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ahm health insurance review

ahm is a health insurance brand owned by Medibank. It sells hospital, extras and packaged cover online and by phone, to anyone in Australia, and its figures are reported as part of Medibank Private Limited, a for-profit, shareholder-owned company. PrivateHealth.gov.au lists ahm separately, with its own policies, but the performance data is Medibank's.

Here's what ahm's policies open to new members include, and what the combined Medibank and ahm figures from the Ombudsman and APRA show.

By Better Rate Mate Editorial Team · Last reviewed against PrivateHealth.gov.au and APRA data · No ratings of our own

ahm at a glance
ahm
Registered insurerahm health insurance
Who can joinOpen to anyone
Business structureFor-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
AmbulanceEmergency ambulance included on its open hospital policies
Sources: PrivateHealth.gov.au insurer profile and open product data (1 September 2026 extract); APRA Annual private health insurance membership and benefits statistics 2024–25 (hospital policies summed by Better Rate Mate).

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.

ahm: official performance data, 2024–25
MeasureahmIndustryReading
Share of all Ombudsman complaints23.9%Market share 26.5%In proportion to its size
Share of investigated complaints17.3%Market share 26.5%
Member retention (hospital cover)85.4%85.0%In line with industry
Benefits paid as % of premiums85.6%84.5%Better than industry
Management expenses % of premium income7.6%10.9%Better than industry
Hospital charges covered89.6%89.0%Better than industry
Medical services with no gap81.8%87.1%Weaker than industry
Medical services with no gap or a known gap96.2%97.1%Weaker than industry
Extras (general treatment) charges covered51.3%50.7%Better than industry
Source: ahm health insurance profile on PrivateHealth.gov.au (checked 28 September 2026), which republishes the Private Health Insurance Ombudsman's State of the Health Funds figures for 2024–25. These figures cover Medibank Private Limited, which includes ahm. "Reading" is our comparison with the industry result; differences under half a percentage point are treated as in line.

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

Hospital agreements by state
ACTNSWVICQLDSAWATASNT
Private hospitals5886452172061
Most held by any insurer7977458172372
Day hospitals6804442212081
Most held by any insurer99864503028112
An agreement hospital has a contract with the fund, which usually means lower or no out-of-pocket hospital costs. Source: PrivateHealth.gov.au insurer profile, 2024–25.

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 health insurance?

Medibank. PrivateHealth.gov.au lists ahm as operating on a for-profit basis and owned by Medibank, and APRA reports it within Medibank Private Limited.

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.

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.