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Compare AHM health insurance
How AHM rates for member complaints, out-of-pocket costs and ambulance cover.
Last updated: 13 May 2024
Who is AHM?
AHM originated in Wollongong, NSW 40 years ago, and was bought by Medibank in 2009. It is a for-profit health fund with 500,000 members and promotes its ‘uncomplicated’ cover and ‘digital first service’.
Phone: 134 246
Website: ahm.com.au
How to save on your AHM health insurance premium
AHM doesn’t offer any discounts for prepaying your premium or paying your premium by direct debit, but they do give discounts to young people who buy health insurance before they turn 30.
Review, switch and save
If you want to check whether you’re getting the best deal, you can review your health insurance at any time (in fact, it’s good practice to do it at least once a year). To help you wade through the seemingly infinite options, our insurance experts developed a tool that lets you compare health insurance policies based on your needs so you can find cover that works for you, and potentially save yourself hundreds.
Does AHM get many complaints from members?
AHM has a Medium complaints rating.
When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don’t get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.
How good is AHM’s gap cover?
A medical gap is the difference between Medicare’s recommended fee and what your doctor actually charges for a treatment or service.
Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called ‘no gap agreements’, or part of that gap, which are called ‘known gap agreements’ (these will have lower out-of-pocket costs, usually less than $500).
Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.
Rating scale
- Well above average
- Above average
- Average
- Below average
- Well below average
Text-only accessible version
Australian Capital Territory
Average.
New South Wales
Below average.
Northern Territory
Average.
Queensland
Below average.
South Australia
Below average.
Tasmania
Average.
Victoria
Below average.
Western Australia
Well below average.
How many hospital agreements does AHM have in each state?
The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you’re treated.
The table below shows how many hospital agreements AHM has in each state and territory compared to the fund with the highest number (the industry maximum). Note that public hospitals don’t have agreements with specific funds and are generally treated as though they’re agreement hospitals.
Text-only accessible version
AHM private hospital agreements
In the Australian Capital Territory it has…
5 private hospital agreements out of an industry maximum of 6.
6 day hospital agreements out of an industry maximum of 9.
In New South Wales it has…
86 private hospital agreements out of an industry maximum of 92.
76 day hospital agreements out of an industry maximum of 105.
In the Northern Territory it has…
1 private hospital agreement out of an industry maximum of 1.
1 day hospital agreement out of an industry maximum of 2.
In Queensland it has…
50 private hospital agreements out of an industry maximum of 58.
43 day hospital agreements out of an industry maximum of 54.
In South Australia it has…
20 private hospital agreements out of an industry maximum of 20.
21 day hospital agreements out of an industry maximum of 31.
In Tasmania it has…
8 private hospital agreements out of an industry maximum of 8.
7 day hospital agreements out of an industry maximum of 9.
In Victoria it has…
64 private hospital agreements out of an industry maximum of 71.
51 day hospital agreements out of an industry maximum of 80.
In Western Australia it has…
21 private hospital agreements out of an industry maximum of 23.
20 day hospital agreements out of an industry maximum of 29.
Does AHM offer ambulance cover?
All AHM hospital and combined policies cover emergency ambulance in all states.
Cover is capped for Starter Basic and Lite Basic Plus policies – one claim per financial year for a singles policy, two claims per financial year for a couples or family policy.
Do you need ambulance cover?
Depending on where you live, you may not need a policy with ambulance cover.
- In Queensland and Tasmania emergency ambulance services are covered by the state government.
- In NSW and the ACT all hospital policies come with emergency ambulance cover – so you’ll be covered with any hospital or combined policy you select.
- In South Australia, Victoria and the Northern Territory you can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover.
- In rural Western Australia you can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover.
- In metropolitan Western Australia if you want to be covered for ambulance, you need to buy a health insurance policy with ambulance cover.
Does AHM offer family policies that cover adult children?
- Adult children are covered on family policies for free until they turn 21.
- Full-time students are covered on family policies for free until they turn 31.
- Adult children younger than 31 can be covered on extended family policies for an extra cost.
Does AHM let you claim online or in-app?
AHM allows online claiming for all services.
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