Hospital Cover and Ancillary Cover

ahm’s Hospital Cover and Ancillary Cover includes cover for extras such as natural therapies, high cost dentistry and glasses.

Note: Hospital Cover & Ancillary Cover or Hospital Cover Level 5 & Ancillary Cover aren't available for purchase or for change of cover.

View the hospital component of this cover »

The table below shows the benefits payable for Ancillary services under ahm’s Hospital Cover and Ancillary Cover effective 1 April 2011. For more information, download a policy document or call us on 134 246.

General Benefits

Natural Therapies Benefit
Osteopath, naturopath, acupuncture, remedial massage, herbalist, rolfing, alexander technique, kinesiology, orthoptist, reflexology, one-on-one pilates, homeopath, feldenkrais, bowen therapy and biochemist 100% up to $45
Combined Financial Year Limit per person
Financial Year Limit per family		 $600
$1,200
Physiotherapy and Associated Services
Physiotherapy, occupational therapy, hand therapy, one-on-one hydrotherapy
100% up to $45
Combined Financial Year Limit per person
Financial Year Limit per family
$600
$1,200
Chiropractic Services
Chiropractic
100% up to $40
Chiropractic x-rays
 $90
Combined Financial Year Limit per person
Financial Year Limit per family
$500
$1,000
Podiatry and Associated Services
Podiatry, biomechanical assessment and cast
100% up to $40
Combined Financial Year Limit per person
Financial Year Limit per family
$400
$800
Orthotics/Orthopaedic shoes (Purchased from a registered Podiatrist or Orthopaedic supplier only. Excludes sporthotics and formthotics). 100% up to $200
Combined Financial Year Limit per person
Financial Year Limit per family
$200
$400
Pharmaceutical Items
Pharmaceutical
(Excludes PBS scripts, patented medicines, contraceptives and herbal medicines)
 100% of balance above general patient PBS amount, up to $50 per item prescribed
Preventive Treatments
Nicobate patches, Hepatitis A/B injections, flu and travel vaccines Up to $30 per item
Combined Financial Year Limit per person
Financial Year Limit per family
$650
$1,300
Dietary
Dietitian, nutritionist consultation
 100% up to $40
Combined Financial Year Limit per person
Financial Year Limit per family
$300
$600
Psychology and Hypnotherapy (provided by registered psychologists only)
Psychology
100% up to $70
Hypnotherapy 100% up to $70
Group psychology $15 per person
Combined Financial Year Limit per person
Financial Year Limit per family
$400
$800
Speech Therapy
Speech therapy
100% up to $50
Combined Financial Year Limit per person
Financial Year Limit per family
$300
$600
Hearing Aids
Hearing Aids 100% up to $600
Hearing Aid repair 100% up to $100
Combined Financial Year Limit (per person per 3 years)
Limit per family per 3 years
$600
$1,200
Optical
Single vision glasses, bifocal glasses, multi-focal glasses, contact lenses, disposable contacts
(prescription - sight correcting lenses only)		 100% up to $300
Combined Financial Year Limit per person
Financial Year Limit per family
$300
$600

Dental Benefits

Below are examples of the most common benefits we pay for dental services and their item numbers. We pay benefits for a lot more than we're able to include here, so make sure you call us before you have any treatment to confirm the benefits you'll receive.

General Dentistry 80% of actual charge up to:
Diagnostic Procedures
GP comprehensive examination or consultation (011)

Combined 2 per person per financial year
$28.80
GP recall examination or consultation (012) $28.00
Single intra-oral x-ray (022) $21.60
Panoramic x-ray (037)
$44.80
Preventive Procedures
Clean & polish (111)
Combined 3 per person per financial year 		$25.60
Scale & clean (114) $47.20
Topical fluoride application (121) 2 per person per financial year $18.40
Custom-made mouthguard (151) 2 per person per financial year $75.20
Fissure sealing (161) $24.00
Oral Surgery
GP simple extraction (311) $64.80
Endodontics (Root Canal Therapy)
GP preparation of one root canal (415) $119.20
Restorative Services
Metal filling (511/513)
1 surface/3 surfaces
$56/$83.20
Anterior (front) tooth coloured filling (521/523)
1 surface/3 surfaces
$61.60/$88
Posterior (back) tooth coloured filling (531/533)
1 surface/3 surfaces
$65.60/$101.60
GP occlusal splint
1 per person per financial year
$266.40
Combined Financial Year Limit per person
Financial Year Limit per family
$800
$1,600
High Cost Dentistry 60% of actual charge up to:
Periodontics
Specialist root planing (per tooth)(222S) $8.40
Oral Surgery
(Benefits vary according to the complexity of the procedure)
Specialist surgical removal of a tooth (eg wisdom tooth) (324S) 		$178.50
Endodontics (Root Canal Therapy)
Specialist preparation of one root canal (415S) $159.00
General Services
Specialist occlusal Splint (965S)

1 per person per financial year

$267.00
Crowns/Bridges/Dentures
Porcelain metal crown (615) $571.80
Full metal crown (618) $532.80
Bridge pontic (643) $471.00
Full upper or lower Denture (711/712)
1 upper and lower per person per 3 financial years 		$355.80
Partial metal chrome upper or lower (727/728) $451.80
Orthodontic
(Benefits vary dependent on item numbers)
Specialist full upper and lower banding (831B)
*(Orthodontic services performed by a general dentist attract a lower benefit.)


Financial Year Limit per person


$540.00*

Combined Financial Year Limit per person
Financial Year Limit per family

$800
$1,600

 

Explanations
Limits - Where a limit is applied to a benefit, each person on your health insurance policy can claim up to that limit every financial year unless it states otherwise.
Providers - All ancillary/extras providers must be registered with ahm.
Broken Appointments - ahm doesn't pay benefits towards broken appointments, so if you've been charged for not attending or cancelling an appointment, you won't be able to claim it.

If you have a health insurance query, please contact us.

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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.