The Finance Algorithm

starter flexi basic

A Basic 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

$68.75a month

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

Medicare levy surcharge
Exempts you
Excess options
$500, $750
Ambulance
Emergency only, call-out fees included
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.

  1. Basic95 policies$158.0521st cheapest of 95
    $127.40$304.30
This policyEvery other Basic 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$70
QLD$161
WA$122
SA$154
NSW$165
ACT$165
VIC$161
TAS$165
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
    $164.80
  2. $750 excess$6.75 less than $500 excess
    $158.05

0 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.

  • Restricted3
  • Not covered35

Restricted 3

  • Hospital psychiatric services
  • Palliative care
  • Rehabilitation

Not covered 35

  • 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
  • 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
  • Plastic and reconstructive surgery (medically necessary)
  • Podiatric surgery (provided by a registered podiatric surgeon)
  • Pregnancy and birth
  • Skin
  • Sleep studies
  • Tonsils, adenoids and grommets
  • 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.

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

From the insurer: This cover also includes Accident Override and limited medically necessary ambulance.

Pays towards 5 of 27 standard services

Yearly limits, per person, against the typical policy

  1. General dentalshared with 4 other services
    $550typical policy $800
  2. Physiotherapyshared with 4 other services
    $550typical policy $450
  3. Chiropracticshared with 4 other services
    $550typical policy $400
This policyTypical policy

What it pays on common claims, against the typical policy

  1. Periodic oral exam (item 012)
    $27.55typical policy $35.20
  2. Scale and clean (item 114)
    $50.00typical policy $66.85
  3. Physiotherapy, first visit
    $30.00typical policy $42.00
This policyTypical policy
ServiceWaiting periodYearly limit, per personExample benefits (all states)
General dental2 months$550shared with 4 other servicesPeriodic oral exam (item 012): $27.55Scale and clean (item 114): $50.00Fluoride treatment (item 121): $18.00Simple extraction (item 322): $98.00
Endodontic (root canals)12 months$550shared with 4 other servicesRoot canal filling (item 417): $119.55
Physiotherapy2 months$550shared with 4 other servicesPhysiotherapy, first visit: $30.00Physiotherapy, later visit: $20.00
Chiropractic2 months$550shared with 4 other servicesChiropractic, first visit: $30.00Chiropractic, later visit: $20.00
Osteopathy2 months$550shared with 4 other servicesOsteopathy, first visit: $30.00Osteopathy, later visit: $20.00

Not covered: major dental, orthodontics, optical, non-pbs medicines, podiatry, psychology, acupuncture, remedial massage, 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.

From the insurer: With starter flexi basic you get one flexi limit to use on one, or all, of your included extras each financial year. The longer you're a member with us, the more you can claim (capped at year 5). See your product guide for more details.

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.