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About your policy
When does my cover start?
Your health insurance cover will start from the date you complete your application; however, you may elect for your policy to start at a future date. Any applicable waiting periods will apply, unless you are switching from a comparable cover with another private health insurer and have served these waiting periods. Claims cannot be paid until a premium payment has been received and the policy is financial at the time of the claim.
Am I covered for doctor visits or outpatient services?
No. The government does not allow private health insurers to pay benefits for doctor visits or outpatient services.
When do I receive a Rebate Statement?
We send out your Rebate statements in July every year. If you have not received yours by the end of July please email ahm.
How do I change my address or personal details?
You can change your contact details online such as telephone numbers, home or postal address or your email address, just login here. If you don't have a password, register here.
If you are moving interstate, please call ahm on 134 246 as your premiums may change.
If you are changing your name, please call ahm on 134 246.
How do I order a new membership card?
You can request a new membership card online, or by calling us on 134 246.
To request a new membership card online, go to Request a new membership card and make a selection from the menu. Your request will be processed within 2 working days, and your new card issued within 7 to 10 working days.
You must be registered for Online Services to request a new membership card online. If you aren't registered for online services, you can register here.
Once we receive your request, your old membership card will be invalid. This means you won't be able to access HICAPS until you receive your new card. However, you can still make claims using our online services. If you recover your old card, please dispose of it carefully. If your new card doesn't arrive within 10 working days, please call us on 134 246.
How do I order a tax summary statement?
If you're registered for our online member services, you can request and print all your transactions for the past financial year. This transactions list is sufficient for ATO requirements. Login to my transactions.
When will I get my annual health insurance tax statement?
We'll mail your annual tax and lifetime health cover statements early in July each year.
What is the health fund ID code for tax purposes?
The health fund ID code for Australian Health Management is AHM.
How do I change my account details?
Download our Payment form and complete and return it to ahm.
Mail the form free of charge to:
Australian Health Management
Reply Paid 75885
Matraville NSW 2036
I am planning a family, is my level of cover appropriate?
If you're thinking about starting a family or having another child, Basic Hospital, Essential Hospital* and Essential Hospital Level 5 won't give you the level of cover you need. For private health insurance which covers obstetrics without restrictions choose Family Hospital Level 5 or Top Hospital (with or without a co-payment).
When you change to a product providing full cover for agreed theatre and accommodation charges for the birth of your baby, you will need to serve a 12 month waiting period. This means that the baby's expected due date must fall after your 12 month waiting period. Therefore we suggest that you change your level of cover to Family Hospital Level 5 or Top Hospital, three (at the minimum) to four months prior to you commencing trying to conceive to ensure that you have served the 12 month waiting period, and both yourself and the baby will be eligible for full private hospital care.
To be eligible for benefits towards the hospitalisation of your newborn child you must have a family or single parent family policy. So if you're planning to have a baby and you have a single policy, you'll need to change to a single parent family or family policy at least two months before the baby's birth for your baby to be covered. A single policy will cover your confinement, however, should your baby require hospitalisation, no benefits will be payable. This rule also applies to premature births.
If you wait until after the birth of your baby to change your cover, then your baby will have to serve all waiting periods.
A newborn won't be charged for hospital accommodation for the first 10 days of life unless they're admitted to a special care nursery. If there are multiple births, the first baby isn't charged for accommodation unless admitted as an inpatient. All other babies will be charged for accommodation so you need to ensure they are covered.
If you have a co-payment it will apply to the mother and admitted babies up to the per person limit (no co-payment applies to babies if you have Top Hospital with a co-payment).
We recognise that planning for your child is very important. ahm offers a range of services to support you and your family. ahm's Total Health for Pregnancy program offers information and support to mothers planning a baby, during the pregnancy and up to the baby's 1st birthday. ahm's Hospital Substitute Program includes a Maternity Option, designed for new mothers and babies to leave hospital earlier and recover at home if clinically appropriate. We provide support services such as nappy supplies, home cleaning and / or early childhood nurses. These services are only available with ahm's Family Hospital*, Family Hospital Level 5 or Top Hospital (with or without a co-payment).
* Please note: From 1st August 2009, Family Hospital and Essential Hospital will be closed.
Find out more about our waiting periods.
More about our Hospital Substitute Programs ».
More information on our range of hospital covers ».
Call us to discuss health insurance options that provide a more comprehensive private hospital benefit for obstetrics and pregnancy related services.
I am going to have a baby, is my level of cover appropriate?
To be eligible for benefits towards the hospitalisation of your newborn child you must have a family or single parent family policy.
So if you're having a baby and you have a single policy, you'll need to change to a single parent family or family policy at least two months before the baby's birth. This rule also applies to premature births.
If you wait until after the birth of your baby to change your cover, then your baby will have to serve all waiting periods.
A newborn won't be charged for hospital accommodation for the first 10 days of life unless they're admitted to a special care nursery. If there are multiple births, the first baby isn't charged for accommodation unless admitted as an inpatient. All other babies will be charged for accommodation so you need to ensure they are covered.
If you have a co-payment it will apply to the mother and admitted babies up to the per person limit (no co-payment applies to babies if you have Top Hospital with a co-payment).
If you're having a baby, Basic Hospital, Essential Hospital* and Essential Hospital Level 5 won't give you the level of cover you need. For private health insurance which covers obstetrics without restrictions try Family Hospital Level 5 or Top Hospital (with or without a co-payment); however a 12 month waiting period applies.
We recognise that planning for your child is very important. ahm offers a range of services to support you and your family. ahm's Total Health for Pregnancy program offers information and support to mothers planning a baby, during the pregnancy and up to the baby's 1st birthday. ahm's Hospital Substitute Program includes a Maternity Option, designed for new mothers and babies to leave hospital earlier and recover at home if clinically appropriate. We provide support services such as nappy supplies, home cleaning and / or early childhood nurses. These services are only available with ahm's Family Hospital*, Family Hospital Level 5 or Top Hospital (with or without a co-payment).
* Please note: From 1st August 2009, Family Hospital and Essential Hospital will be closed.
Find out more about our waiting periods ».
More about our Hospital Substitute Programs ».
More information on our range of hospital covers ».
Call us to discuss health insurance options that provide a more comprehensive private hospital benefit for obstetrics and pregnancy related services.
What is HandyClaim, how does it work?
With HandyClaim, you can elect to have benefits for your claims directly paid into the account of your choice (i.e. cheque, savings). It is not applicable to credit accounts.
You need to complete a HandyClaim authority to be able to claim online.
You can register for Handyclaim
online or download the Payment form and
complete the Handyclaim section. This form can be mailed free of
charge to:
Australian Health Management
Reply Paid 75885
Matraville NSW 2036
How do I make a claim?
You can make your claim in three ways:
- You can claim for extras online - just login here.
- Or you can download a claim form and
return it to ahm, free of charge, to;
Australian Health Management
Reply Paid 75885
Matraville NSW 2036
- You can call one of our Member Service officers on 134 246 and make your claim over the phone once your details are registered.
You can also claim your extras benefits at the point of service using HICAPS. Please see What is HICAPS? for more information.
For more information on claiming, see our page on How to Claim.
What is HICAPS?
Australian Health Management offers the services of HICAPS to our policy holders - an electronic, real time, claims and payments system offering the convenience of on-the-spot claims processing at your provider. If your provider has HICAPS you can just use your membership card to claim.
For more information on HICAPS, and to search for a participating provider, visit the HICAPS web site.
Where can I get a claim form?
Just download a claim form and return it
to ahm, free of charge, to;
Australian Health Management
Reply Paid 75885
Matraville NSW 2036
Can I claim for sports equipment?
Australian Health Management does not pay benefits on sports equipment purchased after 31 December 2002.
How do I claim for Herbal Medicine online?
We do not pay a benefit for expenditure on Herbal Medicine as of 1 April, 2003.
What pharmacy benefits can I claim?
Benefits are only payable on pharmacy items that are scripted medicines recorded on an Authority Prescription Form and are essential to the treatment of a particular illness/injury.
To find out more about your extras benefits click here.
I am going overseas, how do I suspend my policy?
If you're travelling overseas for more than 30 days, you can suspend your policy.
To suspend your policy the principal policy holder needs to send us a written or email request before you leave including the dates of travel. Weâ??ll get back to you before you leave to confirm the terms and conditions.
To reactivate your policy and ensure the waiting periods you've already served are preserved, the principal policy holder must provide proof of the date of entry back into Australia within 30 days of return.
NOTE: All people covered by the policy must be overseas for the policy to be suspended. You’ll still need to serve any waiting periods you may have had before leaving the country and no benefits will be paid for services provided during the suspension period. You may reinstate your policy in writing prior to your return to Australia to allow you to serve these waiting periods. Payment of premiums will be required for this period.
In some overseas countries the cost of medical services is very high. We strongly recommend you consider purchasing Travel Insurance to protect you from any emergency that may occur. ahm offers members discounts on the cost of travel insurance. Buy travel insurance online.
Suspending your policy may result in you being charged the Medicare Levy Surcharge (see Medicare Levy Surcharge). Consult your accountant, tax agent or the Australian Taxation Office.
What are Health Improvement Benefits?
At Australian Health Management, we want to help you improve your health which is why we offer our members Health Improvement benefits on all our Extras Covers, including Disease Management Association fees, Quit Smoking courses and certain Cancer Council products (UV products only). For more information check out our extras covers.
How do I change my level of cover?
You can change your cover in a number of ways:
- Change it online - just nominate your new cover. You need to be registered for online services to complete this form.
- Call ahm on 134 246.
- Download a change of cover form, complete it and send it to ahm.
Please note: when you change your existing cover you may have to serve waiting periods before you can claim for some services.
There is a 12-month waiting period for pre-existing ailments, illnesses or
conditions.
More information on waiting periods ».
How do I add an immediate family member to my policy?
An immediate family member can include your wife, husband or partner, and children under 21 years of age and living at home.
Children, who are single and full time students, can remain covered under the parent's family policy until they are aged 25 and are not required to live at home.
Dependents can be added to the family policy as follows:
- Download a change of cover form, select adding dependents, complete the new details and send the form to ahm; or
- Call ahm on 134 246.
How do I terminate my cover?
Only the principal policy holder and ahm have the right to terminate a policy. Notice of termination must be given in writing, effective from the date specified in the notice (being a date no earlier than the date of the notice). You're entitled to a refund of any premiums paid in advance of the date of termination.
Any policy holder or dependant over the age of 16 covered by a policy can terminate their own individual cover by giving notice in writing to ahm, effective from the date specified in the notice (being a date no earlier than the date of the notice) but cannot terminate the policy.
Cooling off period: If the principal policy holder terminates their policy within 30 days of joining and hasn't claimed a benefit during this period, they're entitled to a full refund.
Last updated 1 July 2009