexible health cover options tailored to the needs of Australians across all life stages. From basic extras to comprehensive hospital cover, AHM caters to singles, couples, families, and seniors, offering a variety of packages to meet individual healthcare requirements. — making it a strong contender in any health insurance comparison. Part of the Medibank group, AHM benefits from Medibank’s extensive network while maintaining a customer-friendly and budget-conscious approach to healthcare. AHM has earned the trust of nearly 950,000 Australians since its founding over 40 years ago.
Key Facts:
- Member base: Approximately 950,000 Australians.
- Established: Over 40 years ago.
- Part of Medibank: One of Australia’s largest and most trusted health insurers.
- Agreement hospitals: Access to Medibank’s extensive hospital network of 500+ private hospitals.
- Policy flexibility: Offers options for singles, couples, families, and seniors.
- Youth discounts: Discounts are available for members aged 18-29.
- Digital services: Fully functional mobile app and website for easy claims management and member services.
This guide will explore AHM’s key offerings, coverage options, and how to get the most out of your policy.
Policy Offerings
AHM health insurance offers a wide variety of policies that cater to all sorts of lifestyles, family statuses, budget preferences, and life stages. Like any health fund, AHM also offers hospital-only cover, extras-only cover, and a combined or comprehensive cover. In AHM’s hospital cover, there are four major tiers, which include Basic, Bronze, Silver, and Gold options. Each next tier offers more and better coverage than its predecessor, and you have complete control over choosing the tier that suits your needs and budget in the best way possible.
Depending on the cover, AHM also offers a wide range of extras-only cover options for day-to-day healthcare needs, including dental, optical, physiotherapy, and more. Following hospital and extras-only cover, AHM also offers complete packages that include cover for in- and out-of-hospital services and extras. These packages are a great way to put your mind at ease and get covered for any things that life may throw at you health-wise.
Please note that the following tables that outline the policy cover details are accurate at the time of article release and are subject to change as health funds add and remove policies regularly. Here is a table that explains what is covered in hospital policies by AHM health insurance:
| Clinical Category | Starter Basi | Essentials Basic Plus | Starter Bronze | Simple Bronze Plus | Core Bronze Plus | Essential Silver Plus | Core Silver Plus | Advanced Hospital Gold |
|---|---|---|---|---|---|---|---|---|
| Rehabilitation | Y (R) | Y (R) | Y (R) | Y (R) | Y (R) | Y | Y | Y |
| Hospital Psychiatric Services | Y (R) | Y (R) | Y (R) | Y (R) | Y (R) | Y (R) | Y (R) | Y |
| Palliative Care | Y (R) | Y (R) | Y (R) | Y (R) | Y (R) | Y | Y | Y |
| Brain and Nervous System | X | X | Y | Y | Y | Y | Y | Y |
| Eyes (Not Cataracts) | X | X | Y | Y | Y | Y | Y | Y |
| Ear, Nose, and Throat | X | X | Y | Y | Y | Y | Y | Y |
| Tonsils, Adenoids, and Grommets | X | Y | Y | Y | Y | Y | Y | Y |
| Bone, Joints, and Muscle | X | X | Y | Y | Y | Y | Y | Y |
| Joint Reconstructions | X | X | Y | Y | Y | Y | Y | Y |
| Kidney and Bladder | X | X | Y | Y | Y | Y | Y | Y |
| Male Reproductive System | X | X | Y | Y | Y | Y | Y | Y |
| Digestive System | X | X | Y | Y | Y | Y | Y | Y |
| Hernia and Appendix | X | Y | Y | Y | Y | Y | Y | Y |
| Gastrointestinal Endoscopy | X | X | Y | Y | Y | Y | Y | Y |
| Gynaecology | X | X | Y | Y | Y | Y | Y | Y |
| Miscarriage and Termination of Pregnancy | X | Y | Y | Y | Y | Y | Y | Y |
| Chemotherapy, Radiotherapy, and Immunotherapy for Cancer | X | X | Y | Y | Y | Y | Y | Y |
| Pain Management | X | X | Y | Y | Y | Y | Y | Y |
| Skin | X | X | Y | Y | Y | Y | Y | Y |
| Breast Surgery (medically necessary) | X | X | Y | Y | Y | Y | Y | Y |
| Diabetes Management (excluding Insulin Pumps) | X | X | Y | Y | Y | Y | Y | Y |
| Heart and Vascular System | X | X | X | X | X | Y | Y | Y |
| Lung and Chest | X | X | X | Y | Y | Y | Y | Y |
| Blood | X | X | X | Y | Y | Y | Y | Y |
| Back, Neck, and Spine | X | X | X | X | Y | Y | Y | Y |
| Plastic and Reconstructive Surgery (medically necessary) | X | X | X | X | Y | Y | Y | Y |
| Dental Surgery | X | Y | X | Y | Y | Y | Y | Y |
| Podiatry Surgery (provided by a registered podiatric surgeon) | X | X | X | Y | Y | Y | Y | Y |
| Implantation of hearing devices | X | X | X | X | Y | Y | Y | Y |
| Cataracts | X | X | X | X | X | X | Y | Y |
| Joint Replacements | X | X | X | X | X | X | Y | Y |
| Dialysis for Chronic Kidney Failure | X | X | X | X | X | X | X | Y |
| Pregnancy and Birth | X | X | X | X | X | X | X | Y |
| Assisted Reproductive Services | X | X | X | X | X | X | X | Y |
| Weight Loss Surgery | X | X | X | X | X | X | X | Y |
| Insulin Pumps | X | X | X | X | X | X | X | Y |
| Pain Management with Device | X | X | X | X | X | X | X | Y |
| Sleep Studies | X | X | X | X | X | Y | Y | Y |
Here is a table that explains what is covered in each extras-only policy cover tier by AHM health insurance:
| Clinical Category | Black 50 Saver | Choosable 50 – Teeth | Value Extras | Black 60 | Black 70 | Lifestyle Extras | Family Extras | Black 70 Boost | Super Extras |
|---|---|---|---|---|---|---|---|---|---|
| Dental – Routine | Y | Y | Y | Y | Y | Y | Y | Y | Y |
| Dental – Routine | Y | Y | Y | Y | Y | Y | Y | Y | Y |
| Dental – Complex | X | Y | Y | Y | Y | Y | Y | Y | Y |
| Dental – Major | X | Y | Y | Y | Y | Y | Y | Y | Y |
| Orthodontics | X | X | X | X | X | Y | Y | X | Y |
| Laser Eye Surgery | X | X | X | X | X | Y | X | X | Y |
| Physiotherapy | Y | X | Y | Y | Y | Y | Y | Y | Y |
| Chiropractic | Y | X | Y | Y | Y | Y | Y | Y | Y |
| Optical | X | X | Y | Y | Y | Y | Y | Y | Y |
| Osteopathy | Y | X | Y | Y | Y | Y | Y | Y | Y |
| Remedial Massage | X | X | Y | Y | Y | Y | Y | Y | Y |
| Acupuncture | X | X | Y | X | X | Y | Y | Y | Y |
| Chinese Medicine | X | X | X | X | X | Y | X | X | Y |
| Exercise Physiology | X | X | Y | X | X | Y | Y | Y | Y |
| Myotherapy | X | X | X | X | X | Y | X | X | Y |
| Pharmacy | X | X | Y | X | X | Y | Y | Y | Y |
| Health Improvement | X | X | Y | X | Y | Y | Y | Y | Y |
| Psychology | X | X | Y | X | X | Y | Y | Y | Y |
| Dietetics | X | X | X | X | X | Y | Y | Y | Y |
| Counselling | X | X | X | X | X | Y | Y | Y | Y |
| Nutrition | X | X | Y | X | X | Y | Y | Y | Y |
| Hypnotherapy | X | X | X | X | X | Y | Y | Y | Y |
| Weight Loss | X | X | X | X | X | Y | Y | Y | Y |
| Speech Therapy | X | X | X | X | X | X | Y | X | Y |
| Occupational Therapy | X | X | X | X | X | X | Y | X | Y |
| Eye Therapy | X | X | X | X | X | X | Y | X | Y |
| Podiatry | X | X | X | X | X | X | Y | Y | Y |
| Audiology | X | X | X | X | X | X | X | X | Y |
| Orthotics and Orthopaedic Shoes | X | X | X | X | X | X | Y | Y | Y |
| Hearing Aids | X | X | X | X | X | X | Y | X | Y |
| Pre and Post Natal Services and Birthing Courses | X | X | X | X | X | X | Y | X | Y |
| Medical Gases | X | X | X | X | X | X | Y | X | Y |
| Joint Fluid Replacement Injections | X | X | X | X | X | X | Y | X | Y |
| Travel and Accommodation | X | X | X | X | X | X | Y | X | Y |
| Outpatient Procedure Room Fees | X | X | X | X | X | X | X | X | Y |
| Post-operative and Medical Aids | X | X | X | X | X | X | X | X | Y |
| Emergency Ambulance (TAS/QLD covered by State Schemes) | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Eligibility and Special Programs
AHM offers a wide variety of health coverage that focuses on helping Australians of different age groups. For individuals seeking weight loss surgery or wanting to get pregnant via IVF, AHM has the Advanced Hospital Gold cover, which offers coverage for almost all possible hospital services. For families, AHM offers policies that cater to the different needs of each family member while keeping you in line with your budget preferences.
With AHM health insurance, there is something special for everyone. If you’re aged 18 – 29 and a principal member or partner, you can get a Youth discount on your hospital coverage. You could get up to 2 dental check-ups per financial year with no out-of-pocket cost and eligible products at selected dentists (excluding specialists), subject to annual limits with AHM extras cover.
If you hold AHM health insurance, you might also be eligible for a list of different discounts like 10% off AHM income protection premiums, 10% off AHM travel insurance, 10% off AHM life insurance premiums, and on Specsavers and OPSM.
Costs and Premiums
Premiums on policies are regular payments you make to maintain the policy’s coverage. You can choose to pay them monthly or yearly, depending on your budget. The amount of your premium will depend on what sort of coverage you have, what services are covered, and what the recurrent cost is. It is important to note that your coverage will cease once you stop paying your premium. Excess and co-payments are out-of-pocket costs you pay while using a service or making a claim. You can decrease your excess while buying a policy based on your premium and the services covered.
Rebates and Government Incentives
The Australian Government’s rebate can reduce premiums based on the policyholder’s age and income and whether the policyholder is single or in a family. Please check out the page, and if you have any questions, please feel free to email us at enquiries@healthdeal.com.au.
The Medicare Levy Surcharge is a levy that is paid by an Australian taxpayer who currently earns above a certain income and does not hold private hospital insurance. However, you might be eligible for a Medicare Levy Surcharge Exemption. Whereas Lifetime Health coverage loading is the additional cost for those, who take out hospital coverage after the age of 31 years and is different from the medicare levy surcharge. This means that if you have not taken out any private hospital cover after turning 30, and later on you decide to buy one, you will have to pay a 2% LHC loading cost on top of your premium for every year you are aged over 30
Digital Services
AHM account management is easy with their smooth-running and highly operational mobile app, available on Google Play and the App Store. Their website is also easy to navigate, and each section has detailed FAQs at the end. You can make claims, contact AHM customer services, browse their offers and policies, and get answers to your questions through their app and website. Like their policies, their mobile app and website are also no nonsense and customer-friendly.
Hospital Agreements and Networks
AHM is backed by Medibank, which is one of Australia’s largest health insurers and has a massive hospital and provider network, which means that several hospitals and practitioners have partnered with AHM through Medibank to offer AHM health insurance members greater access to medical facilities and procedures all over Australia. These networks exist for hospitals and extra cover. Additionally, AHM offers Medically Necessary Ambulance cover, which is included on all AHM hospital and package products, after a 1 day waiting period. AHM Unlimited Emergency Ambulance cover is included on all AHM extras-only products after a 1 day waiting period and is more limited than Medically Necessary Ambulance cover. Remember to double-check your cover information to see if there are any limits to the number of Ambulance services you can use in a year.
Claiming Process
The claiming process for AHM health insurance is super easy, and it only takes a few simple swipes. You can claim via their website, the phone app, at your recognised provider, or by calling them. Here, we look at each of the methods:
Online Website
- First, log in to your account and go to ‘Make a claim’. Make sure you have your receipt with you.
- Select the service you want to claim from the list, like hospital or extras claim, and select ‘Start claim’
- Please provide the provider’s name or number, the person who went, the date of the service, the item number, and the amount paid.
- You may need to upload a copy of your receipt with your claim for some services.
AHM Mobile App
- Log in to the AHM mobile app and go to the ‘Claims’ tab. Make sure you have your receipt with you.
- Select ‘Start claim’. If you haven’t used the AHM mobile app for more than 10 minutes, you may need to re-authenticate with your password or Touch ID/Face ID.
- If there is more than one person on your policy, you’ll need to select who received the service.
- Enter the service, provider name or number and claim details, including the date of the service, item number and amount paid.
At your recognised provider
Present your AHM member card after your appointment, and the claim benefit will be processed electronically on the spot if your recognised provider has a HICAPS machine. You’ll only need to pay the difference between the total amount your recognised provider charges and any benefit AHM pays. The amount you’ll have to pay will depend on your level of coverage, limits and waiting periods. If you’ve reached the limit for that service, you’ll have to pay the full amount.
If you would like to claim by giving them a call, you can do so through their app or website. Make sure to keep the receipts handy because they might require you to send them by email.
AHM has a new update, which took effect on Monday 30th, September 2024. The update is for single customers. AHM will not send them a physical card or welcome pack when a policy is created. Rather, sales staff will be asked to ask the customer to download the digital card using the AHM app. This means when they claim, they will claim using the digital card on their app
Financial Year Extras Limit Reset
AHM is one of a select few health funds that run on a financial year, meaning all their extras limits are reset on July 1 each year. This can be great if you are switching from a calendar year fund and are looking to use some services with yearly limits. Some of AHM’s hospital and extras packaged covers have a ‘flexi limit’. That means you’ll get an amount to use as you see fit on included extras before June 30 each financial year. You also get a separate optical limit. They call it ‘flexi’ because it can be used however you want for that group of services. For example, if you want to use your whole flexi limit of physio and none on chiro, you can. This is unique to AHM, and not all health funds offer such flexibility with their extras cover.
Customer Service and Support
AHM has a variety of contact options. You can contact AHM via:
- AHM app
- Calling service
Their support hours are Monday through Friday, 8 am to 7 pm (AEST/AEDT). You can get information on agreement hospitals, private patient policies, overseas student health cover, the latest features, your account details, file any complaints, and manage or change your personal details like address or contact number. You can also opt-in or opt out for automatic updates on your policy or claims via message or email.
Comparison with Other Providers
To make a careful decision about buying any health cover, we suggest you compare various health fund providers and their products. We encourage you to carefully read their product disclosure statements and refer to their websites for more information. AHM is a great health fund with various key points that make it a leading player in the market. Its unique selling point includes a no nonsense health insurance approach to private health insurance and backing from Medibank’s robust network of partnered hospital practices and practitioners for its members, great customer service, and a smooth-working website/mobile app. Purchase AHM health coverage policies through Health Deal now, or you can use Health Deal’s comparison tool to compare policies from different insurance providers.
Additional Benefits
You may be able to enjoy a few additional benefits in addition to your AHM’s health fund policy. These may include stress management courses, discounts or other AHM insurance products, and prescription glasses deals at Specsavers or OPSM, discounts on the Cancer Council UV product range, and much more.
FAQs
How Long Does It Take to Switch My Health Insurance?
It varies between health insurance companies but is usually quite fast. You can choose a cover start date from today up to 30 days in the future.
Can I Use Medibank’s Hospital Network With AHM?
If you have an AHM health Insurance policy, you can most definitely use Medibank’s extensive hospital network. This is because AHM’s parent company is Medibank, which means you have access to around 500 private hospitals in Australia.
Does AHM Offer Ambulance Cover?
Yes, AHM offers ambulance cover, but the amount of coverage will depend on your policy. However, most plans include cover for medically necessary emergency transport.
What Are AHM’s Hospital Cover Tiers?
AHM’s hospital cover has the following major tiers: Starter Bronze, Simple Bronze Plus, Core Bronze Plus, Essential Silver Plus, Core Silver Plus, and Advanced Hospital Gold options. Each next tier offers more and better coverage than its predecessor, and you have complete control over choosing the tier that best suits your needs and budget.
AHM is an excellent and prominent health fund in Australia that offers many cover options. You can use the Health Deal Insurance Comparison tool to compare AHM’s different policies with other health fund policies to choose the one that fits your needs. Here, you can compare health insurance plans, costs, and providers. For expert insurance advice, you can contact Health Deal at enquiries@healthdeal.com.au. You can speak to our experts at 1300 369 399. Get in touch now to speak with an insurance expert for tailored advice and support in making viable health insurance decisions.
Disclaimer
This guide is for informational purposes only and should not be taken as medical or financial advice. Health Deal is proud to partner with AHM. While we strive to provide accurate and up-to-date information, health insurance policies and benefits may change. Always check with a financial professional before making any decisions. Health Deal compares selected products from a panel of trusted insurers but does not compare all products in the market. For the most current information, please refer to AHM’s official website or speak with one of our health insurance experts. Information sourced from AHM, accessed Feb 2025.
