ahm health insurance

top hospital package gold

Name: top hospital package gold
Brand: ahm health insurance
Price: 1002.2 AUD

$1002.20 / month

(Before Rebate, Discount & Loading)

Available in WA

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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 (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 30), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: ahm covers child dependants up to the age of 21.

Policy ID: AHM/J1A/W0000F

Source: Private Health Information Statement (PHIS)

Hospital Cover

This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with insurer for details.
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.

Extras Cover

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.

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 0

$600 per person up to $1,200 per policy

combined limit for acupuncture, chinese medicine, osteopathy & remedial massage

Initial visit: $45
Subsequent visit: $45

Chinese medicine 0

$600 per person up to $1,200 per policy

combined limit for acupuncture, chinese medicine, osteopathy & remedial massage

Initial visit: $45
Subsequent visit: $45

Chiropractic 0

$500 per person up to $1,000 per policy

Initial visit: $40
Subsequent visit: $40

Dietetics/dietary advice 0

$300 per person up to $600 per policy

Initial visit: $40
Subsequent visit: $40

Endodontic 12

$800 per person up to $1,600 per policy

combined limit for endodontic, major dental & orthodontic

Filling of one root canal: $113.6

General dental 0

$800 per person up to $1,600 per policy

sub-limits apply

Fluoride treatment: $18.4
Scale & clean: $47.2
Surgical tooth extraction: $112
Periodic oral examination: $28

Hearing aids 12

$600 per person up to $1,200 per policy

sub-limits apply

Hearing aid: $600

Major dental 12

$800 per person up to $1,600 per policy

combined limit for endodontic, major dental & orthodontic

sub-limits apply

Full crown veneered: $571.8

Non PBS pharmaceuticals 0

$650 per person up to $1,300 per policy

Per eligible prescription: $50

Optical 0

$300 per person up to $600 per policy

Multi-focal lenses & frames: $300
Single vision lenses & frames: $300

Orthodontic 12

$800 per person up to $1,600 per policy

combined limit for endodontic, major dental & orthodontic

sub-limits apply

Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge

Orthotics (podiatric orthoses) 12

$400 per person up to $800 per policy

Orthotics supply & fit: $200

Osteopathy 0

$600 per person up to $1,200 per policy

combined limit for acupuncture, chinese medicine, osteopathy & remedial massage

Initial visit: $45
Subsequent visit: $45

Physiotherapy 0

$600 per person up to $1,200 per policy

Initial visit: $45
Subsequent visit: $45

Podiatry 0

$400 per person up to $800 per policy

sub-limits apply

Initial visit: $40
Subsequent visit: $40

Psychology 0

$400 per person up to $800 per policy

Initial visit: $70
Subsequent visit: $70

Remedial massage 0

$600 per person up to $1,200 per policy

combined limit for acupuncture, chinese medicine, osteopathy & remedial massage

Initial visit: $45
Subsequent visit: $45

Speech therapy 0

$300 per person up to $600 per policy

Initial visit: $50
Subsequent visit: $50

Acupuncture

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for acupuncture, chinese medicine, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Chinese medicine

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for acupuncture, chinese medicine, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Chiropractic

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Dietetics/dietary advice

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 per policy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person up to $1,600 per policy}

{combined limit for endodontic, major dental & orthodontic}

Examples of maximum benefits

{Filling of one root canal: $113.6}

General dental

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$800 per person up to $1,600 per policy}

{sub-limits apply}

Examples of maximum benefits

{Fluoride treatment: $18.4}

{Scale & clean: $47.2}

{Surgical tooth extraction: $112}

{Periodic oral examination: $28}

Hearing aids

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{sub-limits apply}

Examples of maximum benefits

{Hearing aid: $600}

Major dental

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person up to $1,600 per policy}

{combined limit for endodontic, major dental & orthodontic}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $571.8}

Non PBS pharmaceuticals

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$650 per person up to $1,300 per policy}

Examples of maximum benefits

{Per eligible prescription: $50}

Optical

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $300}

{Single vision lenses & frames: $300}

Orthodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person up to $1,600 per policy}

{combined limit for endodontic, major dental & orthodontic}

{sub-limits apply}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge}

Orthotics (podiatric orthoses)

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Orthotics supply & fit: $200}

Osteopathy

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for acupuncture, chinese medicine, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Physiotherapy

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Podiatry

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Psychology

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: $70}

{Subsequent visit: $70}

Remedial massage

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for acupuncture, chinese medicine, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Speech therapy

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 per policy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

This product also includes Counselling services. Conditions and annual limits apply. Please refer to product guide for more details.

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

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Exercise physiology

Eye therapy (orthoptics)

Health management / Healthy lifestyle

Home nursing

Occupational therapy

Vaccinations

Ambulance cover

In WA 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

top hospital package gold

$1002.20 / month

(Before Rebate, Discount & Loading)

Available in WA

134 246 Sponsor link

Go to site Sponsor link

ahm health insurance

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/J1A/W0000F

top hospital package gold

Policy ID: AHM/J1A/W0000F

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

ahm health insurance

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