Ahm Health Insurance Review

Ahm is a health insurance firm in Australia operating under Medibank Private Limited. ahm is one of the largest health insurers that offers comprehensive cover across hospital-only, extras, and combination packages, with premiums starting from $19.00 per week.

 

🔎 Provider	🥇 Ahm
📌 Date Established	1971
📍 Headquartered	Melbourne, VIC
💡 Registration Number	ABN 47 080 890 259 (Medibank)
👥 The average number of members	950,000 members
👤 Number of Employees	200 – 500
🛡️ APRA-Regulated	ahm is regulated under the APRA via Medibank
⭐ Average Customer Rating	4.1 out of 5 stars based on customer reviews
↪️ Average Number of Reviews	Over 600 customer reviews
📈 Market Share	Approximately 27.1%
📉 Number of plans	22; 8 Hospital-only, 9 extras, 5 hospital and extras combos
📊 Sponsorships	National Pickleball League Australia (NPL)
💹 Is a Mobile App offered	ahm native app and OSHC app
💱 Medical Claims Portal	Online and via the app
⏰ Customer Support Operating Hours	9 am to 6 pm AEDT, Monday to Friday
🗃️ Information Hub and Blog	✅Yes
📑 Chronic Illness Benefits	Cover for chronic illnesses is available under specific policies
📒 Screening and Prevention offered	ahm covers preventive care services, including cancer screenings and health assessments
🍼 Maternity Benefit	Maternity benefits are included in higher-tier plans, such as the Gold Hospital cover
💴 Health Insurance Premium Range (AUD)	From $19.00 - $3,287.65 (main plans; depends on the plan and payment arrangement/intervals)
⏰ Average Waiting Period	Waiting periods vary by service; for example, 12 months for pre-existing conditions and maternity services
⚙️ Is International Medical Cover Offered	ahm offers Overseas Student Health Cover (OSHC) for international students studying in Australia
✈️ International Travel Benefit	Cover for international travel for members at discounted rates

 

Overview

Ahm Health Insurance, founded in 1971 and headquartered in Melbourne, VIC, is an Australian health insurance provider regulated by APRA through its parent company, Medibank. With approximately 950,000 members, Ahm offers a range of 22 health insurance plans, including hospital-only, extras, and combo policies.

The provider is known for its customer-centric approach, evidenced by an average customer rating of 4.1 out of 5 stars based on over 600 reviews. Ahm offers benefits like chronic illness coverage, preventive care, maternity benefits, and international health coverage for overseas students. Additionally, Ahm provides a mobile app and an online claims portal, offering convenience for customers.

 

Frequently Asked Questions

 

What health insurance plans does Ahm offer?

Ahm offers 22 health insurance plans, including 8 hospital-only plans, 9 extras plans, and 5 hospital and extras combo plans.

 

Does Ahm cover maternity services?

Yes, Ahm offers maternity benefits under higher-tier plans, such as the Gold Hospital cover.

 

What are the customer support operating hours for Ahm?

Ahm’s customer support is available from 9 am to 6 pm AEDT, Monday to Friday.

 

Does Ahm offer international coverage?

Yes, Ahm provides Overseas Student Health Cover (OSHC) for international students and discounted international travel benefits for members.

 

How much do Ahm health insurance premiums cost?

Premiums for Ahm health insurance plans range from $19.00 to $3,287.65, depending on the plan and payment arrangements.

 

Our Overall Assessment

Ahm Health Insurance is a reliable provider with a solid reputation and diverse plan offerings. With strong customer ratings and a wide range of benefits, including maternity and chronic illness coverage, Ahm offers good value, especially for international students and those seeking preventative care.

Their mobile app and online claims portal provide convenience, while their competitive pricing makes them a solid choice in the Australian health insurance market.

 

 

Plan Overview

Ahm Health Insurance offers a variety of plans designed to cater to different healthcare needs, budgets, and demographics. From basic, budget-friendly options to top-tier, comprehensive coverage, each plan is tailored to provide essential hospital and extra services with varying levels of exclusions, waiting periods, and premium costs.

Whether you’re a budget-conscious individual, a family needing extensive coverage, or an international student in Australia, Ahm has a plan to meet your needs. Here’s a breakdown of the features, premium range, and benefits associated with each plan.

 

🔎 Plan	💴 Premium Range AUD (Min to Max, Weekly to Yearly)	🚨 Exclusions	❤️ Ideal For	📌 Gap Cover Available	📍 Rebate Percentage	Average Waiting Period	Key Features
🥇 Starter Basic	$19.00 weekly, $992.45 yearly	Major surgeries, pregnancy, eye procedures, joint replacements	Budget-conscious members, basic hospital cover, accident-related cases	✅Yes	Varies	1 day – 12 months	Rehabilitation, hospital psychiatric services, Palliative care
🥈 Essentials Basic Plus	$20.00 weekly, $1,044.45 yearly	Brain, heart, lung treatments, major surgeries, pregnancy	Selective basic hospital services at partner hospitals	✅Yes	Varies	1 day – 12 months	Essential treatments, limited ambulance cover, accident-related admissions override exclusions
🥉 Starter Bronze	$20.35 weekly, $1,064.35 yearly	Cardiac, joint replacements, birth-related services	Minimal, budget-friendly cover with accident protection	✅Yes	Varies	1 day – 12 months	Cancer therapies, restricted ambulance cover, accident override for injury-related admissions
🏅 Simple Bronze Plus	$20.75 weekly, $1,082.90 yearly	Complex surgeries, reproductive care	Single members or families	✅Yes	Varies	1 day – 12 months	Covers lung, chest, chemotherapy, emergency ambulance in certain states, offers GapCover
🎖️ Core Bronze Plus	$26.10 weekly, $1,362.90 yearly	Cardiac care, joint replacements, dialysis	Members across demographics	✅Yes	Varies	1 day – 12 months	Cancer treatment, limited rehab, psychiatric, and palliative care, and emergency ambulance coverage nationwide
🥇 Essentials Silver Plus	$25.85 weekly, $1,350.25 yearly	Cataracts, maternity, major heart surgeries	More inclusive care without advanced surgical cover	✅Yes	Varies	1 day – 12 months	Covers respiratory, digestive, orthopedic, and gynecological treatments, offers GapCover and accident override
🥈 Core Silver Plus	$38.50 weekly, $2,010.25 yearly	Advanced heart and vascular treatments, pregnancy, reproductive services	For individuals and families, comprehensive care without major reproductive services	✅Yes	Varies	1 day – 12 months	Full benefits in Partner Private hospitals restricted mental health and rehab services, and nationwide emergency ambulance cover
🥉 Advanced Hospital Gold	$63.00 weekly, $3,287.65 yearly	None (most services are covered comprehensively)	Top-level cover with minimal exclusions	✅Yes	Varies	1 day – 12 months	Includes major surgeries, maternity, cancer therapies, full emergency ambulance, and GapCover
🏅 Overseas Students Health Cover (OSHC)	Personalised quote required	Complex surgeries, birth services, some specialised treatments	International students on Australian student visas	Not specified	Not Eligible for rebate	1 day – 12 months	Covers essential inpatient services, accident protection, and emergency ambulance cover as required for student visas

ahm Health Insurance has 22 health plans covering most member needs through hospital, extras, and combined plans.

Each plan helps prospective members pinpoint a suitable option based on their healthcare needs, demographics, and budget. Note that pricing/premiums are based on cover for singles in NSW who earn <$75,000 annually and choose the $750 excess.

 

Starter Basic

This plan is the “bare bones” entry-level option with basic hospital service cover and limited benefits for other treatments. It is ideal for anyone who mainly wants accident cover.

 

📈 Weekly Premium	From $19.00 to $992.45 yearly
📉 Hospital Cover	Minimal, applicable to basic services only
📊 Restricted Services	Psychiatric services, rehabilitation, and palliative care
💹 Exclusions	Major surgeries, pregnancy, eye procedures, joint replacements
💱 Ambulance Services	Limited to one trip per single policy, two for couple/family
📌 Accident Override	Restricted/excluded services become covered if hospital care is due to an accident
📍 Excess	$500 or $750

 

 

Essentials Basic Plus

This plan has selective basic hospital cover for essential treatments, with higher limits on partner hospital admissions, ideal for members who want flexible and affordable care.

 

📈 Weekly Premium	From $20.00 to $1,044.45 yearly
📉 Hospital Cover	Focused on select services like tonsil removal, appendix, and dental surgery by a medical doctor
📊 Restricted Services	Limited rehabilitation, psychiatric, and palliative care
💹 Exclusions	Brain, heart, and lung treatments, major surgeries, pregnancy
💱 Ambulance Services	Limited cover outside TAS and QLD
📌 GapCover	Reduces doctor fees if services exceed MBS fees
📍 Accident Override	Accident-related admissions override restrictions and exclusions

 

 

Starter Bronze

Aimed at basic hospital cover, this plan supports services for routine treatments with accident protection, making it an economical choice for low-complexity health needs.

 

📈 Weekly Premium	From $20.35 to $1,064.35 yearly
📉 Hospital Services	Basic admissions in public and private hospitals, including cancer therapies
📊 Restricted Services	Partial cover for mental health, rehabilitation, and palliative care
💹 Exclusions	Cardiac, joint replacement, birth-related services
💱 Ambulance Services	Covers emergency transport excluding state-covered regions (TAS, QLD)
📌 Accident Override	Extends cover for accident-induced admissions

 

 

Simple Bronze Plus

Provides balanced essential hospital services mainly ideal for single members or families needing affordable hospital cover with a few critical inclusions.

 

📈 Weekly Premium	From $20.75 to $1,082.90 yearly
📉 Hospital Services	Covers treatments like lung, chest, and chemotherapy services
📊 Restricted Services	Limited to palliative, mental health, and rehab
💹 Exclusions	Complex surgeries, reproductive care
💱 Ambulance Services	Unlimited emergency cover in specific states
📌 Excess	Per-admission cap at $500 or $750

 

 

Core Bronze Plus

A middle-tier plan for essential hospital care that includes respiratory, nervous, and cancer treatment for different members, from singles to families.

 

📈 Weekly Premium	From $26.10 to $1,362.90 yearly
📉 Hospital Cover	Includes Partner Private hospital benefits for major treatments like cancer care
📊 Restricted Services	Psychiatric, rehabilitation, and palliative care
💹 Exclusions	Cardiac care, joint replacements, and dialysis
💱 Ambulance Services	Nationwide emergency cover
📌 Accident Override	Accident-induced hospitalizations qualify for full cover

 

 

Essentials Silver Plus

This plan includes comprehensive inpatient benefits suitable for members who need a plan for critical and routine care.

 

📈 Weekly Premium	From $25.85 to $1,350.25 yearly
📉 Hospital Cover	Respiratory, digestive, orthopedic, and gynecological services
📊 Restricted Services	Partial cover for psychiatric and rehab care
💹 Exclusions	No benefits for cataracts, maternity, or major heart surgeries
💱 GapCover	Participation reduces doctor fees above standard limits
📌 Accident Override	Full cover granted for accident-related care

 

 

Core Silver Plus

Offers expansive cover with essential and preventive health options, ideal for singles, couples, and families focused on comprehensive hospital services.

 

📈 Weekly Premium	From $38.50 to $2,010.25 yearly
📉 Hospital Services	Full benefits in Partner Private hospitals for core health needs
📊 Restricted Services	Limited mental health and rehab care
💹 Exclusions	Advanced heart and vascular treatments, pregnancy, and assisted reproductive services
💱 Ambulance Services	Unlimited for emergency transport, excluding TAS and QLD

 

 

Advanced Hospital Gold

Ahm’s top-level hospital cover plan for comprehensive health protection that covers high-cost services and complex surgeries.

 

📈 Weekly Premium	From $63.00 to $3,287.65 yearly
📉 Hospital Services	Includes all major surgeries, maternity, and cancer therapies
📊 Extras Cover	Flexible options and annual caps for high-value extras
💹 Ambulance Services	Unlimited nationwide emergency cover
💱 Accident Override	Ensures full cover for accident-related admissions
📌 GapCover	Reduces doctor fees when participating doctors agree

 

 

Overseas Students Health Cover (OSHC)

This is a specialized plan for international students in Australia with essential health coverage that aligns with student visa requirements.

 

📈 Weekly Premium	Varies by cover level and member requirements
📉 Hospital Services	Covers basic inpatient services and accident protection
📊 Ambulance Services	Emergency ambulance cover included
💹 Exclusions	Complex surgeries, birth services, and some specialized treatments

 

📌 Learn more about the Best Overseas Student Health Cover (OSHC)

 

 

Extras

 

🔎 Plan	🅰️ Weekly Premium	🅱️ Yearly Premium	⭐ Unique Features
📈 Black 50 Saver	$3.20	$170.05	Covers 50% on routine dental, physiotherapy, chiropractic, and osteopathy; unlimited emergency ambulance
📉 Choosable 50 – Teeth	$2.95	$155.60	Dental bundle covering routine and complex dental, with 50% reimbursement
📊 Value Extras	$7.50	$393.50	Broad dental, optical, therapies, preventive services; unlimited emergency ambulance and no-gap dental
💹 Black 60	$9.65	$504.35	60% reimbursement on dental, optical, and therapies; flexibility with providers and loyalty rewards
💱 Black 70	$13.60	$711.50	70% back on dental, optical, therapies, and emergency ambulance; high provider flexibility
📈 Lifestyle Extras	$13.15	$688.90	Comprehensive cover for dental, optical, therapies, wellness benefits, and preventive services
📉 Family Extras	$14.25	$745.00	Ideal for families; includes dental, optical, prenatal support and loyalty rewards increasing annual limits
📊 Black 70 Boost	$16.80	$876.65	70% reimbursement across routine and complex extras, additional wellness options
💹 Super Extras	$21.50	$1,122.70	Top-level cover with 100% routine dental, therapies, optical, loyalty rewards, and unlimited emergency ambulance

 

 

Hospital and Extras Packages

 

🔎 Plan	🅰️ Weekly Premium	🅱️ Yearly Premium	⭐ Unique Features
🥇 Starter Flexi Basic	$23.30	$1,216.35	Basic hospital cover that includes accident override, restricted ambulance, and essential extras with a flexible limit of $550
🥈 Essentials Flexi Basic Plus	$30.00	$1,567.35	Limited hospital cover with accident override and comprehensive extras, including flexi and optical limits; GapCover is available
🥉 Lite Flexi Bronze Plus	$35.35	$1,845.10	Bronze hospital cover with accident override, unlimited emergency ambulance, extras featuring loyalty rewards that increase the flexi limit
🏅 Classic Flexi Silver Plus	$43.20	$2,260.05	Mid-tier hospital cover that includes treatments, accident override, high flexi limits, and loyalty rewards for extras
🎖️ Deluxe Flexi Silver Plus	$51.85	$2,712.95	Comprehensive hospital cover and high extras limits with accident override, loyalty rewards, and extensive services for ongoing care needs

 

Frequently Asked Questions

 

What are the key features of the Starter Basic plan?

The Starter Basic plan offers minimal hospital cover, mainly focusing on accident-related admissions. It includes essential services such as psychiatric care and rehabilitation but excludes major surgeries, pregnancy, and joint replacements. This plan is ideal for budget-conscious individuals who need basic coverage.

 

What types of coverage does the Advanced Hospital Gold plan provide?

The Advanced Hospital Gold plan provides comprehensive cover for most major services, including surgeries, maternity, cancer therapies, and emergency ambulance services. It also offers GapCover to reduce out-of-pocket expenses for doctor fees, making it a top choice for those seeking extensive health protection.

 

What is the GapCover feature, and which plans offer it?

GapCover helps reduce the difference between the doctor’s fees and the Medicare Benefits Schedule (MBS) fee. This feature is available in various plans, including the Starter Basic, Essentials Silver Plus, and Advanced Hospital Gold, ensuring members pay less for out-of-pocket medical expenses.

 

What services are excluded from the Essentials Basic Plus plan?

The Essentials Basic Plus plan excludes coverage for complex treatments such as heart, brain, and lung surgeries, as well as pregnancy. However, it covers essential treatments at select partner hospitals and offers flexible care options with accident-related admissions overriding exclusions.

 

Does Ahm provide coverage for international students?

Yes, Ahm offers the Overseas Students Health Cover (OSHC) for international students. This plan covers essential inpatient services, emergency ambulance care, and accident protection, in line with Australian student visa requirements.

 

Our Overall Assessment

Ahm Health Insurance offers a wide range of plans to suit various healthcare needs, from basic hospital coverage to comprehensive, top-tier options. With flexible coverage for accident-related admissions, essential treatments, and extras, Ahm ensures that members can find a plan that fits their budget and health requirements. Their GapCover feature and competitive premiums make Ahm a solid choice for anyone seeking reliable and affordable health insurance.

 

 

User Reviews

 

🥇 Affordable and Reliable Coverage.

I switched to Ahm’s Starter Basic Hospital cover, and I couldn’t be happier. The premiums are affordable, and I feel confident knowing I have reliable coverage for emergencies. Their claims process is straightforward, and the mobile app makes managing everything so easy! – Jess

 

🥈 Comprehensive Care and Great Service.

I opted for the Advanced Hospital Gold plan, and it’s been a game-changer. The coverage is extensive, from major surgeries to maternity care, and the GapCover has saved me a lot on doctor fees. The customer service team has been excellent, always helpful, and quick to respond. – Paula

 

🥉 Perfect for Families.

We switched to the Core Silver Plus plan, and it’s been perfect for our family. We get full coverage in partner hospitals, and the nationwide emergency ambulance cover gives us peace of mind. The extra benefits are also great, especially the loyalty rewards. – Lulu

 

 

Ahm Health Insurance vs Peoplecare Health Insurance vs HBF Health Insurance

 

🔎 Insurance	🥇 Ahm Health Insurance	🥈 Peoplecare Health Insurance	🥉 HBF Health Insurance
📌 Years in Operation	53 years	Over 70 years	Since 1941
👥 Average Number of Members	950,000	Over 75,000	1.2 million+
🛡️ APRA Regulation	Yes (through Medibank)	Yes	Yes
👤 Number of Employees	200 - 500	150+	1,000 – 5,000
📈 Market Share	±27.1%	Approximately 0.5%	7.82%
📉 Market Cover	Australia	Australia	Nationwide
⭐ Customer Rating	4/1/5	4.8/5	4.1/5
🔟 Number of reviews	600+	100+	Approximately 6,500
☎️ Mobile App	Yes	Yes	MyHBF app
💴 Premium Range (AUD)	From $19.00 - $3,287.65	$18.97 to $54.54 per week	$14.96 per week to $2,685.16 per year
🌎 International Travel Benefit	Yes	Yes	Limited suspension options are available
⚙️ Market Capitalisation	Not published	Not published	Not applicable (not-for-profit)
↪️ Unique Features	Offers 2 native apps, low and affordable premiums, offers 22 plans	Comprehensive ambulance cover, digital member services, access gap benefits, not-for-profit and member-owned	Reinvestment into member benefits, flexible plans

 

 

Advantages of Using Ahm Health Insurance

Ahm Health Insurance stands out with its customer-focused approach and simple, reliable coverage options. Their hospital and extra plans are easy to understand, helping members choose the right level of coverage without confusion. Backed by Medibank, Ahm benefits from strong, established support while serving over 950,000 members across Australia. Ahm has received awards for customer satisfaction, including the Roy Morgan Customer Satisfaction Award and recognition from Canstar for their OSHC.

Key features like GapCover help reduce in-hospital doctor fees, and Accident Override turns restricted services into covered benefits after an accident. Plus, their digital platform makes managing your health insurance effortless.

 

 

Gap Cover

ahm Health Insurance’s Gap Cover helps members manage out-of-pocket expenses associated with in-hospital treatments by covering gaps when doctors charge above the Medicare Benefits Schedule (MBS) fees.

Below, we’ll explore the unique aspects of Ahm’s Gap Cover, including the discretionary participation of doctors and specific exclusions, which let members limit expenses while they receive quality care.

 

How Ahm’s Gap Cover Works

GapCover alleviates in-hospital charges by closing the difference between doctor fees and MBS limits, but only if treatment is received from a participating doctor.

Rahm’s GapCover applies only when each doctor involved in a treatment agrees to its terms, forcing members to confirm participation with each specialist—such as surgeons, anesthetists, and assistants.

 

Key Limitations and Eligibility

GapCover applies selectively, covering in-hospital doctor fees instead of broader hospital expenses. in addition:

 

• GapCover doesn’t include diagnostic services like blood tests, X-rays, or ultrasound imaging.
• GapCover is unavailable for any services excluded from the member’s health policy or for treatment in public hospitals.

 

A participating doctor can charge up to a maximum known gap of $500 per claim, providing a predictable upper limit for members. If the doctor charges above this cap without informed consent, Ahm can revert benefits to the standard MBS fee.

 

 

App Features

ahm offers two mobile apps to support its members: the ahm Health Insurance App and the ahm OSHC (Overseas Student Health Cover) App. Both apps streamline health management and provide access to essential services, policy, and claim management.

 

Core Features of the Ahm Health Insurance App

Members can locate healthcare providers who directly bill Ahm. Moreover:

 

• Offers a digital version of the membership card for members to present it for claims at participating providers.
• Offers a 24/7 support line and access to registered nurses, mental health counseling, and interpreter services for immediate support.
• Members can access policy m to view cover levels, inclusions, and restrictions.
• Users can submit most extra claims directly through the app, minimizing the need for paperwork and streamlining reimbursement.

 

In addition, the app lets members monitor annual extra limits and review their claims history.

 

Core Features of the ahm OSHC App

OSHC members can submit claims on most medical services via the app, with a quick view of claims history to monitor expenses. In addition:

 

• The app helps members find providers who bill Ahm directly, saving time and reducing upfront payments.
• The OSHC app provides access to cover details and a digital membership card for healthcare appointments, requiring only a photo ID for verification.
• Some app features are available in simplified Chinese for non-English-speaking members.
• Members can book online consultations with qualified doctors.

 

Offers a 24/7 health advice line, medical support from registered nurses, and mental health counseling.

 

 

How to Apply for Health Insurance with Ahm

 

1. Step 1: Prepare Required Information

Before starting, gather your Medicare card number and preferred bank account details for premium payments.

2. Step 2: Explore Plan Options

Visit Ahm’s website to browse through their hospital and extra plans, as well as combined packages. Review the options to find a plan that fits your health needs and budget.

3. Step 3: Select a Plan

Choose the plan that best suits your needs. Once selected, you’ll be directed to Ahm’s online application form.

4. Step 4: Enter Personal Details

Complete the form with your personal information, including your Medicare number, address, and bank account details for payments.

5. Step 5: Review Your Selections

Double-check all the details you’ve entered, ensuring everything is correct.

6. Step 6: Submit the Form

After reviewing, submit the form to complete your application. Ahm will begin processing your registration right away.

7. Step 7: Cooling-Off Period

Ahm offers a 30-day cooling-off period, during which you can cancel your policy and receive a full refund if no claims have been made.

 

 

How to apply for Gap Cover with Ahm

To apply for Gap Cover with Ahm Health Insurance, follow these steps to ensure you’re fully covered and understand eligibility requirements.

 

• Begin the process by requesting the GapCover application form. ahm provides this form on demand, and you must provide all required details precisely as directed.
• Ahm’s customer support is available on 1300 309 438 to assist with getting the form and to guide you through completion.
• Complete each section, especially details regarding the treating practice and banking information, as payments under GapCover will be processed through Electronic Funds Transfer (EFT).
• Once the form is completed, follow Ahm’s specific instructions for submission.

 

After submission, ahm will review the application. You will be registered under GapCover upon approval, allowing access to reduced out-of-pocket expenses on eligible in-hospital claims.

 

 

How to Submit a Claim with Ahm

With Ahm, embers can submit claims via the Ahm mobile app, online portal, or directly at the healthcare provider. Below, we provide a step-by-step guide on submitting claims, with tailored instructions for each method to ensure members are supported at every step.

 

In-person at Recognised Providers

Members can present their AHM member card after receiving a service to initiate on-the-spot claims. This method applies to providers with a HICAPS machine, which enables immediate claims processing.

After presenting the card, the member only pays the difference between the provider’s charge and the amount covered by Ahm. The exact amount paid depends on the service limits, annual limits, and any applicable waiting periods associated with the member’s cover.

Members who’ve reached their annual claim limit for a service will be liable for the total cost of subsequent claims until the new benefit year starts.

 

Online Submission via ahm Account

To claim online, members log into their Ahm account and click “Make a claim.”

 

• The member can select the relevant service category.
• Once within the claims section, the following details must be provided: provider’s name or number, service date, item code, and amount paid.
• Members are also prompted to upload a copy of their receipt to complete the claim.
• Receipts can be uploaded directly within the claims form, and each service item requires an individual entry with corresponding details.

 

Once submitted, benefits are deposited into the nominated bank account within 2 to 5 business days.

 

Claiming Through the ahm Mobile App

On the app, members can navigate to the “Claims” tab.

 

• Members can select “Start claim.”
• Members must then provide the service provider’s name, date, item number, and amount paid.
• Members can only submit one service item per claim on the app, making it optimal for single-service claims.

 

Benefits are typically processed and paid within the standard 2- to 5-day window directly to the member’s bank account if the claim is approved.

 

Mail-In Claims for Hospital Bills and Special Cases

For hospital claims involving specialist bills or Medicare interactions, members need to use designated forms, which can be obtained directly from Ahm.

If a bill is received directly from a specialist, members must complete both a Medicare and a Two-way claim form to submit to Medicare. Once complete, the forms are sent to Ahm directly using the addresses provided on the website.

If members already have a Medicare Statement of Benefits, they can use the Ahm claim form. This form and the statement can be uploaded through the member’s online account or sent by mail to the designated Ahmed postal address for processing.

 

 

How to Upgrade or Downgrade My Plan

Ahm Health Insurance lets members upgrade or downgrade plans within the 30-day cooling-off period and once their plan timeframe has lapsed. Here’s an overview of the key steps in changing your AHM plan:

 

• Members can log into the Ahm member portal and select the “Review My Cover” option.
• Review the waiting periods and cover adjustments as plans will involve these, especially if upgrading to a plan with enhanced benefits. ahm members must note that waiting periods apply for additional services not previously covered or if the upgraded plan offers a higher benefit level on existing services.
• When considering an upgrade, check the new plan’s inclusions, exclusions, and any differences in daily charges or excess amounts. Downgrades result in limitations on specific treatments.

 

The online change feature might not be available for all plans. If this is the case or if there is a balance outstanding on an account, Ahm recommends contacting customer support to assist with the manual processing of the change.

 

 

How do I add a Beneficiary?

Adding a beneficiary to an Ahm policy lets family members or dependents join an existing plan. Ahm’s eligibility guidelines are key when adding a dependent or child to a policy. For instance, children can be added to a couple, single-parent family, or family membership, provided they meet certain conditions.

ahm supports adding a child within the first 12 months of birth to ensure they are fully covered from the birth date. If this timeframe lapses, cover only starts from the date of request.

In cases of dependents over 18, ahm extends cover until age 31, contingent on unmarried status and residency conditions.

To add a beneficiary to an Ahm Health Insurance policy, members can follow these steps:

 

Initiate a Request

To add a dependent, call Ahm’s customer support line at 1300 481 776. The process differs depending on your membership type.

For Single-Parent and Family Memberships

If you have a single-parent or family membership, you can directly call Ahm to add your dependent.

For Single Memberships

If you’re on a single membership, you must upgrade to a family plan. This involves changing your membership type and paying the difference in premiums, effective from the dependent’s addition date.

Provide Proof of Relationship and Identity

For dependents over 18, you must provide proof of relationship and identity to meet Ahm’s eligibility criteria.

Understand Waiting Periods

Dependent members will face the same waiting periods as the primary member, based on when the primary member’s waiting periods have been served.

Adding a Newborn

If adding a newborn within two months, they inherit the primary member’s waiting period benefits, meaning no additional waiting periods apply.

Premium Changes

Adding a dependent may increase your premiums. You will be informed of the additional cost and need to cover any prorated premium difference from the date the dependent is added.

 

 

How to Submit a Compliment or Complaint

To ensure that all feedback is addressed promptly, Ahm’s offers a few ways for members to submit compliments and complaints. Here’s how members can do this:

 

Compliments

Members who want to provide positive feedback can do so using any contact channels on the Ahm website.

 

Complaints

Members who experience issues with services or claims can submit complaints via phone, email, or online messaging. Detailed instructions are available on each option to ensure clarity and prompt handling.

 

When complaining, members must include all relevant information, such as policy details, a description of the issue, and their preferred resolution.

 

Contact Channels for Feedback

 

• Call Ahm’s customer support on 1300 481 776 (Monday to Friday, 9 am to 6 pm AEST).
• Send feedback or complaints to [email protected]. Emailing can also provide a paper trail for follow-up if required.
• Members can submit feedback by logging into their account and selecting the messaging or feedback options using the Ahm website.

 

Complaint Handling Process

Once a complaint is submitted, Ahm’s team immediately tries to resolve simple issues. The complaint is assigned to a dedicated case manager for more complex matters requiring additional investigation.

This specialist then oversees the process, providing members with an estimated timeline for resolution and offering updates as necessary.

Overall, ahm tries to resolve complaints in ten working days. Members are informed immediately if additional time is needed, and any urgent cases like admissions or financial hardship are prioritized.

 

 

How to Switch My Health Insurance to Ahm?

Ahm offers a simple process to help new members maintain continuous coverage when they switch from a different health insurer. Here’s how the switch works:

Members must submit their current health insurance policy number and the insurer’s name. This information allows Ahm to handle the transfer on behalf of the member, streamlining the transition process.

Ensure that your premiums are fully up-to-date with your current insurer before switching.

Ahm will request a transfer certificate from your previous insurer to confirm details of your past cover, including any waiting periods served. This document is issued within 14 days and lets ahm apply any served waiting periods to comparable benefits to the new plan.

Ahm recognizes any waiting periods completed with the previous insurer for similar cover. Should the new plan include additional benefits or higher limits, additional waiting periods apply. Cover with ahm can begin once the previous policy ends, and you can backdate up to 30 days to avoid gaps. Members should select a start date based on the end of their current policy.

 

 

Pet Cover

Ahm Health Insurance offers pet coverage using a partnership with Petinsurance.com.au. Ahm’s pet insurance options cover significant aspects of pet health and include the following features:

 

• Pet insurance from Ahm includes options for accident-only and comprehensive accident and illness coverage.
• Members can claim up to 80% of eligible veterinary bills. The maximum claim amount is capped annually at either $20,000 or $30,000.
• Ahm’s pet cover includes the GapOnly® service, which calculates eligible expenses at the vet’s office. Members only pay the “gap” or the portion not covered by insurance when their pet goes to the vet.
• Members with Ahm pet insurance also get non-insurance benefits via myPetPass™, like 24/7 online vet advice, discounts on pet medications, and savings on pet care essentials.

 

Premiums and Payment Options

Pet cover premiums vary based on the cover. ahm has flexible payment options; members can pay fortnightly, monthly, or annually.

Members can also choose their excess, which provides additional flexibility in managing premium costs.

 

🔎 Cover Type	💴 Annual Claim Limit	💶 Reimbursement Rate	🩷 Additional Benefits
🐶 Accident Only	$20,000 or $30,000	Up to 80%	GapOnly®, myPetPass™ benefits
🐱 Accident and Illness	$20,000 or $30,000	Up to 80%	GapOnly®, myPetPass™ benefits

 

 

Travel Insurance

ahm has travel insurance options designed that cover essential travel-related expenses and contingencies. ahm offers several travel insurance options across international and domestic options, with features for regular and occasional travelers.

 

International Comprehensive Cover

 

• Ahm covers personal belongings, including lost, stolen, or accidentally damaged luggage and essential travel documents. New items purchased in the past two years could be eligible for full reimbursement without depreciation deductions.
• Ahm offers COVID-19-related medical cover if a member or their dependents are diagnosed while traveling overseas.
• Covering overseas medical and hospital expenses is unlimited, providing financial security in case of injuries, illnesses, or necessary surgeries during international trips.

 

Members receive up to $3,000 for non-refundable, pre-paid travel expenses, including flights and accommodation. This covers cancellations due to unforeseen circumstances.

 

Domestic Travel Insurance

 

• Domestic insurance covers trip cancellations up to $10,000, providing relief if travel plans are disrupted.
• ahm includes rental car insurance excess protection of up to $5,000.

 

Cover extends to medical costs arising from COVID-19 for members diagnosed while traveling domestically.

 

Additional Options and Annual Multi-Trip Plans

 

• Ahm’s annual multi-trip insurance provides ongoing cover for multiple trips within the year for frequent international travelers, including core international benefits such as unlimited medical cover and luggage protection.
• Members can add specific cover options like snow sports, increased luggage limits, and motorcycle or moped cover.

 

Ahm also offers cruise cover for trips involving extended stays.

 

 

Regulation

Ahm Health Insurance is part of Medibank Private Limited, one of Australia’s biggest health insurers, so it has solid backing regarding resources and expertise. This means that Ahm members can rely on an established support system and a network built with extensive industry knowledge.

Plus, ahm follows the Private Health Insurance Code of Conduct, which means they’re committed to clear communication and ethical practices.

 

 

Awards and Recognition

 

🏆 Award	📈 Recognized Product/Category	📉 Year	📊 Recognising Body
🥇 Canstar Outstanding Value	Overseas Student Health Cover (OSHC)	2024	Canstar
🥈 Roy Morgan Customer Satisfaction	Overall Customer Satisfaction	Consecutive for 4 Years	Roy Morgan
🥉 WeMoney Best Value for Cruise Cover	Cruise Travel Insurance	2024	WeMoney
🏅 Finder Best Tech Innovation	Life Insurance	2023	Finder
🎖️ Mozo Experts Choice	Travel Insurance	2022, 2023	Mozo

 

 

Customer Support and Contact Details

Here’s how you can contact Ahm’s customer support

 

Phone Support

• Ahm’s primary phone support is available from 9 am to 6 pm AEDT, Monday to Friday, excluding national public holidays.
• For general inquiries, members in Australia can call 1300 481 776.
• When contacting from overseas, use the number +61 3 8329 1520.

 

SMS for Joining Inquiries

Prospective members interested in joining Ahm can text 0439 183 474.

 

Callback Request

Members and non-members can complete the callback form on Ahm’s website, and a representative will contact them.

 

Online and Website Support

Existing members can manage their health insurance and access support resources directly through the Ahm website or mobile app.

 

 

Rebates and Discounts

ahm Health Insurance provides rebates and discounts, each with unique eligibility criteria and benefits.

 

💰 Rebate/Discount	⭐ Eligibility	💛 Benefit
1️⃣ Australian Government Rebate (AGR)	Medicare-eligible members	Provides a percentage rebate on premiums according to income and age. Members under 65 earning under $97,000 can receive a 24.608% rebate
2️⃣ Youth Discount	Members aged 18-29 who hold hospital cover	Discount on hospital premiums for younger members with reduced rates until they turn 41
3️⃣ 6 Weeks Free Promotion	New members on eligible hospital & extras cover using code “6WFHE”	Six weeks of free cover after maintaining eligible cover for 60 days
4️⃣ Loyalty Rewards	Long-term ahm members	Annual increases in extras cover limits
5️⃣ Travel Insurance Discount	ahm and Medibank health insurance members	10% discount on Ahm travel insurance for single-trip and comprehensive travel policies
6️⃣ Lifetime Health Cover (LHC) Loading	Members over age 30 without continuous hospital cover	Adds a 2% annual loading to hospital premiums for each year without cover after age 30
7️⃣ Pet Insurance - 1 Month Free	New pet insurance policyholders through AHM by Dec 9, 2024	The first month of pet insurance free
8️⃣ Hoyts 2-for-1 Fridays	ahm members with active health insurance	Two-for-one standard movie tickets at Hoyts Cinemas on Fridays
9️⃣ Student Rewards for OSHC Members	ahm Overseas Student Health Cover (OSHC) members	Access to discounts on popular brands (e.g., Apple, Samsung)

 

 

Additional Health Services and Products

Here are some additional health services and products that Ahm offers:

 

• Telehealth Services: ahm includes telehealth cover for services such as psychology, physiotherapy, and diet and nutrition, allowing members to consult healthcare professionals from home.
• Health Improvement Benefits: ahm has programs for preventive care and wellness, like stress management courses, quit-smoking aids, and subsidized cancer screenings.

 

Members can also access fitness class discounts, aiding in maintaining physical health.

 

 

Pros and Cons

 

✅ Pros	❌ Cons
Wide plan variety, covering essentials for singles, couples, families, and seniors	Limited hospital cover for high-cost treatments
Offers a Youth Discount for members aged 18-29	Some plans lack comprehensive maternity and reproductive services
There are loyalty rewards, with increasing extra limits	Limited dental and vision benefits on some plans

 

In Conclusion

 

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Frequently Asked Questions

 

What is the cooling-off time for new members?

ahm provides new members with a 30-day cooling-off period. If you aren’t pleased and haven’t made any claims, you can cancel your policy during this period to get a refund on the premiums paid.

 

Does Ahm provide discounts for young members?

ahm provides age-based discounts, or Youth Discounts, to members under thirty.

 

How does Ahm’s GapCover work?

Ahm’s GapCover helps you cover the gap between what Medicare pays and what your doctor charges for covered services.