| ahm | |
|---|---|
| Registered insurer | Medibank Private Limited (ahm is a Medibank brand) |
| Who can join | Open to anyone |
| Business structure | For-profit, owned by Medibank |
| Hospital policies (30 June 2025) | 1,532,670 (25.0% of all hospital policies), covering 3,032,305 people. Figure is for Medibank Private Limited, which includes ahm |
| Hospital tiers on sale (1 September 2026) | Gold, Silver Plus, Bronze Plus, Bronze, Basic Plus, Basic |
| Excess options on open hospital policies | $500, $750 |
| Age-based discount (18-29) | Offered on its open hospital policies |
| Ambulance | Emergency ambulance included on its open hospital policies |
| Question | What the official data shows |
|---|---|
| Out-of-pocket costs in hospital | 81.8% of in-hospital medical services had no gap for the member (industry 87.1%), and 89.6% of hospital charges were covered (industry 89.0%), 2024-25 |
| Waiting periods and pre-existing conditions | The legal maximums apply: 12 months for a pre-existing condition (signs or symptoms in the 6 months before you joined or upgraded) and for pregnancy and birth, 2 months for other hospital treatment. Every hospital policy open to new members in the Government's data at 1 October 2026, at every fund, used the 12-month pre-existing wait |
| Switching from another fund | Waits you've already served on the same or a lower level of cover carry across to ahm, and from it. Ask your old fund for a clearance certificate and keep the break between policies short |
| The Medicare Levy Surcharge | Excess options on its open hospital policies go up to $750, so all are within the $750 singles limit, and every policy was flagged as meeting the surcharge rules in the Government's data at 1 October 2026 |
| Adult children (dependants) | Up to age 30, studying or not, in the fund's own record (Government data, 1 October 2026). Adult dependants often need an extended family option |
| Claims experience | 23.9% of Ombudsman complaints about insurers on a 26.5% market share (ratio 0.90), and 17.3% of the complaints the Ombudsman investigated, 2024-25 |
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How ahm fits with Medibank
PrivateHealth.gov.au describes ahm as operating on a for-profit basis and owned by Medibank. The ahm brand is positioned by the company as simpler, digital-first cover. Its PrivateHealth.gov.au record lists overseas student cover but not overseas visitors or corporate products, which Medibank sells under its own name.
Because the two brands are one registered insurer, the complaints, retention, benefits and gap figures below are the same as on our Medibank review. What differs is the product range.
What ahm sells
At 1 September 2026 ahm's open hospital policies covered every tier: Gold, Silver Plus, Bronze Plus, Bronze, Basic Plus and Basic. Excess options on those policies were $500 and $750, so you won't find a low-excess ahm hospital policy. Every open hospital policy was listed with the age-based discount for people who join aged 18 to 29, and every one included emergency ambulance.
The $500 and $750 excesses are both within the Medicare Levy Surcharge limit for a one-person policy, so any ahm hospital policy qualifies as appropriate cover for the surcharge.
What the shared Medibank figures mean for ahm members
Medibank and ahm together drew 23.9% of Ombudsman complaints in 2024-25, below their 26.5% market share, and returned 85.6% of premiums as benefits (industry 84.5%) with management expenses of 7.6% (industry 10.9%).
The figure to note is medical gaps: 81.8% of in-hospital medical services had no gap, below the industry's 87.1%. That covers both brands. Ask your specialist whether they participate in the fund's gap arrangements before a planned admission.
ahm against the industry: 2024-25 data
Every year the Private Health Insurance Ombudsman compares all insurers on the same measures, and PrivateHealth.gov.au republishes the results on each insurer's profile. The table below is ahm's (reported at the level of the registered insurer), with the industry result beside each figure. Its complaints-to-market-share ratio was 0.90: a figure of 1.00 means complaints exactly in proportion to size.
| Measure | ahm | Industry | Reading |
|---|---|---|---|
| Share of all Ombudsman complaints | 23.9% | Market share 26.5% | In proportion to its size |
| Share of investigated complaints | 17.3% | Market share 26.5% | |
| Member retention (hospital cover) | 85.4% | 85.0% | In line with industry |
| Benefits paid as % of premiums | 85.6% | 84.5% | Better than industry |
| Management expenses % of premium income | 7.6% | 10.9% | Better than industry |
| Hospital charges covered | 89.6% | 89.0% | Better than industry |
| Medical services with no gap | 81.8% | 87.1% | Weaker than industry |
| Medical services with no gap or a known gap | 96.2% | 97.1% | Weaker than industry |
| Extras (general treatment) charges covered | 51.3% | 50.7% | Better than industry |
How to read it: complaint share is the fairest single comparison of service across funds of different sizes, because it's measured against market share. Benefits as a % of premiums shows how much of the premium pool went back to members as claims; a mutual that returns more is not necessarily cheaper, and a fund can move this figure by changing prices. The gap measures show how often members avoided an out-of-pocket medical bill after a hospital stay, which is what most people mean by "good cover".
Hospital agreements
| ACT | NSW | VIC | QLD | SA | WA | TAS | NT | |
|---|---|---|---|---|---|---|---|---|
| Private hospitals | 5 | 81 | 60 | 49 | 16 | 20 | 6 | 1 |
| Most held by any insurer | 7 | 95 | 73 | 63 | 17 | 23 | 7 | 1 |
| Day hospitals | 6 | 74 | 40 | 40 | 21 | 18 | 7 | 1 |
| Most held by any insurer | 11 | 109 | 73 | 58 | 35 | 28 | 12 | 2 |
What to check before you join ahm
- No excess below $500 on ahm's open hospital policies. If you want a $0 or $250 excess, look elsewhere.
- Complaints and gap figures are Medibank's combined numbers, not ahm-only.
- Check which 'Plus' categories a Bronze Plus or Silver Plus policy adds before comparing it with another fund's policy of the same name.
- Over 31 and joining for the first time? Work out your Lifetime Health Cover loading first, and if you earn over the threshold, check the Medicare Levy Surcharge you'd avoid.
Common questions about ahm
Who owns ahm, and who is it affiliated with?
Medibank. ahm is part of Medibank: ahm's website says ahm health insurance is a business of Medibank Private Limited, and PrivateHealth.gov.au lists ahm as owned by Medibank. APRA's register of private health insurers names Medibank Private Limited as the registered insurer; ahm isn't registered separately.
Are ahm and Medibank the same company?
Yes. ahm describes 'ahm health insurance' as Medibank Private Ltd trading as ahm health insurance, so both brands are the one registered insurer and share one set of Ombudsman and APRA figures. They sell different policies, so compare the policy rather than the brand.
Do ahm extras limits roll over?
Not as a rule. ahm says its extras annual limits normally reset on 1 July and unused limits expire. For the 2025/26 year it made an exception: members who held an ahm extras cover on 30 June 2026 and keep the same cover had unused routine dental limits rolled over into 2026/27, and members on super extras or a flexi limit cover had most other unused annual limits rolled over too (not optical or orthodontics with a separate limit, lifetime limits or hearing aid limits). ahm says the rollover isn't a permanent feature and isn't guaranteed in future years.
Does ahm cover ambulance?
Emergency ambulance is included on all of ahm's hospital policies open to new members, according to the Government's product data at 1 September 2026.
Does ahm have a Gold hospital policy?
Yes. ahm's open hospital policies at 1 September 2026 included Gold, as well as Silver Plus, Bronze Plus, Bronze, Basic Plus and Basic.
Other fund reviews
See every registered health insurer compared on complaints and benefits, or read how the private health insurance rebate and hospital cover tiers work.
General advice only. It doesn't consider your circumstances. Read the PDS and TMD before you decide.
This review is general information based on published government and regulator data. We don't rate or rank funds, and it doesn't consider your circumstances. Check a policy's Private Health Information Statement before you buy.