The Finance Algorithm

classic flexi silver plus

A Silver Plus hospital and extras policy from ahm.

Premiums for every state, cover type and excess this policy is sold with, and what it covers, from the statement ahm files with the government. Monthly, before the rebate and any Lifetime Health Cover loading.

From

$156.50a month

Single, NT, $750 excess, before the rebate.

Medicare levy surcharge
Exempts you
Excess options
$500, $750
Ambulance
Emergency only, call-out fees included, no limit
Who can join
Anyone

The Private Health Information Statement for this price, on PrivateHealth.gov.au.

Against every other Silver hospital and extras policy in NSW & ACT

Single cover, each policy at its cheapest excess, counting policies anyone can buy.

  1. Silver156 policies$292.7069th cheapest of 156
    $200.20$738.80
This policyEvery other Silver policy

Monthly premium by state and cover type

NSW prices also apply in the ACT. Each price in the tables opens its official Private Health Information Statement on PrivateHealth.gov.au, with a PDF to download.

Single premium in each state

NT$161
QLD$311
WA$246
SA$299
NSW$305
ACT$305
VIC$295
TAS$295
CheaperDearer

To the nearest dollar, a month before the rebate. The tables below have every price to the cent.

What a higher excess saves

Single cover in NSW & ACT, a month. The excess is what you pay towards a hospital stay before the policy pays.

  1. $500 excess
    $304.70
  2. $750 excess$12.00 less than $500 excess
    $292.70

31 of 38 clinical categories covered in full, 1 restricted

Restricted means the policy pays only the minimum, about what a public hospital charges, so a private hospital stay can leave a large bill. Not covered means the policy pays nothing for that treatment in hospital.

  • Covered in full31
  • Restricted1
  • Not covered6

Covered 31

  • Back, neck and spine
  • Blood
  • 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
  • Heart and vascular system
  • Hernia and appendix
  • Implantation of hearing devices
  • Insulin pumps
  • Joint reconstructions
  • Kidney and bladder
  • Lung and chest
  • Male reproductive system
  • Miscarriage and termination of pregnancy
  • Pain management
  • Pain management with device
  • Palliative care
  • Plastic and reconstructive surgery (medically necessary)
  • Podiatric surgery (provided by a registered podiatric surgeon)
  • Rehabilitation
  • Skin
  • Sleep studies
  • Tonsils, adenoids and grommets

Restricted 1

  • Hospital psychiatric services

Not covered 6

  • Assisted reproductive services
  • Cataracts
  • Dialysis for chronic kidney failure
  • Joint replacements
  • Pregnancy and birth
  • Weight loss surgery

Waiting periods

Pre-existing conditions
12 months
Psychiatric, rehabilitation and palliative care
2 months
All other hospital treatment
2 months

Excess and other costs

Excess options: $500, $750, paid when you are admitted. No excess for dependants.

Offers the age-based discount for people who join between 18 and 29.

Pays towards 11 of 27 standard services

Yearly limits, per person, against the typical policy

  1. General dentalshared with 9 other services
    $900typical policy $800
  2. Optical
    $250typical policy $220
  3. Physiotherapyshared with 9 other services
    $900typical policy $450
  4. Chiropracticshared with 9 other services
    $900typical policy $400
This policyTypical policy

What it pays on common claims, against the typical policy

  1. Periodic oral exam (item 012)
    $30.00typical policy $35.20
  2. Scale and clean (item 114)
    $50.00typical policy $66.85
  3. Single vision lenses and frames
    100% of the feetypical policy $220.00
  4. Physiotherapy, first visit
    $37.00typical policy $42.00
This policyTypical policy
ServiceWaiting periodYearly limit, per personExample benefits (all states)
General dental2 months$900shared with 9 other servicesPeriodic oral exam (item 012): $30.00Scale and clean (item 114): $50.00Fluoride treatment (item 121): $18.00Simple extraction (item 322): $98.00
Endodontic (root canals)12 months$900shared with 9 other servicesRoot canal filling (item 417): $119.55
Optical6 months$250Multifocal lenses and frames: 100%Single vision lenses and frames: 100%
Physiotherapy2 months$900shared with 9 other servicesPhysiotherapy, first visit: $37.00Physiotherapy, later visit: $30.00
Chiropractic2 months$900shared with 9 other servicesChiropractic, first visit: $35.00Chiropractic, later visit: $28.00
Podiatry2 months$900shared with 9 other servicesPodiatry, first visit: $31.00Podiatry, later visit: $25.00
Acupuncture2 months$900shared with 9 other servicesAcupuncture, first visit: $20.00
Remedial massage2 months$900shared with 9 other servicesRemedial massage, first visit: $20.00
Chinese herbal medicine2 months$900shared with 9 other servicesChinese herbal medicine, first visit: $20.00Chinese herbal medicine, later visit: $20.00
Orthotics2 months$900shared with 9 other servicesOrthotics: $150.00
Osteopathy2 months$900shared with 9 other servicesOsteopathy, first visit: $37.00Osteopathy, later visit: $30.00

Not covered: major dental, orthodontics, non-pbs medicines, psychology, hearing aids, blood glucose monitors, audiology, antenatal and postnatal, dietetics, exercise physiology, orthoptics, health management programs, home nursing, occupational therapy, speech therapy, vaccinations.

From the insurer: This cover features a Flexi Limit for the Included Extras which covers Routine & Complex Dental, Physiotherapy, Chiropractic, Osteopathy, Natural Therapies, Podiatry & Orthotics. This limit is loyalty based and increases up to a maximum of $1,300 after 5 continuous financial years of membership.

Example benefits are what the policy pays for that item at a provider without a special arrangement with the insurer; a percentage is of the fee charged. The typical policy is the middle one of the 708 extras policies on the market that aren't sold only through employers.

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Source: PrivateHealth.gov.au data (Private Health Insurance Ombudsman) via data.gov.au, licensed CC BY 3.0 AU. Normalised by The Finance Algorithm from the extract dated 1 Oct 2026, read on 23 Oct 2026.

Premiums are monthly and shown before the Australian Government rebate and any Lifetime Health Cover loading or age-based discount. Confirm the price and the cover with the insurer before you buy; the official statement for every policy is on PrivateHealth.gov.au. This is general information, not advice, and no insurer pays to be listed or ranked here.