Terms and Conditions
ahm health insurance is a business of Medibank Private Limited ABN 47 080 890 259. ‘ahm health insurance’ and ‘ahm’, we, us and our are references to Medibank Private Ltd trading as ahm health insurance.
We reserve the right to amend the Terms and Conditions at any time. Your use of ahm.com.au, members.ahm.com.au and the ahm Mobile App constitute your agreement to be bound by these Terms and Conditions. These Terms and Conditions were last updated on 3 April 2023. If you have any questions about these Terms and Conditions, you can contact us.
All information, text, materials, graphics and advertisements on ahm.com.au, members.ahm.com.au and the ahm Mobile App (‘Content’) are Copyright © 1998 – 2023 ahm health insurance, a business of Medibank Private Limited ABN 47 080 890 259, its related bodies corporate, its suppliers and/or licensors unless expressly indicated otherwise on ahm.com.au, members.ahm.com.au and the ahm Mobile App.
You must not modify, copy, reproduce, republish, frame, upload to a third party, post, transmit or distribute this Content in any way except as expressly provided for or expressly authorised in writing by us or our affiliates. Only on the condition that you keep all Content intact and in the same form as presented on ahm.com.au, members.ahm.com.au and the ahm Mobile App (including without limitation all copyright, trade mark and other proprietary notices and all advertisements), you may:
- download and view the Content for your personal, non-commercial use using an industry-standard Web browser, or
- supply the Content to your subscriber if you are an Internet service and/or access provider.
You must not use ahm.com.au, members.ahm.com.au and the ahm Mobile App in any manner or for any purpose which is unlawful or in any manner which violates any right of ours or an affiliate or which is prohibited by the Terms and Conditions.
All trade marks displayed on ahm.com.au, members.ahm.com.au and the ahm Mobile App are trade marks of ahm, its related bodies corporate, or their respective owners. Nothing contained on ahm.com.au, members.ahm.com.au and the ahm Mobile App should be construed as granting any licence or right of use of any trade mark displayed on the Site without the express written permission of ahm, the relevant ahm affiliate or third party owner.
Some of the trade marks may be available to you to place on your own website as a hyperlink to the relevant ahm website, but such use requires the express written authorisation of ahm or the relevant affiliate, and any use must be in accordance with the trade mark usage guidelines of the relevant trade mark owner.
The Competition and Consumer Act 2010 and similar State and Territory Legislation in Australia may confer rights and remedies on you in relation to the provision by ahm and its related bodies corporate of goods or services on ahm.com.au, members.ahm.com.au and the ahm Mobile App which cannot be excluded, restricted or modified (‘Non-excludable Rights’). ahm does not exclude any Non-excludable Rights but does exclude all other conditions and warranties implied by custom, law or statute.
Except as provided for by the Non-excludable Rights:
- all Content is provided ‘as is’ and without warranties of any kind, either express or implied
- ahm, its related bodies corporate and its suppliers expressly disclaim all warranties of any kind including but not limited to implied warranties of merchantability and fitness for a particular purpose,
- ahm, its related bodies corporate do not warrant that the functions contained in any Content or any Communications Facility or your access to ahm.com.au, members.ahm.com.au and the ahm Mobile App will be uninterrupted or error-free, that any defects will be corrected or that ahm.com.au, members.ahm.com.au and the ahm Mobile App or the server which stores and transmits Content to you are free of viruses or any other harmful components,
- ahm and its related bodies corporate do not warrant or make any representation regarding your access to, or the results of your access to, ahm.com.au, members.ahm.com.au and the ahm Mobile App (including any related or linked website) or any Content in terms of correctness, accuracy, timeliness, completeness, reliability or otherwise; or
- you assume the entire cost of any necessary verification, maintenance, repair and/or correction of any relevant Content.
Content on ahm.com.au, members.ahm.com.au and the ahm Mobile App is not intended to be used to diagnose, treat, cure or prevent any disease, and it should not be used for therapeutic purposes. You are responsible for assessing the accuracy and relevance of all Content.
ahm has the sole right to determine your eligibility for access, the extent of your access and the level of services available via the Content. The range of services that ahm makes available to you through the Content may differ depending on the smartphone that you use. We may ask you to verify your identity to facilitate your access to all or part of the Content. The method of verifying your identity may include a multi-factor authentication layer. If you do not verify your identity, in the prescribed manner and when requested, you may not have access to all or part of the Content.
Limitation of liability
Under no circumstances (including but not limited to any act or omission on the part of ahm) will ahm or its related bodies corporate be liable for any indirect, incidental, special and/or consequential damages or loss of profits whatsoever which result from any use or access of, or any inability to use or access, ahm.com.au, members.ahm.com.au and the ahm Mobile App or any Content.
You expressly acknowledge and agree that ahm or its related bodies corporate does not exert control over users of ahm.com.au, members.ahm.com.au and the ahm Mobile App (including individuals referred to as guests and experts) and is not liable either for their opinions or their behaviour including any information and/or advice and any defamatory statements or offensive conduct.
Subject to the Non-excludable Right, and otherwise to the fullest extent permitted by law, ahm’s liability and the liability of its related bodies corporate for breach of any implied warranty or condition which cannot be excluded is limited at the option of ahm and its related bodies corporate to the following:
- in the case of services supplied or offered by ahm and its related bodies corporate:
- the supply of the services again, or
- the payment of the cost of having services supplied again; and
- in the case of goods supplied or offered by ahm and its related bodies corporate:
- the replacement of the goods or the supply of equivalent goods,
- the repair of such goods,
- the payment of the cost of replacing the goods or acquiring equivalent goods; or
- the payment of the cost of having the goods repaired.
The Australian Government requires all health insurance providers and members to incorporate a program of fraud control as part of their overall risk management strategy. Our objective is to minimise loss from fraud so that we can maximise the amount available for benefit payments to you.
We use an independent firm and our own teams to investigate suspected instances of fraud. Our aim is to recover any money and, more importantly, deter further fraudulent behaviour.
The easiest way for you to help us is to simply be aware of what you are being billed for. Make sure the dates of service are correct and that you received the treatment recorded. It is also important to treat your member card like a credit card, and not to leave it with any provider. If your card is lost, please report it to us straight away.
If you have reason to suspect fraudulent activity, please complete this form with as much detail as possible. You can choose to remain anonymous but please be assured that we follow high standards of investigative practice and always protect the interests of all parties.
Governing law and jurisdiction
The Terms and Conditions are governed by and construed in accordance with the laws of Victoria, Australia. You irrevocably and unconditionally submit to the non-exclusive jurisdiction of the courts of Victoria. If any provision of the Terms and Conditions is found to be invalid or unenforceable by a court of law, such invalidity or unenforceability will not affect the remainder of the Terms and Conditions, which will continue in full force and effect.
ahm.com.au, members.ahm.com.au and the ahm Mobile App may be accessed throughout Australia and overseas. We make no representation that the Content or goods or services on ahm.com.au, members.ahm.com.au and the ahm Mobile App comply with the laws (including intellectual property laws) of any country outside of Australia. If you access ahm.com.au, members.ahm.com.au and the ahm Mobile App and the ahm Mobile App from outside Australia, you do so at your own risk and you are responsible for ensuring compliance with all laws in the place where you are located.
We will make all reasonable efforts to ensure that ahm.com.au, members.ahm.com.au and the ahm Mobile App are available 24 hours a day, 7 days a week. However, electronic services are subject to interruption or breakdown. Therefore, access is offered on an ‘as is’ and ‘as available’ basis only.
ahm.com.au, members.ahm.com.au and the ahm Mobile App contain hyperlinks and other pointers to internet websites operated by third parties. These linked websites are not under the control of ahm and ahm is not responsible for the contents of any linked website or any hyperlink contained in a linked website.
ahm provides these hyperlinks to you as a convenience only and the inclusion of any link does not imply any endorsement of the linked website by ahm or its affiliates. You link to any such website entirely at your own risk.
When you visit ahm.com.au, members.ahm.com.au and the ahm Mobile App, our servers collect routine logging information such as the pages visited, the time of your visit, the web browser that you are using and the IP address associated with your request. This information is used in aggregated form to help us manage our servers and websites and to improve our understanding of the needs of users. The information may also be used when investigating security incidents.
ahm.com.au, members.ahm.com.au and the ahm Mobile App use Google Analytics Premium and other third party tools to better understand how people uses these sites. This makes information similar to that of routine server logs available to Google or other third party statistics providers. The analytic reports that are produced are aggregated and do not identify individual people.
Third party vendors, including Google, show ahm ads on websites across the internet. ahm uses third party cookies from Google to inform, report, optimise and serve ads based on visits to ahm.com.au, members.ahm.com.au and the ahm Mobile App via Google Advertising cookies. This is done using the following applications:
- Remarketing with Google Analytics
- Google Display Network Impression Reporting
- DoubleClick Platform integrations
- Google Analytics Demographics and Interest Reporting
If you would like more information about the above, including how to opt out of data being collected or used by the aforementioned third party cookies from Google, you can follow this link: https://www.google.com/intl/en/analytics/learn/privacy.html(opens in a new tab)
We collect and use some of the information you provide when you join ahm or when you access ahm.com.au, members.ahm.com.au and the ahm Mobile App by following a link on an ahm email. We use this information to:
- monitor the use of, and improve, the information and functions on ahm.com.au, members.ahm.com.au and the ahm Mobile App
- understand your interactions and preferences
- to provide you with information about products and services that may interest you
This information may be linked to cookies set in your browser and to information you have provided to us previously. You may use your browser preferences to disable these cookies.
Some ahm websites present content and functionality provided by third parties. The content, and any information gathered, is not controlled by ahm and users should consult the privacy policies of the third party providers. ahm will take reasonable steps to advise users when third parties are involved in ahm transactions.
Online services for members
In order to access members.ahm.com.au and the ahm Mobile App, you must be the Principal Member and be registered.
To use members.ahm.com.au and the ahm Mobile App, the Principal member is required to register their Member ID and set a password. The same Member ID and Password will be used to access your account on both the App and members.ahm.com.au.
The Principal member must take reasonable care to keep their password confidential.
The use of members.ahm.com.au and the ahm Mobile App may be subject to transaction limits, such as:
- the maximum amounts that may be submitted before any claims are processed and benefits paid
- the maximum amounts that may be paid subject to annual limits
- the maximum amounts for credit card payments per transaction.
’the good stuff’ by ahm
Participation in ’the good stuff’ by ahm program is subject to separate terms and conditions, which are available at thegoodstuff.ahm.com.au/terms-and-conditions. In order to use certain parts of thegoodstuff.ahm.com.au and participate in the program, you must register an account. You can do this by following the prompts at thegoodstuff.ahm.com.au. You must take reasonable care to keep your password confidential.
Making a claim on members.ahm.com.au or the ahm Mobile App
You may be required to verify your identity, using the prescribed method when requested, to make a claim on members.ahm.com.au or the ahm Mobile App. If you do not verify your identity, in the prescribed manner and when requested, you may not be able to make a claim on members.ahm.com.au or the ahm Mobile App.
- By submitting a claim via members.ahm.com.au and the ahm Mobile App, the Principal Member makes the following declaration:
- Each time you lodge a claim via members.ahm.com.au and the ahm Mobile App, you are declaring and agreeing that:
- all information supplied in connection with the claim is true, correct and supported by valid invoices or receipts;
- benefits are not payable by the Fund in relation to any service until you have paid the provider of the service in full for the service.
- you’ll need to keep original receipts for 3 years for audit purposes, unless you have attached a clear image of the full invoice or receipt with your claim;
- if the image provided is not clear or does not show the full receipt or invoice, you may be required to provide another copy;
- you may be asked to produce relevant invoices or receipts prior to finalising the assessment of any claim and prior to the payment of any benefit;
- if your claims have been selected for audit:
- you will provide up to 3 years of invoices and receipts within 14 days of any request;
- benefits payable to you can be held until the valid invoices and receipts are received and verified by the Fund;
- your ability to make a claim via members.ahm.com.au and the ahm Mobile App will be suspended until a time when claims can be verified;
- a refund of any benefits paid may be sought if a claim cannot be substantiated by valid invoices and receipts;
- the Fund reserves the right to recover any overpayment of any claim which cannot be substantiated from any future claims or premium refunds;
- if you do not produce valid invoices and receipts, your claim can be deemed invalid, access to members.ahm.com.au and the ahm Mobile App be removed or your membership with the Fund can be terminated.
- the Fund does not guarantee a response or payment of benefits within any particular period;
- the successful lodgement of a claim via members.ahm.com.au and the ahm Mobile App does not guarantee the payment of any benefit. The payment of benefits is at all times subject to the Fund Rules and policies as amended from time to time^;
- if the claim has been paid in full, any benefits payable in respect of the claim will be paid to the policy holder of your policy in their nominated bank account. If the claim has not been paid in full, any benefits payable in respect of the claim will be paid to the provider of the service that is the subject of the claim;
- you authorise any health service provider to give the Fund any information as may be necessary to assess the claim;
- the expenses detailed in the claim are not, and will not be subject to a compensation or damages claim*;
- you will inform the Fund immediately if you become aware that any details of the claim are incorrect;
- the services described in the claim were actually provided and received from a Recognised Provider #;
- you have the facilities to access and receive electronic communications (e.g. email) regarding the claim and will regularly check to access and view such communications. A communication will not under any circumstances be treated as invalid by virtue of any delay or omission by you to access and view it after it is received at your designated electronic system or address;
- A daily benefit limit of $1,000 per membership applies to claims submitted via members.ahm.com.au and the ahm Mobile App.
- The membership premiums must be up to date as at the time of receiving the service to receive any benefits back for claims submitted via members.ahm.com.au and the ahm Mobile App.
- To the maximum extent permitted by law, ahm (together with its related entities, employees, agents, contractors and suppliers) (“ahm Protected Parties”) accept no responsibility, and will not be liable or responsible in tort (including negligence), contract or statute to you or any other person for any loss, damages, costs, expenses, injuries or other claims (including consequential loss or damage, loss of profits or anticipated profits, loss of revenues, economic loss or loss of opportunity), as a result (direct or indirect) of any defect, deficiency or discrepancy in the online claims service via members.ahm.com.au and the ahm Mobile App (including its form, content and timeliness of delivery).
- The Competition and Consumer Act 2010 and certain State and Territory legislation may confer certain guarantees, conditions and warranties into these terms which cannot be excluded, restricted or modified (’Non-excludable Rights’). ahm does not exclude any Non-excludable Rights, but does exclude all other conditions and warranties implied by custom, law or statute. Subject to the Non-excludable Rights, and otherwise to the maximum extent permitted by law, the liability of ahm and the ahm Protected Parties (if any) arising from the breach of any implied condition or warranty which cannot be excluded is limited at the option of ahm and its related bodies corporate to the following:
- in the case of goods;
- the replacement of the goods or the supply of equivalent goods;
- the repair of the goods;
- the payment of the cost of replacing the goods or of acquiring equivalent goods; or
- the payment of the cost of having the goods repaired; and
- in the case of services, supplying the services again or payment of the cost of having the services supplied again.
- in the case of goods;
- To the extent that a provision in these terms is expressed to be for the benefit of any ahm Protected Party, where a contract or agreement incorporates these terms, ahm health insurance enters into that contract or agreement in its own capacity and in its capacity as trustee and agent for that ahm Protected Party, and ahm health insurance is entitled to enforce that provision for the benefit of itself and for the benefit of that ahm Protected Party.
^ Terms and conditions of membership are contained in the Fund Rules. You can view a copy of the Fund Rules online at ahm.com.au. Rules and benefit levels may change from time to time. If you anticipate treatment or a procedure for which you are expecting a benefit from the Fund, please contact us before commencing treatment to establish whether the benefit you expect will be paid.
* Benefits are not payable where the relevant member has, or may have, an entitlement to receive compensation or damages. In such circumstances, the Fund expects that the relevant member will pursue that entitlement. The Fund may make provisional benefit payments on application, subject to our Fund Rules and policies, but the relevant member must agree to repay such payments, in full, from their final settlement. If a claim for which benefits have been paid appears at a later point in time to be one in respect of which an entitlement to compensation or damages exists, the Fund reserves the right to recover the amount of benefits paid.
# A recognised provider is a health provider whose services are recognised for the payment of benefits by Medibank.
ahm Health Insurance Chat is a service established and maintained by ahm Health Insurance, a business of Medibank Private Limited ACN 080 890 259, which enables you to chat to an ahm Health Insurance consultant in real-time to assist you to navigate your way around ahm Health Insurance’s website and, where possible, discuss your ahm health insurance cover. The ahm Health Insurance Chat facility uses LivePerson Inc’s engagement technology.
Eligibility for access
ahm Health Insurance Chat is intended solely for use by Australian residents and holders of valid Australian visas who are eligible to purchase our insurance products. To be eligible to use ahm Health Insurance Chat you must be 16 years of age or older. ahm Health Insurance has the sole right to determine your eligibility for, and the extent of your access to, ahm Health Insurance Chat.
Appropriate use of ahm Health Insurance Chat
- corrupt, damage or interfere with ahm Health Insurance Chat or any ahm Health Insurance or third party data, software, hardware, website or information technology systems;
- send any offensive, inflammatory, defamatory, fraudulent or otherwise unlawful information or information that infringes third party rights;
- adversely affect the reputation or public image of ahm Health Insurance; or
- cause annoyance or inconvenience to ahm Health Insurance or any third party.
During your Chat with an ahm Health Insurance consultant, you may provide personal information including your:
- email address if you would like ahm Health Insurance to email correspondence to you;
- telephone number if you would like an ahm Health Insurance consultant to contact you following the Chat to resolve any outstanding issues you may have or for follow up purposes; and/or
- postal address if you would like ahm Health Insurance to post correspondence to you.
In providing ahm Health Insurance your email address, telephone number and/or your postal address, you consent to ahm Health Insurance using your email address and/or telephone number to contact you for the above purposes.
Any personal information (including sensitive information) (Information) you provide during the Chat will be collected by ahm Health Insurance in its capacity as the Chat service provider and LivePerson in its capacity as the communications technology provider.
ahm Health Insurance and LivePerson each handle the Information they collect about you in accordance with their respective privacy policies, which you can access via the following links:
- assist you to navigate the ahm Health Insurance website;
- answer your queries or resolve any issues you may have regarding ahm Health Insurance’s products and services;
- answer your queries or resolve any issues you may have regarding your ahm Health Insurance’s cover; and
- continue to develop and improve the ahm Health Insurance Chat service, the ahm Health Insurance website and ahm Health Insurance’s products and services.
In order to provide the Chat service, ahm Health Insurance and LivePerson may disclose your Information to third parties, including technology maintenance and support services providers. These providers may be located, or provide services from, overseas including in the United Kingdom, the United States of America, Israel and the Netherlands.
You may choose to access and use ahm Health Insurance Chat on an anonymous basis and/or nominate an alias for use by the ahm Health Insurance consultant during your Chat. However, this may mean that ahm Health Insurance is only able to provide you with general advice and assistance during the Chat.
Intellectual property rights
ahm Health Insurance Chat is provided to you on ‘as is’ and ‘as available’ basis and may, from time to time, contain errors, faults and inaccuracies. Subject to the consumer guarantees provided for in consumer protection legislation (including the Australian Consumer Law), ahm Health Insurance makes no representation and provides no express or implied warranty or guarantee about the security of ahm Health Insurance Chat, the safety of any file or software associated with it (such as safety from any virus or defects including those that could damage or interfere with any data, software or hardware with which it might be used) or that access to ahm Health Insurance Chat will be uninterrupted or fault free. ahm Health Insurance does not provide telecommunications services and does not warrant that you will have continuous access to ahm Health Insurance Chat or that it will be supplied fault free. ahm Health Insurance will not be liable in the event that ahm Health Insurance Chat is unavailable to you for any reason including due to computer downtime attributable to malfunctions, upgrades, preventative or remedial maintenance activities or interruption in telecommunications supply. ahm Health Insurance reserves the right to suspend or terminate the availability of ahm Health Insurance Chat at any time.
Any response provided by an ahm Health Insurance consultant through ahm Health Insurance Chat is provided for information purposes only. Subject to the consumer guarantees provided for in consumer protection legislation (including the Australian Consumer Law), ahm Health Insurance does not give any express or implied warranties and makes no representations in relation to the responses provided by an ahm Health Insurance consultant through ahm Health Insurance Chat. While reasonable care has been taken in its preparation, ahm Health Insurance does not guarantee or warrant the accuracy, quality, completeness, reliability or currency of the responses provided by an ahm Health Insurance consultant through ahm Health Insurance Chat or of any ahm Health Insurance websites, materials, information, products or services promoted through ahm Health Insurance Chat, or their usefulness in achieving any purpose. You should make and rely on your own assessment and enquiries to verify the accuracy of the information provided through ahm Health Insurance Chat.
You agree to access and use ahm Health Insurance Chat entirely at your own risk including in relation to all information that you choose to transmit through ahm Health Insurance Chat.
Limitation of liability
Subject to the consumer guarantees provided for in consumer protection legislation (including the Australian Consumer Law), ahm Health Insurance and its officers, employees and agents accept no liability for any loss, damage, illness or injury (including any loss of profits or income, business interruption or loss or corruption of data or other information):
- arising from:
- your access to or use of ahm Health Insurance Chat;
- the information on ahm Health Insurance Chat being incorrect, incomplete or misleading;
- any action or indecision by you in reliance of the information contained in ahm Health Insurance Chat; and
- any delay or interruption in access to or use of ahm Health Insurance Chat; and
- for any personal injury, including death, caused by access to, use or misuse of ahm Health Insurance Chat including its content and services.
You agree to defend, indemnify and hold harmless ahm Health Insurance and its officers, directors, employees and agents from and against all claims, actions, loss, damages, liabilities and costs related to or arising directly or indirectly from the following:
- subject to the consumer guarantees provided for in consumer protection legislation (including the Australian Consumer Law), your use of ahm Health Insurance Chat.
If you would rather not have this information stored on your computer, you can configure your browser so it does not accept cookies. However, if you disable cookies you will not be able to access ahm Health Insurance Chat.
Other terms and conditions