What is private hospital cover?

Help with the bill for included treatments when you’re admitted to hospital as a private patient.

What do most people use hospital cover for?

These aren’t all included in every type of hospital cover, what you can use your cover for will depend on the cover that you choose.

Gastrointestinal endoscopy

Hospital treatment for things like colonoscopies or gastroscopy.


Hospital treatment for things like endometriosis or polycystic ovaries.


Hospital treatment for surgery to remove a cataract and replace with an artificial lens.

Heart and vascular system

Hospital treatment for things like heart failure and heart attacks, monitoring of heart conditions and varicose veins.

Joint reconstructions

Hospital treatment for things like torn tendons or damaged ligaments.

Bone, joint and muscle

Hospital treatment for the investigation and treatment of things like carpal tunnel, fractures and hand surgery.

See all hospital services

Public hospital or private hospital?

If you need to go to hospital, you’ll be able to access private hospitals with ahm hospital cover.


  • Public health costs are mainly paid for by Medicare
  • There can be some long waits, unless it’s an emergency
  • You won’t be able to choose the hospital or doctor most of the time
  • You may not be covered for ambulance care
    (unless you live in QLD or TAS or have an ambulance subscription)
public hospital sign


  • It costs money if you want to visit a private hospital in Australia
  • You’ll be treated as soon as you and your specialist and hospital are ready
  • Let’s you choose your specialists and your hospital
  • Help with the cost of medically necessary ambulance care
private hospital sign

Tiers of hospital cover

All health insurance companies use the same, standard ‘tiers’ of cover. The name of the different tiers lets you know the amount of hospital treatments and services they include.

Badge with basic on it


Bronze medal


Silver medal


Gold medal


plus sign

If you see ‘plus’ added, it means there are more than the minimum treatments or services for that tier.

More about tiers

How much will it cost to go to hospital?

If you have private health insurance hospital cover, you can go to a private hospital as a private patient, and use your cover to help with the bill for any services or treatments included in your cover.

You’ll probably pay an excess

This is a flat, up-front cost you pay when you’re admitted to a private hospital, and you want to use your cover. If you opt for a higher excess your monthly hospital cover fees will be lower.

More about excess
excess numbers and dials

You might pay out-of-pocket costs

Out-of-pocket costs are all the bills involved in your treatment or service, minus any reimbursements from either us or Medicare.

The amount we can pay depends on your cover and your waiting periods. These are all important things to check when you’re looking at different cover options.

More about out-of-pocket costs(opens in a new tab)
pant pocket filled with cash

Tax & hospital cover

The Medicare Levy Surcharge (MLS) could be costing you extra at tax time, if you earn above a certain threshold amount. Join ahm hospital cover and you could save on the surcharge – simple.

What’s the Youth Discount?

If you’re aged 18 – 29 and a Principal member or partner, you can get a discount on your hospital cover.

Compare your options

We’ve got lots of different types of hospital cover, find one that suits you.