Whether you’re looking for private health insurance for the very first time, or want to switch from your current provider, it’s important to compare options from a variety of health insurers, like GMHBA Health Insurance.
GMHBA Health Insurance Review
Comparing health funds enables you to determine if they provide the best option for your needs if they offer true value for money, and if they exclude cover for anything that might be important to you.
We’ve reviewed GMBHA’s features, benefits and exclusions, so you can decide if their policies will suit your unique requirements and your budget.
About GMHBA Private Health Insurance
GMHBA Limited is a not-for-profit, 100% member-based private health insurer with over 80 years’ experience and has become Australia’s leading regionally based health insurance company with more than 230,000 members.
GMHBA Hospital cover options
- Entry level cover as a private patient for in-hospital treatments, including accommodation in a shared room in a public hospital only.
- Covers GMHBA approved hospital-substitution and chronic disease management services, Joint investigations and reconstruction, cancer treatment, intensive and coronary care and rehabilitation services.
- Excludes cover for hospital treatments that Medicare pays no benefit for (for example, cosmetic surgery), also excludes operating theatre costs, insulin pump, dialysis, gastric banding and related services.
- Provides a moderate level of cover.
- Private room guarantee.
- The cover includes cancer treatment, intensive and coronary care and rehabilitation services.
- Excludes cover for dental implants and corneal implants performed in a hospital. Further excludes: Pregnancy, assisted reproductive services and birth related services, joint replacement, dialysis and gastric banding, and hospital treatments Medicare does not pay for.
- Most comprehensive hospital cover.
- Covers everything in Silver, plus: Joint investigations and reconstruction, pregnancy and birth related services, although you can choose to remove this and receive lower premiums.
- Covers also include dental implant surgery and rehabilitation services.
- Excludes cover for hospital treatments that Medicare does not pay any benefit for.
- No co-payments.
GMHB Combined Family Packages
The health fund strives to offer families total peace of mind through their comprehensive family packages. No Hospital excess is required for kids under the age of 21 and you receive up to 100% back on optical, preventative dental and ambulance subscription, up to your annual limits.
Compare GMHBA Extras Insurance
GMBHA Extras cover can provide benefits for treatments usually not covered by Medicare, like visits to the dentist, physio, or chiropractor. GMHBA offers three levels of Extras cover. These include Bronze, Silver, and Gold, and each gives you cover for a defined set of treatments and services.
- For each of the three GMHBA Extras policies, you can choose to claim from set benefits, or you can claim to get a certain percentage of the total cost back. If you choose the percentage policies, you will pay slightly higher premiums, but this could work out in your favour if you plan on claiming a lot or have specific health needs as you will not reach your benefit cap as quickly.
- There are more inexpensive set benefit options for each plan, allowing you to claim for the total cost of a service. But for longer or more expensive sessions, you could be reimbursed with a lower percentage of the costs.
- Certain services must be medically recommended by a registered treatment provider who may need to fill out part of claims form for you to get reimbursed.
Bronze Extras Cover
The most affordable option with cover for the three most popular extras: optical, general and preventative dental, and physiotherapy.
Silver Extras Cover
While the premiums are higher than Bronze, Silver Extras generally provides you with a wider range of treatments and services. These include general and major dental, optical, ambulance, psychology, pharmacy, dietetics, occupational therapy, hearings aids, and more.
Gold Extras Cover
Ideal for those able to afford to pay for comprehensive cover. It includes everything in Bronze and Silver Extras, as well as additional services like exercise physiology, antenatal and postnatal classes, and weight loss programs.
|What’s covered?||GMHBA Bronze Extras Cover||GMHBA Silver Extras Cover||GMHBA Gold Extras Cover|
|Percentage received back.||55%||65%||75%|
|Antenatal and postnatal classes|
|Blood glucose monitors|
|Chiropractic and osteopathy|
|Eye therapy and speech therapy|
|Fluoride dietary supplements|
|General dental services (includes basic services: check-ups, simple tooth extractions, etc.)|
|Major dental services (includes complex services: dentures, crowns, bridges, endodontics, etc.)|
|Naturopathy, homoeopathy, acupuncture, and remedial massage|
|Optical services||$150||$200||$250 (includes laser eye surgery)|
|Pharmacy and travel vaccinations|
|Physiotherapy, myotherapy, and hydrotherapy|
|Preventative health benefits|
|Sleep apnoea monitor|
|TENS monitor (TENS is transcutaneous electrical nerve stimulation, a therapy to relieve pain)|
|Weight loss programme|
GMHBA Additional Features & Benefits
- You gain access to their Connect Rewards program upon joining a combined hospital & extras policy. This reward program lets you accumulate Connect Dollars each year that you are with GHMBA. You can then use your Connect Dollars to pay for further services under your plan, even if you’ve reached your annual limits.
- You gain access to preventative health benefits, including Bowel cancer screening (1 every 2 years), quit smoking programmes (1 per year), nicotine replacement patches (a single 12-week patch course per year), and melanoma surveillance photography (1 per year).
GMHBA Waiting Periods and Excesses
Waiting periods apply to people taking out a new GMHBA policy, upgrading their policy or have a pre-existing medical condition, for example, cancer or diabetes.
- New policy or upgrading: 12 months.
- Obstetrics and Maternity: 12 months.
- Pre-existing injuries or illnesses: 12 months. Excluding psychiatric, rehabilitation and palliative care.
- Most extras benefits: 2 months.
- Optical, home and domestic aids: 6 months.
- Major dental services: 12 months.
- Health Appliances: 12 months.
- An excess allows you to share some of the costs associated with hospital admissions and in return, you pay lower premiums.
- Your hospital cover excess will be deducted from the benefit paid by the health fund.
- GMHBA members have the flexibility of choosing from a $0, $250 or $500 excess which will be deducted from the benefit amount they receive.
- There is no excess payable for child dependants under 21 on GMHBA’s Gold Hospital cover.
How do I claim online from my GMHBA health fund policy?
To claim online, you first need to sign into the GMHBA member self-service centre. After that, you need to fill in the details of your claim for services received in the last two months and already paid for. Lastly, save and store your receipts because they may be audited later.
Even though GMHBA provides many benefits, it’s important to shop around and compare their features, benefits, and exclusions to other health insurance companies and decide if they’re the best option for you and your family.
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