Top Hospital

Looking for peace of mind? Look no further!

Top Hospital is our most comprehensive cover, providing for services such as pregnancy, heart procedures and hip and knee replacements, in addition to hospital accommodation and ambulance charges. 

To keep the premium lower, Top Hospital is also available with two levels of co-payment – Level 5 and Level 8. Find out more about how the co-payment works.

And you can also access ahm’s Health Management Programs to help you achieve and maintain good health. 

For a full run down, download a policy document.

 


Looking for a package?

Combine any of our Hospital covers with any of our Extras covers to create a package to suit you. Use our Quick Quote tool to find the combination that best suits your needs and budget.

What you're covered for?

There are more services we pay for than we can include here, so make sure you call us before you go to hospital or have any treatments to confirm the benefits you’ll receive.

Hospital cover options
Most common hospital services		 Top Hospital Top Hospital
Level 5		 Top Hospital
Level 8
Co-payments
(per person per membership year)		 Nil $5001 $8001
Ambulance transport
where medically necessary
Obstetrics and labour ward
Fertility treatments – IVF and GIFT
(inpatient services only)
Midwife assisted home births
Male and female sterility reversals
Hip & knee joint replacements
Major eye surgery
Dialysis
Gastric banding surgery
Psychiatric services
Rehabilitation
Palliative care
Cardio-thoracic procedures
including open heart and bypass surgery and other invasive cardiac procedures such as angiograms and stents
Surgically implanted prostheses
We’ll cover the cost of any No Gap prostheses, and the minimum benefit for Gap Permitted Prosthesis
Travel & accommodation
for a hospitalisation
Disease management appliances
Health management programs
Health checks

1Co-payment waived for child dependants, adult child dependants, student dependants and non-compensable accidents.

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Where you're covered

We’ll cover you when treated at a:

  • Partner private hospital (including Partner day surgery)
  • Public hospital
  • Non agreement hospital*

* Default (minimum) benefit only

Restricted services

We pay the default (minimum) benefit only for restricted services and services not covered by Medicare in either a private or public hospital. Restricted services include:

  • Podiatric surgery
  • Cosmetic surgery where not considered medically necessary
  • Services not covered by Medicare unless otherwise specified
  • Services where Medicare doesn’t pay a benefit (e.g. where patient is not Medicare eligible).

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Health improvement benefits

Health managament programs
Pregnancy programs Benefit
ahm’s Pregnancy Support Program ahm pays 100% of the cost
Disease prevention programs Benefit
ahm’s Health Risk Assessment ahm pays 100% of the cost
ahm’s Health Coaching ahm pays 100% of the cost
Chronic disease management programs Benefit
ahm’s Chronic and Complex Care ahm pays 100% of the cost
Health checks Financial year limit Benefit
Doctor health checks and Healthy Heart checks (where not claimable through Medicare, an employer or another party) 1 per person $50
Disease management appliances Financial year limit Benefit
Blood pressure monitor 1 per policy every 3
continuous financial years		 $100
CPAP machine or BiPAP respirator 1 per policy every 5
continuous financial years		 $600
CPAP machine or BiPAP respirator mask and/or rental Combined per policy
per financial year		 $100
Blood glucose testing machine 1 per policy every 3
continuous financial years		 $100
Instant injector or insulin pen 1 per policy every 3
continuous financial years		 $100
Nebuliser 1 per policy every 2
continuous financial years		 $100
Peak Flow Meter 1 per policy every 2
continuous financial years		 $50
Spacer 1 per policy every 2
continuous financial years		 $50
TENS machine 1 per policy every 3
continuous financial years		 $80
Lymphoedema Garments 3 items per person,
per financial year		 $50 per item
Consultations 4 consultations per person,
per financial year		 $40 per consult
More health benefits Benefit
Insulin pump and speech processor replacements ahm pays 100% up to the listed minimum price on the Government’s Prosthesis List
Travel and accommodation $75 per day combined up to $750 per person every Membership year

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Waiting periods

When you take out private hospital cover or change your level of cover, you’ll have to wait a set time before you can claim for services and benefits you weren’t previously covered for.

Where benefits are greater on your new level of cover, we’ll pay the benefit at the amount on your previous level of cover until the waiting period is served.

1 day
  • Hospital treatment as a result of an accident
  • Ambulance
  • Disease prevention programs
  • Chronic disease management programs
  • Travel and accommodation
2 months
  • Hospital treatment (where there’s no pre-existing conditions)
  • Rehabilitation, psychiatric and palliative care (regardless of whether pre-existing)
  • Doctor health checks and Healthy Heart checks
12 months
  • Pre-existing conditions
  • Obstetrics, pregnancy and birth related conditions in a public or private hospital
  • Disease management appliances
  • Pregnancy Support Program
  • Hospital substitute services that are obstetric related or if a pre-existing condition
  • Midwife delivery services
  • Speech processor and insulin pump replacements


Important information

For more information on how your policy works, please read our Important Information for hospital cover.

Please Note: This is important information about your policy. Please read this in conjunction with your policy document which you can download and save for future reference.

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