The Finance Algorithm

deluxe 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

$208.75a 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$368.45131st 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$214
QLD$391
WA$324
SA$360
NSW$381
ACT$381
VIC$381
TAS$377
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
    $381.35
  2. $750 excess$12.90 less than $500 excess
    $368.45

34 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 full34
  • Restricted1
  • Not covered3

Covered 34

  • Back, neck and spine
  • Blood
  • Bone, joint and muscle
  • Brain and nervous system
  • Breast surgery (medically necessary)
  • Cataracts
  • Chemotherapy, radiotherapy and immunotherapy for cancer
  • Dental surgery
  • Diabetes management (excluding insulin pumps)
  • Dialysis for chronic kidney failure
  • 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
  • Joint replacements
  • 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 3

  • Assisted reproductive services
  • 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 12 of 27 standard services

Yearly limits, per person, against the typical policy

  1. General dentalshared with 10 other services
    $1,100typical policy $800
  2. Major dentalshared with 10 other services
    $1,100typical policy $1,000
  3. Optical
    $300typical policy $220
  4. Physiotherapyshared with 10 other services
    $1,100typical policy $450
  5. Chiropracticshared with 10 other services
    $1,100typical policy $400
This policyTypical policy

What it pays on common claims, against the typical policy

  1. Periodic oral exam (item 012)
    $34.65typical policy $35.20
  2. Scale and clean (item 114)
    $74.45typical policy $66.85
  3. Full crown, veneered (item 615)
    $510.00typical policy $773.80
  4. Single vision lenses and frames
    100% of the feetypical policy $220.00
  5. Physiotherapy, first visit
    $40.00typical policy $42.00
This policyTypical policy
ServiceWaiting periodYearly limit, per personExample benefits (all states)
General dental2 months$1,100shared with 10 other servicesPeriodic oral exam (item 012): $34.65Scale and clean (item 114): $74.45Fluoride treatment (item 121): $25.50Simple extraction (item 322): $99.00
Major dental12 months$1,100shared with 10 other servicesFull crown, veneered (item 615): $510.00
Endodontic (root canals)12 months$1,100shared with 10 other servicesRoot canal filling (item 417): $120.55
Optical6 months$300Multifocal lenses and frames: 100%Single vision lenses and frames: 100%
Physiotherapy2 months$1,100shared with 10 other servicesPhysiotherapy, first visit: $40.00Physiotherapy, later visit: $30.00
Chiropractic2 months$1,100shared with 10 other servicesChiropractic, first visit: $40.00Chiropractic, later visit: $30.00
Podiatry2 months$1,100shared with 10 other servicesPodiatry, first visit: $31.00Podiatry, later visit: $25.00
Acupuncture2 months$1,100shared with 10 other servicesAcupuncture, first visit: $20.00Acupuncture, later visit: $20.00
Remedial massage2 months$1,100shared with 10 other servicesRemedial massage, first visit: $20.00Remedial massage, later visit: $20.00
Chinese herbal medicine2 months$1,100shared with 10 other servicesChinese herbal medicine, first visit: $20.00Chinese herbal medicine, later visit: $20.00
Orthotics2 months$1,100shared with 10 other servicesOrthotics: $150.00
Osteopathy2 months$1,100shared with 10 other servicesOsteopathy, first visit: $40.00Osteopathy, later visit: $30.00

Not covered: 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 & Major Dental, Physiotherapy, Chiropractic, Osteopathy, Natural Therapies, Podiatry & Orthotics. This limit is loyalty based & increases up to a maximum of $1,500 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.