If your provider offers the below services via phone or video call and they are included on your extras cover, we’ll pay benefits towards individual telehealth consultations for services received after 30 March 2020 and online exercise classes accessed between 1 July 2021 and 30 June 2023.
The current services available are:
- Psychology (excludes psychology consultations that form part of a mental health plan where Medicare benefits are payable)
- Counselling (excludes counselling consultations that form part of a mental health plan where Medicare benefits are payable)
- Physiotherapy
- Exercise physiology
- Speech therapy
- Diet and nutrition
- Podiatry
- Occupational therapy
- Lactation consultations
Check your product guide to see if the service is included on your extras cover and if any waiting periods and annual limits apply.
Just so you know, we’ll only pay benefits towards dental and Orthodontic treatments that are delivered in person, and by a recognised provider. Dental and Orthodontic treatments are subject to annual limits, lifetime limits and waiting periods, check your product guide for more info.
Things you need to know before making a claim
- Please ask your provider for a receipt so you can claim any benefits back as you may be required to pay for the service in full at the time of your consultation.
- If you’re undergoing an existing course of treatment, you must receive telehealth consultations from the same provider you’ve received treatment from in the last 6 months.
- If you’re a new patient or your usual provider isn’t available, you should consult with your GP before accessing telehealth consultations.
What are telehealth services?
Telehealth refers to using phone or video calls to provide you with health support, without having to see your provider in person.
Are these services suitable for me?
You should always consult a trusted health care professional before making decisions about your health care. The information we’ve provided about these telehealth services is not health care advice and isn’t tailored to meet your individual health care needs.
What criteria do I need to meet to claim Psychology telehealth services?
These benefits are available to members who have an extras product that includes psychology and where the following eligibility criteria are met:
- Patients undergoing an existing course of treatment must receive telehealth consultations from the same provider they’ve received treatment from in the last 6 months.
- New patients should consult with their general practitioner before accessing telehealth consultations.
- The service is undertaken in accordance with Australian Psychological Society guidelines
- Excludes psychology consultations that form part of a mental health plan where Medicare benefits are payable.
These benefits will be subject to any waiting periods and annual limits.
How do I claim on telehealth services?
There are a few ways that you can make a claim including online, through the ahm mobile app, via email or mail, as long as the service was received after 30 March 2020.
Don’t forget to ask your provider to email or post the receipt to you.
Please note that as HICAPs facilities are not available for virtual transactions, this will most likely mean that you will need to pay for the treatment in full and then make your claim with us to receive any money back.
To claim online:
- Log in to your account and go to ‘Make a claim'. Make sure you have your receipt with you.
- Select the relevant service you want to claim for and select 'Start claim'.
- Enter the provider name or number, who went, the date of service, item number (select either initial or subsequent telehealth consultation and for exercise physiology, select ‘exercise physiology by teleconsultation’) and the amount paid.
To claim via app:
- Log in to the ahm mobile app and go to the ‘Claims’ tab. Make sure you have your receipt with you.
- Select ‘Start claim’.
- If there is more than one person on your policy, you’ll need to select who received the service.
- Enter the service, provider name or number and claim details including the date of the service, item number (select either initial or subsequent telehealth consultation and for exercise physiology, select ‘exercise physiology by teleconsultation’) and amount paid.
For online claims:
- Download and complete a claim form.
- Upload your form and receipt by logging in to your account.
For mail claims:
- Fill in a claim form and post it to us
- Make sure you attach your original receipts (these aren’t returned so make sure to keep a copy)
Any benefit will be deposited in your bank account.
Claim forms can be downloaded from forms and guides
Please note that you’ll need to keep original receipts for 3 years for audit purposes.
What will the benefits be?
If you’re on an eligible extras cover, any benefits we'll pay towards telehealth consultations will be the same as face-to-face consultations and subject to any waiting periods and annual limits.
Check your product guide to see if these services are included on your extras cover and if any waiting periods or annual limits apply.
Will the benefit payments be back dated?
We’ll pay benefits for services received after 30 March 2020 for all telehealth services including Psychology, Diet and nutrition, Speech therapy, Physiotherapy, Occupational therapy, Podiatry and Exercise Physiology.
Check your product guide to see if these services are included on your extras cover and if any waiting periods or annual limits apply.
Why have you not put this in place earlier?
Our members' safety, privacy and quality of care is of utmost importance to us. When approving certain services for inclusion, we take the necessary time and effort to ensure that our members are only provided with evidence-based treatments. We also ensure that providers have the appropriate clinical guidelines and support in place to ensure the highest standard of care and support.
Will all providers be offering these telehealth services?
We recommend you contact your recognised provider directly because is it up to individual providers of whether or not they provide these services.
Will telehealth be available for other Extras services? And if so, when?
We are constantly looking for ways to expand our products and services for ahm members. We’re also continuing to develop ways to provide even more support for our members during the COVID-19 pandemic. We’ll be in touch when we have more to share and we’ll be making regular updates on our website as things evolve.
What if I don't have those services included on my product, am I still eligible?
To be eligible to claim benefits on the new telehealth consultations, these services must be included on your extras cover. Check your product guide to see if these services are included on your extras cover and if any waiting periods or annual limits apply.
If they are not included on your extras cover but you would still like to use these telehealth services, you’ll be out of pocket for 100% of the cost.
Please contact us to discuss whether you are on the right extras cover for your needs.
What if I have suspended my membership?
You are not able to make a claim whilst your policy is suspended. To start receiving any benefits towards eligible services, you’ll need to reactivate your membership and pay your premiums from this date. Contact us on 13 42 46 or chat weekdays from 9am – 6pm (AEST/AEDT).
Claiming for online exercise classes
Can’t access your regular exercise classes right now? If have Health Improvement Benefits included under your extras cover, you may be able to claim benefits towards online exercise classes which replace face to face services that you’d normally access. As with all Health Improvement Benefit claims, the service needs to be recommended by your health practitioner before you start the class or program. You also need to submit a Health Improvement Benefit approval form signed by your health practitioner along with your claim and dated before your date of service.
You may be able to claim on instructor-led online classes that are being used to substitute an in-person service including:
- Gym classes or memberships
- Personal Trainer
- Exercise physiologist
- Aqua aerobics
- Boot Camp
The last eligible date of service to claim online exercise classes is 30 June 2023. This temporary service has expired. All Health Improvement Benefits will return back to face to face services only.
Check your product guide to see if have Health Improvement Benefits included in your cover. Excludes fitness app subscriptions. Annual limits and waiting periods apply.
Page last updated: 24 April 2024