As part of the Medibank family we have a team of health experts who are constantly monitoring developments and following the advice from the Australian Government Department of Health. Rest assured we’ll continue to support you and cover you for health treatments included in your ahm policy.
Our dedicated team are available to answer your questions on: 13 42 46 or on live chat. We’re here from 8am – 7pm Monday to Friday (AEDT).
Will my elective surgery be affected?
As of midnight, on Wednesday 25 March 2020, all non-urgent elective surgeries in Public Hospitals are suspended, with Private Hospitals doing the same on 1 April 2020.
Announced by the Prime Minister, this decision will ensure that all health services can focus their efforts and resources on assisting communities for any incoming coronavirus cases.
Please note, emergency surgeries WILL NOT be affected by this announcement.
You will likely hear from your specialist regarding these changes. However, if you have surgery booked this week, or any other concerns, we recommend calling your specialist or admitting hospital as soon as possible to see how this may affect you.
During this time, it’s vital that the most vulnerable members of our community receive the support they may need. If you have any questions please reach out to the team on 13 42 46 or on live chat. We’re here from 8am – 7pm Monday to Friday (AEDT).
What are my options for managing my cover if I’m financially impacted by COVID-19?
We are very mindful that the current situation with COVID-19 may place some customers under financial pressure, which is why we're introducing an initial support package.
Regardless of your level of existing hospital cover, ahm will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes (standard waiting periods apply).
We have also introduced a financial hardship policy, which includes suspension to customers’ policies.
We would encourage people who are suffering financial hardship to contact us for more information.
So what happens if I’m hospitalised because of coronavirus?
Regardless of your level of existing hospital cover, ahm will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes. This includes customers with Basic and Bronze levels of cover where currently excluded. If you are admitted to a public hospital and treated as a public patient, your treatment is fully covered by Medicare and you don’t have to use your private health insurance. In fact, you may end up paying extra if you do use your private cover (for instance, if your policy includes an excess).
Please check with your hospital.
During this time, it’s more important than ever that you feel supported in any decisions involving your health. If you have any questions, please reach out to the team on 13 42 46 or on live chat. We’re here from 8am – 7pm Monday to Friday (AEDT).
Will there be any out-of-pocket costs if I’m admitted to hospital?
If you are admitted to hospital and treated as a private patient, you may have some out-of-pocket expenses.
For treatments included under your policy, Medicare and ahm will jointly cover the cost of each MBS-listed item that was provided in your treatment, up to the MBS fee (the set government fee).
However, if your treating doctors choose to charge more than the MBS fee, you may have to pay the gap amount as an out-of-pocket cost. Read more about how ahm’s GapCover scheme can help reduce some of these out-of-pocket costs.
Also, keep in mind that some private hospitals charge an emergency department facility fee. Because this is generally a fee that the hospital charges an outpatient, it isn’t usually covered by private health hospital insurance.
And if your policy includes an excess, then this is also payable by you.
Regardless of a members’ level of existing hospital cover, ahm will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes.
Will hospital wait times be affected by what's happening now?
It's likely wait times will be affected but this will depend on the hospital, and the state in which you'll be treated. As of 25 March 2020, elective surgeries are suspended, with Private Hospitals doing the same on 1 April 2020. Which means there will be longer wait times for non-urgent procedures. If you are unsure of an upcoming procedure, please contact your hospital directly.
Aside from ahm, where else can I find support?
Understandably, these are stressful and uncertain times. Even if you don't feel ill, you may still find it difficult to cope with things like social distancing and any potential financial pressures.
You may find it worthwhile to visit Beyond Blue for some very helpful information to help look after your mental health.
Does ahm pay benefits towards face masks?
Unfortunately, benefits will not be payable for face masks that are purchased to avoid contracting COVID-19 (or any other ailment) under any private health cover.
Is it safe to keep other medical services like the dentist?
The most recent advice from the Australian Government is that health services like dentists, physiotherapists can remain open at this time.
This may change at any time, so please contact your health service provider directly to confirm their availability.
It's also worth asking what additional measures they have in place to ensure everyone's safety.
Why should I keep extras?
The most recent advice from the Australian Government is that health services like dentists, optical providers and physiotherapists can remain open at this time.
We all hope COVID-19 is relatively short lived and we can go back to normal conditions later in the year. By keeping your extras cover, you can continue to access extras services such as dental, optical and physiotherapy, which continue to remain open for business. It also means you'll avoid re-serving waiting periods, which could range from 2 months to 2 years if you were to cancel your policy and then re-join.
Keeping your Extras cover will also enable you to maintain any loyalty limits and/or life time limits you may have accrued.
Why should I keep hospital Cover?
We all hope COVID-19 is relatively short lived and we can go back to normal conditions later in the year. With this in mind, it is important to understand that once a policy is terminated, you may be required to re-serve waiting periods already served. For example, if you have a pre-existing condition (PEC) and cancel your cover, you may need to serve a 12 month waiting period when you re-join. Or if you choose to downgrade your cover now and upgrade when the service is required, you may need to re-serve waiting periods for standard clinical categories not included in the lower cover.
Whilst elective surgeries have been temporarily cancelled due to COVID-19, your private hospital insurance will still cover you for any urgent admissions, where the service is included or restricted on your policy and you have served any required waiting period.
Category 1 and some category 2 elective surgeries are still being performed – and for some our customers they will need their cover for those surgeries.
Will ahm pay benefits towards telehealth for Psychology?
Yes, ahm will pay benefits towards psychology services delivered via individual (one-on-one) telehealth consultation from 30 March 2020 through to 30 September 2020.
This service will be eligible for ahm members who have an Extras product that includes cover for clinical psychology, and are:
- undergoing an existing course of treatment, and who have seen the psychologist providing the teleconsultation over the past six months, or;
- new patients who have had telepsychology services recommended by their GP (members will not be required to provide proof of their general practitioner’s recommendation).
The benefits paid towards the psychology telehealth consultation will be the same as a face-to-face consultation.
What if I need other extras services, such as Physiotherapy during this lock down?
ahm is looking into extending benefit payments to some other allied health professions, such as Physiotherapy, over the coming weeks.
That means customers will still be able to use their Extras.
Article last updated: 2 April 2020