We pay benefits towards the following services but please remember it is important that you should contact us prior to any major treatments, especially staying in the hospital.
- Doctors*: We pay 100% of the Medicare Benefits Schedule fee (MBS Fee) for General Practitioners' standard consultations (doctors may charge above the MBS Fee) and 85% of the MBS Fee for other out-of-hospital services.
- Hospitals*: Including accommodation, operating theatre and same day services.
- Prescription Medicines*: You pay a set amount towards the cost (PBS amount) and we pay the rest, up to a maximum of $50 per item to a maximum of $300 for a single membership ($600 family). As an overseas student, you may face significant out of pocket costs if you need treatment with "high cost" pharmaceuticals, particularly oncology (cancer) treatment.
- Pathology and X-rays*: We pay 85% of the MBS Fee for out-of-hospital services or 100% of the MBS Fee for in-hospital services.
- Emergency ambulance transport*: We cover 100% of the cost of emergency transportation in an ambulance.
- Prosthetic devices: We cover the full cost of any No Gap prostheses and the minimum benefit for Gap permitted prostheses. Surgically implanted prostheses could include, for example, stents for coronary arteries, artificial hips/knees or titanium plates/screws for reconstructions & bone breaks.
Waiting periods may apply. For full details of what you’re covered for, download a copy of the ahm OSHC policy document
*Important: Waiting periods apply for pre-existing conditions. That is, an ailment, illness or condition which either you or one of your dependants have, the signs or symptoms of which, in the opinion of a Medical Practitioner appointed by ahm, existed at any time in the 6 month period before you or your dependant arrived in Australia. For pre-existing medical conditions and pregnancy related services including childbirth there is a waiting period of 12 months. That means you won't be covered for these conditions until the waiting period is over. For a pre-existing condition of a psychiatric nature, there is a waiting period of 2 months.
More information about waiting periods can be found in the ahm OSHC policy document