ahm health insurance
elite gold copay
$961.10 / month
(Before Rebate, Discount & Loading)
Available in SA
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healthslips.com.au Policy Information
You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading, an Age-based Discount or an insurer discount. Check with your insurer for details.
This policy covers: Two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults).
Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 30) and non-students (21 to 30), as well as persons with a disability who qualify as a child, non-classified* dependant, student and non-student in these age ranges. *Non-classified dependant: ahm covers child dependants up to the age of 21.
Policy ID: AHM/J138/SIBB2Y
Hospital Cover
- This policy exempts you from the Medicare Levy Surcharge.
- This policy does not provide accident cover.
- This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
The following payments may also apply for hospital admissions
Excess: No excess
Co-payments: Every time you go to hospital you will have to pay:
- $250 per day for a shared room for overnight admissions - up to $500 per hospital stay
- $250 per day for a private room for overnight admissions - up to $500 per hospital stay
- $250 for day surgery (no overnight stay)
- The maximum co-payment is $500 per year
The following waiting periods for hospital admissions apply to new or upgrading members
Waiting periods:
- 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
- 12 months for other pre-existing conditions
- 12 months for pregnancy and birth (obstetrics)
- 2 months for all other treatments
Gap Cover
This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.
Other features of this hospital cover
Includes travel & accommodation benefits and benefits for doctors health checks. Members on this product are eligible to receive ahm At Home services included in this product, subject to applicable waiting periods and clinical appropriateness. Services are subject to provider availability and geographic location.
Ambulance cover
In SA this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.
Other features of this ambulance cover: Unlimited benefits for medically necessary ambulance trips to the nearest hospital that is able to provide the level of care you require. TAS and QLD have State schemes to cover ambulance services for residents of those States.
Insurer Details
ahm health insurance
elite gold copay
$961.10 / month
(Before Rebate, Discount & Loading)
Available in SA
Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/AHM/J138/SIBB2Y
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