About your membership

When does my cover start?

Your cover will start from the date you apply; however, you may elect for your cover to start at a future date. Any applicable waiting periods will apply, unless you are switching from another fund and have served these waiting periods.

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Am I covered for doctor visits or outpatient services?

No. The government does not allow health funds to pay benefits for doctor visits or outpatient services.

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When do I receive a Rebate Statement?

We send out your Rebate statements in July every year. If you have not received yours by the end of July please email the fund.

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How do I change my address or personal details?

You can change contact details online such as telephone numbers, home or postal address (within the same state) or your email address, just login here. If you don't have a password, register here.

If you are changing your name or moving interstate please call the fund on 134 246.

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How do I order a new membership card?

You can request a new membership card online, or by calling us on 134 246.

To request a new membership card online, go to Request a new membership card and make a selection from the menu. Your request will be processed within 2 working days, and your new card issued within 7 to 10 working days.

You must be registered for Online Services to request a new membership card online. If you aren't registered for online services, you can register here.

Once we receive your request, your old membership card will be rendered invalid. This means you will not be able to access HICAPS until you receive your new card. However, you will still be able to make claims using our online services. If you recover your old card, please dispose of it carefully.

If your new card does not arrive within 10 working days, please call us on 134 246.

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How do I order a tax summary statement?

If registered for our online member services, you can request and print all your transactions for the past financial year. This transactions list is sufficient for ATO requirements. Login to my transactions.

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When will I get my annual health insurance tax statement?

We'll mail your annual tax and lifetime health cover statements early in July each year.

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What is the health fund ID code for tax purposes?

The health fund ID code for Australian Health Management is AHM.

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How do I change my account details?

Download our Payment form and complete and return it to the fund.

Mail the form free of charge to:
Australian Health Management
Reply Paid 75885
Matraville NSW 2036

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I have Essential Hospital and I am going to have a baby. What am I covered for?

If you have Essential Hospital, obstetric benefits are payable at a greatly reduced rate in a private hospital.

In a shared ward of a public hospital you are covered in full for accommodation and you can have the doctor of your choice.

If you elect to have your baby in a private hospital, a reduced level of benefits for accommodation is payable and no theatre fees or labour ward benefits are payable. You will incur significant out of pocket expenses if you elect a private hospital confinement.

To change to a product providing cover for agreed theatre and accommodation charges for the birth of your baby, you will need to serve a 12 month waiting period. This means that the baby's expected due date must fall after your 12 month waiting period. Therefore we suggest that you transfer your policy to Family Hospital or TOp Hospital which includes obstetric services, three (at the minimum) to four months prior to you commencing trying to conceive. This will ensure that you have served the 12 month waiting period, so that both yourself and the baby will be eligible for private hospital care.

If you are on a single policy which already covers obstetrics in full, you must transfer your membership to a family hospital cover at least two months prior to the baby's birth. This will ensure that you are eligible for benefits for possible hospitalisation of your new born. This also applies in the case of a premature birth. If you remain on your single membership you are covered for your confinement, however, should your baby require hospitalisation, no benefits will be payable.

Find out more about our waiting periods.

For health insurance which covers obstetrics without restrictions try Family Hospital or Top Hospital. These covers can be taken with or without a co-payment.

More information on our range of hospital covers.

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I am having a baby, when will it be covered?

To ensure you are eligible for benefits for the possible hospitalisation of your new born, you must transfer your membership to a family hospital cover at least two months prior to the baby''s birth. This also applies in the case of a premature birth.

If you remain on your single membership you are covered for your confinement, as long as your cover has no obstetrics restrictions. However, should your baby require hospitalisation, no benefits will be payable.

We recognise that planning for your child is very important. The fund offers a range of services to support you and your family. Our Total Health for Pregnancy program offers information and support to mothers planning a baby. Our Hospital Support Programs are designed for new mothers and provide you with a choice of where you would like to spend your recovery after the delivery of your baby. Our nursing staff work in conjunction with your doctor and hospital staff to decide whether the program suits you. We can provide you with support services that include nappy services, home cleaning, early childhood nurses. Hospital Support Programs .

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What is HandyClaim, how does it work?

With HandyClaim, you can elect to have benefits arising from claims directly paid into the account of your choice (ie cheque, savings). It is not applicable to credit accounts.

You need to complete a HandyClaim authority to be able to claim online. You can register for Handyclaim online or download the Payment form and complete the Handyclaim section. This form can be mailed free of charge to:
Australian Health Management
Reply Paid 75885
Matraville NSW 2036

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How do I make a claim?

You can make your claim in three ways:
  1. You can claim for extras online - just login here.
  2. Or you can download a claim form and return it to the fund, free of charge, to;
    Australian Health Management
    Reply Paid 75885
    Matraville NSW 2036
  3. You can call one of our Member Service officers on 134 246 and make your claim over the phone once your details are registered.

You can also claim your extras benefits at the point of service using HICAPS. Please see What is HICAPS? for more information.

For more information on claiming, see our page on How to Claim.

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What is HICAPS?

Australian Health Management offers the services of HICAPS to our members - an electronic, real time, claims and payments system offering the convenience of on-the-spot claims processing at your provider. If your provider has HICAPS you can just use your membership card to claim.

For more information on HICAPS, and to search for a participating provider, visit the HICAPS web site.

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Where can I get a claim form?

Just download a claim form and return it to the fund, free of charge, to;
Australian Health Management
Reply Paid 75885
Matraville NSW 2036

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Can I claim for sports equipment?

Australian Health Management does not pay benefits on sports equipment purchased after 31 December 2002.

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How do I claim for Herbal Medicine online?

We do not pay a benefit for expenditure on Herbal Medicine as of 1 April, 2003.

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What pharmacy benefits can I claim?

Benefits are only payable on pharmacy items that are scripted medicines recorded on an Authority Prescription Form and are essential to the treatment of a particular illness/injury.

To find out more about your extras benefits click here.

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I am going overseas, how do I suspend my membership?

Australian Health Management is happy to suspend your membership provided the following conditions are met: -

a) You are temporarily absent from Australia for at least 30 days
b) You provide a written or email application with the dates of travel (from and to) prior to departure to establish eligibility.

Upon your return to Australia, we will require you to:

a) Recommence your membership within 30 days with proof of entry being required (joining date is the actual date of entry back into Australia) in order to receive continuity of membership.
b) Serve the balance of any waiting periods if not completed before the suspension. This will also apply if you upgrade your cover.

In some overseas countries the cost of medical services is very high. We strongly recommend you consider taking out Travel Insurance to protect you from any emergency that may occur. Australian Health Management offers members discounts on the cost of travel insurance. Buy travel insurance online.

Please be aware that no claims will be paid for any services provided during the period of suspension.

It is also important to be aware of the Medicare Levy Surcharge in relation to suspensions for High Income Earners. To avoid liability to the surcharge a person is required to have continuous private patient hospital cover.

Therefore if you classify as a high income earner (see thresholds below), under Section 8 of the Medicare Levy Act 1986 and decide to suspend your policy, you will incur the Medicare Levy Surcharge for the number of days in the tax year during which hospital cover has been suspended and health fund benefits for hospital treatment are not payable.

  • If you are a single earning over $50,000 p.a.
  • As a family earning over $100,000 p.a.

Although the Health Department are confident in the advice they have provided, compliance with the Medicare Levy Surcharge is ultimately the responsibility of the Australian Taxation Office. Please contact the ATO enquiry line 132 861 for confirmation.

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What are Health Improvement Benefits?

At Australian Health Management, we want to help you improve your health which is why we offer our members Health Improvement benefits on all our Extras Covers, including Disease Management Association fees, Quit Smoking courses and certain Cancer Council products (UV products only). For more information check out our extras covers.

 

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How do I change my level of cover?

You can change your cover in a number of ways:
  • Change it online - just nominate your new cover. You need to be registered for online services to complete this form.
  • Call the fund on 134 246.
  • Download a change of cover form, complete it and send it to the fund.

Please note: when you change your existing cover you may have to serve waiting periods before you can claim for some services.

There is a 12-month waiting period for pre-existing ailments, illnesses or conditions.
More information on waiting periods>.

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How do I add a spouse/dependant to my cover?

Dependants can be covered on a family policy. This can include your wife, husband or partner, and children under 21 years of age and living at home.

Children who are single and full time students, can remain covered under the parent’s family policy until they are aged 25 and are not required to live at home.

Dependants can be added to the family policy as follows:

  • Download a change of cover form, select adding dependants, complete the new details and send the form to the fund; or
  • Call the fund on 134 246.

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How do I terminate my cover?

If you wish to terminate your health cover with Australian Health Management, you must notify us in writing.

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Last updated 1 May 2007