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ahm health insurance

deluxe flexi silver plus

$653.80 / month

(Before Rebate, Discount & Loading)

Available in SA

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: One adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult).

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.

This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with insurer for details.
This policy does not provide benefits for travel or accommodation outside of hospital.

Policy ID: AHM/J72/SBOD1Y Source: Private Health Information Statement (PHIS)

Hospital Cover

Covered

Restricted Cover

Not Covered

This policy includes cover for

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)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Pregnancy and birth

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: You will have to pay an excess on admission. This is limited to a maximum of $500 per person per year.

Excess payments do not apply to hospital admissions for dependants.

Co-payments: No co-payments

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
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.

ahm Health Insurance does not operate a preferred provider scheme. Included Extras benefits apply to any recognised provider. See https://members.ahm.com.au/find-a-provider.

Policy ID: AHM/J72/SBOD1Y Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $20
Subsequent visit: $20

Chinese medicine

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $20
Subsequent visit: $20

Chiropractic

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $40
Subsequent visit: $30

Endodontic

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Filling of one root canal: $120.55

General dental

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Fluoride treatment: $25.5
Scale & clean: $74.45
Surgical tooth extraction: $99
Periodic oral examination: $34.65

Major dental

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Full crown veneered: $510

Optical

$300 per person

Multi-focal lenses & frames: 100% of charge
Single vision lenses & frames: 100% of charge

Orthotics (podiatric orthoses)

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Orthotics supply & fit: $150

Osteopathy

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $40
Subsequent visit: $30

Physiotherapy

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $40
Subsequent visit: $30

Podiatry

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $31
Subsequent visit: $25

Remedial massage

$1,100 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, general dental, major dental, orthotics (podiatric orthoses), osteopathy, physiotherapy, podiatry & remedial massage

Initial visit: $20
Subsequent visit: $20

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Dietetics/dietary advice

Exercise physiology

Eye therapy (orthoptics)

Health management / Healthy lifestyle

Hearing aids

Home nursing

Non PBS pharmaceuticals

Occupational therapy

Orthodontic

Psychology

Speech therapy

Vaccinations

Other features of this general treatment cover: This cover features a Flexi Limit for the Included Extras which covers Routine, Complex & Major Dental, Physiotherapy, Chiropractic, Osteopathy, Natural Therapies, Podiatry & Orthotics. This limit is loyalty based & increases up to a maximum of $1,500 after 5 continuous financial years of membership

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

deluxe flexi silver plus

$653.80 / month

(Before Rebate, Discount & Loading)

Available in SA

Call now 134 246 Sponsor link

http://www.ahm.com.au

134 246

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/J72/SBOD1Y