Standard limits
Standard limits
Limits vary depending on your cover. Some are fairly standard across all funds and types of cover. The best way to get information specific to your limits is to refer to the relevant product guides.
Annual limit
Annual limit
An annual limit is the maximum amount we can help with the bills for your services and items included on your cover within a financial year (1 July to 30 June). Annual limits are subject to per person limits.
Family limit
Family limit
A family limit is the total amount that can be claimed by all members on your cover, in a financial year. Each person on your cover can claim up to their ‘per person’ limit, except if a family limit has already been capped by other members on the cover.
Learn more about health insurance for families.
Per person limit
Per person limit
Each person on your cover can claim up to the per person limit within a financial year - except if a family limit has already been reached by other members on the cover, or if a lifetime limit applies and has already been reached by that person.
All other limits
All other limits
Not all limits are created equal. Some don't reset every year (rude).
Lifetime limit
Lifetime limit
A lifetime limit is the total benefit you can claim for a service in a lifetime, across all insurers. At ahm, lifetime limits only apply to orthodontics and laser eye surgery. When you reach this limit, we can’t help with the bill for those services ever again, even if you change your cover. It’s important to remember that lifetime limits carry across providers. That means if you were to reach your lifetime limit at ahm, it would not reset if you switch to another insurance fund.
Rolling limits
Rolling limits
While most limits reset or rollover on 1 July, a rolling year begins on the date a service was first provided, with the limit applying to the 12-month period following the date of service.
Most ahm limits are reset annually, but some services included (such as pre and post-natal services) are based on a ‘rolling’ year, instead of a financial year. Rolling limits are subject to per person limits.
Loyalty limits
Loyalty limits
With loyalty limits, the longer you’re a member, the more you can claim (up to a maximum limit – refer to your product guide). Loyalty limits are only offered on some types of extras cover, and are calculated by using the number of full financial years the Principal Member has continuously held an ahm cover.
Common questions
Find cover that suits your needs
Find cover that suits your needs
Tell us what you need and we’ll show you cover that suits. You can even choose your payment frequency and excess.