value extras

Including:

100% back on optical

Frames, prescription lenses and contact lenses included.

Psychology and counselling

Service must be provided by an ahm recognised psychologist or counsellor.

No gap dental check-ups

Available at select dentists.

value extras

Including:

100% back on optical

Frames, prescription lenses and contact lenses included.

Psychology and counselling

Service must be provided by an ahm recognised psychologist or counsellor.

No gap dental check-ups

Available at select dentists.

value extras

$-/weekly

Join now

*Price is for single cover in NSW paying weekly by direct debit. Price reduced by an Australian Government Rebate of 24.608% (based on an age of under 65 years old, single income of $97,000 or less per year).

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Extras

What’s included

$650 per person

$1300 per family

per service

There’s a shared limit across these 3 services. Use it all on one of them or spread it across the others.

Routine dental

On this product, we pay benefits towards routine dental up to your annual limit.

Dental treatments include:

x-rays
examinations and consultations
clean and polish procedures
tooth extractions
minor restorative services such as fillings.

Complex dental

On this product, we pay benefits towards complex dental up to your annual limit.

Dental procedures including root canal therapy (endodontics), and root planing, jaw injuries or non-tooth related surgery (periodontics).

Major dental

On this product, we pay benefits towards major dental up to your annual limit.

Major dental procedures including crowns, bridgework, veneers, implants and more. Benefits for dentures are not included on value extras.

Major dental does NOT include orthodontic treatments.

On this product you get 2 no gap dental check-ups at select dentists^

That’s 2 dental check-ups with no out of pocket cost every financial year (up to your annual limit). No gap dental check-ups include comprehensive and periodic examinations, clean and polish or scale and clean, and fluoride treatments only. Excludes x-rays, tooth extractions and fillings. Waiting periods may apply.
Find a participating dentist

^Excludes specialists

$200 per person

$400 per family

None

There’s a shared limit across these 3 services. Use it all on one of them or spread it across the others.

Remedial massage

On this product, we pay benefits towards remedial massage up to your annual limit.

Acupuncture

On this product, we pay benefits towards acupuncture up to your annual limit.

Exercise physiology

On this product, we pay benefits towards exercise physiology up to your annual limit.

$200 per person

$400 per family

None

On this product, we pay benefits towards physiotherapy up to your annual limit.

Physiotherapy benefits include one-on-one consultations, as well as group or class sessions for hydrotherapy, clinical pilates (by a recognised physiotherapist), antenatal exercise and rehabilitation.

You can claim 1 initial consultation per person, per financial year. You can also claim 1 initial telehealth consultation per person, per financial year.

$200 per person

$400 per family

None

On this product, we pay benefits towards chiropractic up to your annual limit.

Chiropractic treatment involves the manipulation or adjustment of the spine and the diagnosis and management of spinal health related problems.

Benefits are paid towards consultations with a Chiropractor.

You can claim 1 initial consultation per person, per financial year.

$100 per person

$200 per family

None

There’s a shared limit across these 5 services. Use it all on one of them or spread it across the others.

Psychology

On this product, we pay benefits towards psychology up to your annual limit.

Benefits are paid towards psychology consultations with a recognised Psychologist.

You can claim 1 initial consultation per person, per financial year. You can also claim 1 initial telehealth consultation per person, per financial year.

Counselling

On this product, we pay benefits towards counselling up to your annual limit.

Benefits are paid towards counselling consultations with a recognised Counsellor.

Hypnotherapy

On this product, we pay benefits towards hypnotherapy up to your annual limit.

Benefits are paid towards hypnotherapy consultations with a recognised Psychologist.

You can claim 1 initial consultation per person, per financial year.

Health improvement

On this product, we pay benefits towards health improvement up to your annual limit.

Depending on your level of extras health cover, we'll contribute to the costs of some treatments designed to keep you healthy.

Some included treatments are:

quit smoking benefits
Cancer Council UV products
preventive tests
health checks
stress management courses
disease management association fees
exercise classes

Some restrictions apply and you may need medical evidence that you qualify for some benefits.

Pharmacy

On this product, we pay benefits towards pharmacy up to your annual limit.

Benefits are paid towards non-PBS pharmacy items that are prescription-only and prescribed by a medical practitioner. This includes oral contraceptives and cosmetic pharmaceuticals for medical conditions, travel and other vaccinations, and hormonal implants that are essential to treat a particular illness, injury or condition.

We’ll pay a benefit for each eligible pharmacy item after you pay the set PBS general patient amount as a co-payment up to your limit.

Items available without a prescription including over the counter, off the shelf, herbal medicines and vitamins can’t be claimed.

1 day

We define this as emergency transport to hospital due to a sudden or unexpected event where the only practical way of getting to a hospital is by ambulance.

We also pay towards attendance fees where an ambulance is called but transportation isn’t required.

We don’t pay benefits for ambulance subscriptions and we don’t pay benefits for other ambulance services such as:

transfers between hospitals
travelling from home to hospital for tests
any transport on discharge from hospital (e.g.hospital to home)

Tasmania and Queensland have State schemes that cover ambulance services for residents of those States.

1 day waiting period applies.

Looking for more services?Check out lifestyle extras

You choose extras providers — not us

First, what exactly are extras providers? That’s just what we call the dentists, optometrists, chiros, physios and other professionals who provide health services. Unlike some health insurers, we’ll pay the same benefits at most extras providers, as long as they are legally qualified to practise in Australia and have been recognised by ahm. So you choose your provider, not us.

Know what you’ll get back

Use our benefit calculator to find out upfront what you’ll get back on your extras services. To see what we pay for each service view the product guide.

No gap dental check-ups

We’ve struck a great deal at select dentists^ to offer you up to 2 dental check-ups per financial year with no out of pocket costs (up to your annual limit).

No gap dental check-ups include:

Periodic and comprehensive examination
Clean and polish or scale and clean
Fluoride treatment

Excludes x-rays, tooth extractions and fillings. To learn more and find select dentists, visit our no gap dental page

^Excludes specialists

Supporting documents

Before buying any of our health insurance, it’s important that you read and understand the product information for the cover you have chosen.

Product guide (pdf)(opens in a new tab)

Member guide (pdf)(opens in a new tab)

Common questions

As soon as you have served your waiting periods.

If you’re switching from another private health insurer, we’ll generally recognise any waiting periods you’ve already served for comparable benefits.

A waiting period is a set amount of time before you can claim any money back for a service included on your cover. Waiting periods apply when you first join (or re-join after not having had health insurance for some time) or if you change to a higher level of cover that has additional services or higher limits.

For more information on claiming and waiting periods see the Member Guide.

Your out-of-pocket expenses may vary depending on a range of factors, but significantly if the service is included, partially covered (restricted) or excluded.

For a list of what we pay for each service, view the product guide(opens in a new tab).

Included hospital services

When you go to hospital, there might be a gap between what we pay for your medical services, and what your doctor charges you. This is the referred to as a medical gap and is your out-of-pocket expense.

Medical gaps exist because some doctors may charge higher fees than what is set out in the Medicare Benefit Schedule (MBS).

Doctors can choose to participate in GapCover or not on a per claim, per treatment and per patient basis, so you should always check with them prior to agreeing to each claim as part of your treatment. If your doctor chooses to participate in GapCover for the claim forming part of your treatment, then we’ll provide benefits up to an agreed fee and the maximum gap that you’ll have to pay is $500 per claim per provider (i.e. per each doctor’s account).

GapCover doesn’t apply to diagnostic services such as blood tests, x-rays and ultrasounds, out-of-hospital medical services and services not included on your policy. GapCover doesn’t apply to things such as excess payments and co-payments. You may still have out of pocket costs.

You can search for doctors who’ve previously registered to participate in GapCover with our find a provider tool. This doesn’t mean they’ll do so for your claim forming part of your treatment. You should always check upfront with your doctor before agreeing to each claim forming part of your treatment.

For more information on GapCover refer to What is GapCover? or Member Guide.

Partially covered hospital services

In addition to any out-of-pocket costs as a result of a medical gap, partially covered services only pay limited benefits towards your accommodation and won’t cover the full cost of treatment.

If you choose to use a hospital service that is only partially covered, you may be left with additional out-of-pocket expenses related to your stay in hospital.

To reduce your out-of-pocket expenses, you may choose to be treated as a private patient in a public hospital, rather than a private hospital. However, this will not reduce your out-of-pocket expenses entirely.

Should you need to use a partially covered hospital service, give us a call on 134 246 before you go into hospital for your treatment and we can confirm what you’re covered for.

Excluded hospital services

If you choose to use a hospital service that is not covered, and you use the private health care system, your out-of-pocket will be the entire cost of the treatment. ahm will pay no benefits towards the cost of your treatment.

Included extras

Your out-of-pocket expenses for your extras services will be the difference between what your provider charges and what we pay back on that particular service.

Switching to ahm is easy - just tell us the name of your current health insurer when you join, and we’ll organise it for you. Also, any waiting periods you’ve already served are generally carried over for comparable services, so you might not need to wait to claim.

During the switch you’ll still be insured with us. That’s because your cover with ahm starts from the date your cover ends with your current insurer.

With hospital cover you get the opportunity to choose your own doctor and specialist, and more choice over which hospital you go to.

Hospital cover will help:

avoid or reduce waiting times on non-emergency treatments in a hospital
with medical fees not covered by Medicare
with reducing fees above the Medicare Benefits Schedule (MBS) through GapCover
avoid the Medicare Levy Surcharge (MLS) if you earn over $97,000 as a single or $194,000 as a couple/family
avoid the government’s Lifetime Health Cover loading by taking out hospital cover before 1 July following your 31st birthday

Put plainly, extras insurance helps with the cost of health services and therapies that aren’t covered by Medicare. Things like dental, physio, optometry, massage (and many, many more) are known as extras. The type of services and amount you can claim will depend on the level of extras cover you take out.

A pre-existing condition is any kind of ailment, illness or condition where you had the signs or symptoms (in the opinion of one of our Medical Practitioners) 6 months before you joined private health insurance or changed your cover.

Our appointed Medical Practitioner is the only person authorised to decide if an ailment, illness or condition is pre-existing. They must consider any information that was provided by the medical practitioner who treated the ailment, illness or condition.

For more information on pre-existing conditions see the Member Guide(opens in a new tab).

This is a set amount of time you must wait before you can claim any money back for a service included in your cover.

A waiting period applies when you: