There is a list of Medicare Benefit Schedule (MBS) items associated with every type of hospital treatment. These items are grouped into clinical categories that vary between health insurers.
To ensure consistency across all health insurers, the Australian Government is standardising these clinical categories, as well as the list of MBS items within those categories. This will mean some MBS items on standard cover will be moving from one clinical category to another.
If these changes impact you, we'll communicate directly with you and send you a new product guide after 1 April 2019 with your new product name and standard clinical categories.
What item codes are impacted?
The information in the above table is current as at 14 January 2019
Will my premium be cheaper because of this change?
These government mandated changes won’t necessarily result in lower premiums. The purpose of this change is to simplify how hospital products are offered across the industry. We will communicate with our members about any premium changes in the coming months.
Why is ahm making changes to MBS items now when it has until 1 April 2020 to make this change?
We are making this change to comply with the government reforms on private health insurance. All insurers must comply with these reforms by 1 April 2020. At ahm we’re all about the simple bit, so we’re implementing this change from 1 April 2019 on some of our products to begin letting members know exactly where they stand in relation to the reforms.
I am planning on going to hospital – does this impact me?
The impact of these changes will depend on your circumstances. If you’re on a hospital product being changed on 1 April 2019, it’s important to know only a small number of MBS items on your hospital cover are impacted. Before you go to hospital, get in touch so we can tell you everything you need to know.
I am already booked in for surgery – does this impact me?
If you’re on a hospital product being changed on 1 April 2019, we’ll still pay benefits under your current hospital cover towards ongoing courses of treatments and for pre-booked hospital admissions scheduled to occur after 1 April 2019. The ongoing treatment or hospital admission must have been booked on or before 1 March 2019. You’ll simply need to provide us with written confirmation of the course of treatment or pre-booked hospital admission (e.g. a copy of your hospital admission form) - send it to firstname.lastname@example.org and we'll get in touch.