ahm

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About ahm

What is ahm?

ahm health insurance (ahm) is a private health insurer that operates as an open health fund. 

Background 

Established in Wollongong NSW 40 years ago, ahm was taken over by Medibank Private in 2009. 

Currently, it has over 950,000 members. 

Who can join ahm?

Anyone can take out health cover with ahm because it is an open health fund.

What products does ahm offer?

ahm offers:

• Hospital Cover
• Extras Cover
• Combined Hospital and Extras Cover
• Overseas Student Health Cover.

Do ahm policies include Ambulance Cover?

ahm includes medically necessary Ambulance Cover with: 

• Hospital Cover
• Combined Hospital and Extras Cover.

Check your policy to see whether Ambulance Cover is capped.

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Is ahm a not-for-profit health insurer?

No. ahm is a for-profit health insurer.

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Does ahm operate in all Australian states and territories?

Yes. ahm operates in all Australian states and territories.

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How does ahm Hospital Cover compare with other insurers?

Benchmarks	ahm	Industry average
Member retention for Hospital Cover	86.9%	86.9%
% hospital-related charges covered	90.0%	89.9%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

Note: As ahm is a subsidiary of Medibank, these statistics are for Medibank.

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Does ahm have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. ahm has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

Location	Number of private Agreement Hospitals	Industry maximum
ACT	5	6
NSW	92	98
NT	1	2
QLD	50	60
SA	20	23
TAS	9	9
VIC	65	76
WA	21	24

ahm also has agreements with a number of day hospitals so it can provide services at low cost or with no out-of-pocket costs:

Location	Number of day Agreement Hospitals	Industry maximum
ACT	6	9
NSW	77	103
NT	1	2
QLD	44	57
SA	21	30
TAS	6	8
VIC	53	79
WA	20	24

Source: ahm: performance

Note: As ahm is a subsidiary of Medibank, these statistics are for Medibank.

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How does ahm Extras Cover compare with other insurers?

Benchmark	ahm	Industry average
% Extras Cover charges covered	52.6%	51.1%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

Note: As ahm is a subsidiary of Medibank, these statistics are for Medibank.

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How does ahm compare with other private health insurers?

Benchmarks	ahm	Industry average
Market share	27.1%	–
% services with no gap	83.8%	88.3%
% services with no gap or where known gap payment made	96.5%	97.2%
Market share of complaints to the PHIO	29.9%	3.1%
% complaints investigated by the PHIO	19.2%	3.1%
Benefits as a % of contributions	83.4%	80.5%
Management expenses as a % of contribution income	7.4%	13.1%
Management expenses per average policy	$263	$592

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

Note: As ahm is a subsidiary of Medibank, these statistics are for Medibank.

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Is ahm a member of any industry associations?

Yes. Through its parent company Medibank, ahm is a member of Private Healthcare Australia (PHA). This body represents 21 registered health insurers and 98% of people covered by private health insurance.

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Does ahm let you claim online or via an app?

Yes. ahm allows you to make a claim online for most (but not all) services. Use its online portal with your membership number or the ahm app.

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How to contact ahm

Phone:

134 246

Website:

https://ahm.com.au/

SMS:

0439 183 474

Address:

Not available

Postal address:

Locked Bag 4
WETHERILL PARK NSW 2164

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