ahm
lite flexi bronze plus
ahm
How $322.65 is worked out
- Premium as filed - $425.20 a month
- Government rebate - 24.1% of the premium (never of the loading): -$102.55
- A month - $322.65
Go to insurer no commission on this policy
Hospital: what is covered
Covered (21)
- Back, neck and spine
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Hernia and appendix
- Joint reconstructions
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Skin
- Tonsils, adenoids and grommets
Restricted (3)
- Hospital psychiatric services
- Palliative care
- Rehabilitation
Not covered (14)
- Assisted reproductive services
- Blood
- Cataracts
- Dialysis for chronic kidney failure
- Heart and vascular system
- Implantation of hearing devices
- Insulin pumps
- Joint replacements
- Pain management with device
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Sleep studies
- Weight loss surgery
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Bronze Plus
- Hospital - Private hospital, or a shared room in a public hospital
- Excess - Capped per person per year. $750 per person a year. No excess for dependants.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Offered for 18 to 29 year olds
- Accident cover - Yes
- Travel and accommodation benefits - No
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: This cover also includes Accident Override, unlimited medically necessary ambulance, no excess for Dependants and TENS machine (12 months waiting period, benefit replacement periods: 3 years for purchase and 1 year for hire).
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental | 2 months | Check-up (item 012): $30.00; Scale and clean (item 114): $50.00; Fluoride treatment (item 121): $18.00; Tooth extraction (item 322): $98.00 | $800 per person a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $119.55 | $800 per person a year (shared with other services) |
| Glasses and contact lenses | 6 months | Single vision glasses: 100% back; Multifocal glasses: 100% back | $200 per person a year |
| Prescriptions not on the PBS | 2 months | Prescription: $50.00 | $800 per person a year (shared with other services) |
| Physiotherapy | 2 months | First visit: $37.00; Follow-up visit: $30.00 | $800 per person a year (shared with other services) |
| Chiropractic | 2 months | First visit: $35.00; Follow-up visit: $28.00 | $800 per person a year (shared with other services) |
| Psychology | none | First visit: $71.00; Follow-up visit: $45.00 | $800 per person a year (shared with other services) |
| Acupuncture | 2 months | First visit: $20.00; Follow-up visit: $20.00 | $800 per person a year (shared with other services) |
| Remedial massage | 2 months | First visit: $20.00; Follow-up visit: $20.00 | $800 per person a year (shared with other services) |
| Antenatal and postnatal | none | First visit: $25.00; Follow-up visit: $25.00 | no yearly limit |
| Chinese herbal medicine | 2 months | First visit: $20.00; Follow-up visit: $20.00 | $800 per person a year (shared with other services) |
| Dietitian | 2 months | First visit: $32.00; Follow-up visit: $25.00 | $800 per person a year (shared with other services) |
| Health management programs | 2 months | Benefit: $8.00 | $800 per person a year (shared with other services) |
| Osteopathy | 2 months | First visit: $37.00; Follow-up visit: $30.00 | $800 per person a year (shared with other services) |
| Speech therapy | 2 months | First visit: $50.00; Follow-up visit: $26.00 | $800 per person a year (shared with other services) |
Not covered: Major dental, Braces, Podiatry, Hearing aids, Blood glucose monitors, Audiology, Exercise physiology, Eye therapy (orthoptics), Home nursing, Occupational therapy, Orthotics, Vaccinations.
Other services, as filed: With lite flexi bronze plus you get one flexi limit to use on one, or all, of your included extras each financial year plus a separate optical limit. The longer you’re a member with us, the more you can claim (capped at 5 year). The product also includes: - Hypnotherapy (initial consultation $71, subsequent consultation $45, group consultation $45, waiting period 2 months) - Dietitian and nutritionist (initial consultation $32, subsequent consultation $25, waiting period 2 months), weight loss class / course ($8/$80, waiting period 2 months) - Prenatal and postnatal services and birthing courses, provided by a registered midwife (waiting period 2 months, defined benefits) - Range of Health Improvement Benefits including yoga, Pilates quit smoking, disease management association fees, stress management courses, Cancer Council UV products, preventative tests, scans and screenings, health checks and swimming lessons (for ages 0 - 17 years) etc. Waiting period 2 months. Defined benefits. - Counselling services. No waiting period. Defined benefits. Conditions and annual limits apply. See your product guide for more details.
Ambulance
Emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in Northern Territory
ahm has agreements with 2 private hospitals here, as filed with the Ombudsman.
The list
- Darwin Day Surgery - Wanguri (day hospital)
- Darwin Private Hospital - Tiwi
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
85.4% is the Commonwealth Ombudsman's figure for Medibank, the insurer of ahm, in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement J106/DFUY2Y, filed by ahm health insurance, issued 1 Apr 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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