ahm health insurance

boost flexi basic plus

Name: boost flexi basic plus
Brand: ahm health insurance
Price: 441.4 AUD

$441.40 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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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/J84/NDSR1D

Source: Private Health Information Statement (PHIS)

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

Back, neck and spine

Blood

Bone, joint and muscle

Brain and nervous system

Breast surgery (medically necessary)

Chemotherapy, radiotherapy and immunotherapy for cancer

Dental surgery

Diabetes management (excluding insulin pumps)

Digestive system

Ear, nose and throat

Eye (not cataracts)

Gastrointestinal endoscopy

Gynaecology

Hernia and appendix

Hospital psychiatric services

Implantation of hearing devices

Insulin pumps

Joint reconstructions

Kidney and bladder

Lung and chest

Male reproductive system

Miscarriage and termination of pregnancy

Pain management

Palliative care

Podiatric surgery (provided by a registered podiatric surgeon)

Pregnancy and birth

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Cataracts

Dialysis for chronic kidney failure

Heart and vascular system

Joint replacements

Pain management with device

Plastic and reconstructive surgery (medically necessary)

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 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
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

This cover also includes Accident Override, no excess for Dependants and unlimited medically necessary ambulance.

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 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $20
Subsequent visit: $20

Ante-natal/Post-natal classes 0

No annual limit

Initial visit: $25
Subsequent visit: $25

Chinese medicine 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $20
Subsequent visit: $20

Chiropractic 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $35
Subsequent visit: $28

Dietetics/dietary advice 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $32
Subsequent visit: $25

Endodontic 12

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Filling of one root canal: $119.55

General dental 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Fluoride treatment: $18
Scale & clean: $50
Surgical tooth extraction: $98
Periodic oral examination: $30

Non PBS pharmaceuticals 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Per eligible prescription: $50

Optical 6

$200 per person

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

Osteopathy 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $37
Subsequent visit: $30

Physiotherapy 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $37
Subsequent visit: $30

Psychology 0

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $71
Subsequent visit: $45

Remedial massage 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $20
Subsequent visit: $20

Speech therapy 2

$800 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services

Initial visit: $50
Subsequent visit: $26

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $20}

{Subsequent visit: $20}

Ante-natal/Post-natal classes

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Chinese medicine

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $20}

{Subsequent visit: $20}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $28}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $25}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Filling of one root canal: $119.55}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Fluoride treatment: $18}

{Scale & clean: $50}

{Surgical tooth extraction: $98}

{Periodic oral examination: $30}

Non PBS pharmaceuticals

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Per eligible prescription: $50}

Optical

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $30}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $30}

Psychology

Waiting period: 0 month

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $71}

{Subsequent visit: $45}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $20}

{Subsequent visit: $20}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, general dental, non pbs pharmaceuticals, osteopathy, physiotherapy, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $26}

With boost flexi basic plus you get one flexi limit to spend across all of your included extras each financial year and a separate optical limit. The longer you're a member with us, the more you can claim with an increasing flexi limit each financial year (capped at year 5). This product also includes Hypnotherapy ($71 for initial consultation and $45 for subsequent consultations, waiting period is 2 months) and a range of Health Improvement Benefits including: Yoga, Pilates, Quit smoking, Disease management association fees, Cancer Council UV products, Stress management courses, Preventative tests, scans and screenings, Health checks, Exercise classes and Swimming lessons (for ages 0-17 years). This product also includes Counselling services. Conditions and annual limits apply. Please refer to your product guide for more details.

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

Audiology

Blood glucose monitors

Exercise physiology

Eye therapy (orthoptics)

Health management / Healthy lifestyle

Hearing aids

Home nursing

Major dental

Occupational therapy

Orthodontic

Orthotics (podiatric orthoses)

Podiatry

Vaccinations

Other features of this general treatment cover: This cover features a flexi limit to use on one or all of your included extras as well as a separate optical limit. The flexi limit increases up to a maximum of $1,200 after 5 continuous financial years of membership.

boost flexi basic plus

Policy ID: AHM/J84/NDSR1D

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

ahm health insurance

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