essentials flexi basic plus
A Basic 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
Single, NT, $750 excess, before the rebate.
- Medicare levy surcharge
- Exempts you
- Excess options
- None, $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 Basic hospital and extras policy in NSW & ACT
Single cover, each policy at its cheapest excess, counting policies anyone can buy.
- Basic95 policies$203.2076th cheapest of 95
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
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.
- No excess$211.45
- $750 excess$8.25 less than no excess$203.20
No excess
$750 excessat most $1,500 a year for couples and families
5 of 38 clinical categories covered in full, 3 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 full5
- Restricted3
- Not covered30
Covered 5
- Dental surgery
- Hernia and appendix
- Joint reconstructions
- Miscarriage and termination of pregnancy
- Tonsils, adenoids and grommets
Restricted 3
- Hospital psychiatric services
- Palliative care
- Rehabilitation
Not covered 30
- Assisted reproductive services
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
- 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
- Implantation of hearing devices
- Insulin pumps
- Joint replacements
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Pain management
- Pain management with device
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Skin
- Sleep studies
- 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: none, $750, paid when you are admitted.
Offers the age-based discount for people who join between 18 and 29.
From the insurer: This cover also includes Accident Override.
Pays towards 7 of 27 standard services
Yearly limits, per person, against the typical policy
- General dentalshared with 5 other services$700typical policy $800
- Optical$200typical policy $220
- Physiotherapyshared with 5 other services$700typical policy $450
- Chiropracticshared with 5 other services$700typical policy $400
What it pays on common claims, against the typical policy
- Periodic oral exam (item 012)$30.00typical policy $35.20
- Scale and clean (item 114)$50.00typical policy $66.85
- Single vision lenses and frames100% of the feetypical policy $220.00
- Physiotherapy, first visit$37.00typical policy $42.00
| Service | Waiting period | Yearly limit, per person | Example benefits (all states) |
|---|---|---|---|
| General dental | 2 months | $700shared with 5 other services | Periodic 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 | $700shared with 5 other services | Root canal filling (item 417): $119.55 |
| Optical | 6 months | $200 | Multifocal lenses and frames: 100%Single vision lenses and frames: 100% |
| Physiotherapy | 2 months | $700shared with 5 other services | Physiotherapy, first visit: $37.00Physiotherapy, later visit: $30.00 |
| Chiropractic | 2 months | $700shared with 5 other services | Chiropractic, first visit: $35.00Chiropractic, later visit: $28.00 |
| Remedial massage | 2 months | $700shared with 5 other services | Remedial massage, first visit: $20.00Remedial massage, later visit: $20.00 |
| Osteopathy | 2 months | $700shared with 5 other services | Osteopathy, first visit: $37.00Osteopathy, later visit: $30.00 |
Not covered: major dental, orthodontics, non-pbs medicines, podiatry, psychology, acupuncture, hearing aids, blood glucose monitors, audiology, antenatal and postnatal, chinese herbal medicine, dietetics, exercise physiology, orthoptics, health management programs, home nursing, occupational therapy, orthotics, speech therapy, vaccinations.
Other services: With essentials flexi basic plus you get one flexi limit to use on one, or all, of your included extras each financial year and a separate optical limit. The longer you’re a member with us, the more you can claim (capped at year 5). See your product guide for more details.
From the insurer: 100% back on optical, up to the annual limit (6 months waiting period apply)
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.