The important stuff about your hospital cover
Because you've got hospital cover with ahm, we’ll help with bills for things when you’re admitted to hospital as a private patient like doctor’s fees, accommodation, operating fees and intensive care.
The types of services included on your hospital cover depend on the level of cover you've got. Generally, the higher the level of cover, the more services you can claim towards.
Your hospital cover allows you to choose your specialist if you go to a private hospital.
The amount we’re able to help with your bills will depend on what you’re claiming for, where you’re being treated, your cover and your waiting periods.
While we’ll help with the cost of services and treatments included in your cover, you may still need to pay an amount out-of-pocket. You may experience an out-of-pocket cost if the bill for your treatment or service exceeds the benefits that we pay towards these under your cover, as well as any benefits payable by Medicare.
Excess refers to the flat, up-front cost you may need to pay when you’re admitted to a hospital and you want to use your hospital cover. Excess options are different depending on your needs and budget.
Excess is displayed in this section along with membership year and when it resets.
Take note of any waiting periods that apply to your hospital cover. A waiting period is a set amount of time you must wait before we can help with the cost of items and services that are included under your cover. We can’t help out with any items, treatments or services you receive during a waiting period.
Switched from another fund?
We might be waiting for your old fund to send us some of your info. This can take up to 21 days, and once we receive it, we’ll honour any equivalent waiting periods you served for services on your old cover. Some waiting periods may apply if your old cover was at a lower level or didn’t include services which are included on your new cover.
'Pre-existing condition' refers to any ailment, illness or condition that you showed signs or symptoms of in the 6 months before you joined ahm or changed your cover.
If a Medical Practitioner appointed by ahm determines you have a pre-existing condition, you’ll need to wait 12 months from the date that you joined ahm or changed your cover before you can claim benefits for treatment for that service on your hospital cover if you’ve:
- taken out private hospital cover for the first time; or
- changed to a cover that has additional services, and you want to claim for these.
For more information on pre-existing conditions, check your member guide or contact us.
For more info, message us or call 13 42 46 weekdays, 8am – 7pm (AEST/AEDT).