ahm health insurance

lite 60 basic plus

Name: lite 60 basic plus
Brand: ahm health insurance
Price: 416.6 AUD

$416.60 / month

(Before Rebate, Discount & Loading)

Available in SA

134 246 Sponsor link

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

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/J48/SDLG1D

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 does not provide benefits for travel or accommodation outside of hospital.

Covered

Restricted Cover

Not Covered

This policy includes cover for

Dental surgery

Hernia and appendix

Hospital psychiatric services

Joint reconstructions

Miscarriage and termination of pregnancy

Palliative care

Rehabilitation

Tonsils, adenoids and grommets

This policy does not include 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

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

Implantation of hearing devices

Insulin pumps

Joint replacements

Kidney and bladder

Lung and chest

Male reproductive system

Pain management

Pain management with device

Plastic and reconstructive surgery (medically necessary)

Podiatric surgery (provided by a registered podiatric surgeon)

Pregnancy and birth

Skin

Sleep studies

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 of $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

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.

Other features of this hospital cover

This cover also includes Accident Override and unlimited medically necessary ambulance.

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

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Chinese medicine 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Chiropractic 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Endodontic 12

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Filling of one root canal: 60% of charge

Exercise physiology 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

General dental 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Fluoride treatment: 60% of charge
Scale & clean: 60% of charge
Surgical tooth extraction: 60% of charge
Periodic oral examination: 60% of charge

Optical 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Multi-focal lenses & frames: 60% of charge
Single vision lenses & frames: 60% of charge

Osteopathy 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Physiotherapy 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Remedial massage 0

$1,000 per person

combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Acupuncture

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chinese medicine

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chiropractic

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Filling of one root canal: 60% of charge}

Exercise physiology

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

General dental

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Fluoride treatment: 60% of charge}

{Scale & clean: 60% of charge}

{Surgical tooth extraction: 60% of charge}

{Periodic oral examination: 60% of charge}

Optical

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Multi-focal lenses & frames: 60% of charge}

{Single vision lenses & frames: 60% of charge}

Osteopathy

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Physiotherapy

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Remedial massage

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, endodontic, exercise physiology, general dental, optical, osteopathy, physiotherapy, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

With lite 60 basic plus you get one limit to use on one, or all, of your included extras each financial year.

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

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Dietetics/dietary advice

Eye therapy (orthoptics)

Health management / Healthy lifestyle

Hearing aids

Home nursing

Major dental

Non PBS pharmaceuticals

Occupational therapy

Orthodontic

Orthotics (podiatric orthoses)

Podiatry

Psychology

Speech therapy

Vaccinations

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

lite 60 basic plus

$416.60 / month

(Before Rebate, Discount & Loading)

Available in SA

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/J48/SDLG1D

lite 60 basic plus

Policy ID: AHM/J48/SDLG1D

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

ahm health insurance

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