GMHBA Health Insurance Review

Published: October 29, 2019

GMHBA is a not-for-profit health insurance company with over 85 years’ experience. With 2.3% of the market share, you’ll find GMHBA to be one of the major health funds in Australia. Their health insurance products include a variety of Hospital and Extras policies, which you can mix and match to suit your requirements and budget.

Whether you’re purchasing private health insurance for the very first time, or want to switch from your current provider, it’s important to compare options.

In this review, we take a detailed look at GMHBA's products, features and the pros and cons of choosing them as your health fund.

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About GMHBA private health insurance

GMHBA Limited is a 100% member-based, not-for-profit private health insurer with more than 230,000 members. The company started in 1934 in Geelong, Vitoria, where its head office is still located. With growing demand, the insurer expanded to new branches all across Australia.

At the end of the 2019 financial year, the company reportedly paid $601 million in annual benefits. For every dollar they received in premiums, they paid 86 cents back to members in benefits.

Select GMHBA health insurance policies now include AIA Vitality membership! AIA Vitality and GMHBA have partnered together, to offer members access to the globally renowned wellness program, that rewards you for being healthy.

Health insurance policies

The company offers a wide range of health insurance policies to meet your requirements at different stages of your life, whether you're single, pregnant, a couple or family.

GMHBA Hospital cover

Hospital insurance provides a benefit for treatments and services received inside the hospital. There are 4 broad categories to choose from: Basic, Bronze, Silver and Gold. However, there are 8 Hospital policies in total, each tailored to suit a specific range of requirements.

GMHBA offers three different Excess levels. An Excess is an amount you agree to pay when admitted to hospital. Singles can choose an Excess of $250, $500 or $750, while couples and families have a choice of $500, $1,000 or $1,500.

Basic Plus

Provides public hospital cover but excludes private hospital accommodation.

  • Restrictive cover for most services, for example, joint reconstruction, rehabilitation, hospital psychiatric services and palliative care.
  • Excludes dialysis for chronic kidney failure, insulin pumps and weight loss surgery.

Bronze Essential with AIA Vitality

Entry-level GMHBA hospital cover might help you avoid the Lifetime Health Cover (LHC) loading and Medicare Levy Surcharge (MLS).

  • Includes AIA Vitality and covers 18 clinical categories, for example, hernia and appendix, joint reconstruction and your kidney and bladder.
  • Provides restrictive cover for rehabilitation, hospital psychiatric services and palliative care.
  • Excludes 17 clinical categories, such as joint replacement, cataracts, dental surgery and the heart and vascular system.

Bronze Plus

Includes everything in the Bronze Essential policy but without AIA Vitality. Plus, it covers 4 additional clinical categories, including blood, dental surgery and medically necessary plastic and reconstructive surgery.

Silver Plus

Moderate private hospital cover, including protection for 29 clinical categories.

  • Full coverage for implantation of hearing devices, lung and chest, palliative care and rehabilitation.
  • Restrictive cover for hospital psychiatric services.
  • Excludes 8 clinical categories, for example, pregnancy and birth-related services, dialysis for chronic kidney failure and cataract surgery.

Silver Core with AIA Vitality

Very similar to the Silver Plus policy. However, it includes the AIA Vitality wellness program and restricts coverage for rehabilitation, hospital psychiatric services and palliative care. Excludes pain management with devices.

Silver Plus Premium

Provides a higher level of hospital insurance, with 34 clinical categories covered.

  • Restrictive cover for hospital psychiatric services.
  • Excludes assisted reproductive services, pregnancy and weight loss surgery.

Silver Plus Classic with AIA Vitality

The same coverage as the Silver Plus Premium Policy with the added benefit of gaining access to the AIA Vitality rewards program.

Gold Ultimate Hospital

Most comprehensive GMHBA Hospital policy with 38 clinical categories. You’ll receive full coverage for pregnancy and birth-related services, assisted reproductive treatments, weight loss surgery and hospital psychiatric services.

Take note: The company has special agreements with an extensive list of hospitals across Australia. These arrangements provide members with accommodation, theatre, delivery suite, intensive/coronary care and a range of services offered by the hospital. You can find a GMHBA Participating hospital when visiting their website and choosing your location.

Request & compare GMHBA hospital cover

GMHBA Extras

Extras provide benefits for treatments received outside of the hospital. GMHBA Extras only offers three levels of cover; Basic, Mid and Top.

With each of the three categories, you can choose to have set benefits or claim a percentage of the total cost back. If you choose the percentage options, you generally pay a slightly higher premium, but you might not reach your benefit cap as quickly.

Compare Extras from GMHBA

Extras Basic Extras
Set benefits or get 55% of your cost back
Mid Extras
Set benefits or get 65% of your cost back
Top Extras
Set benefits or get 75% of your cost back
AIA Vitality
General Dental
Major Dental
Orthodontics
Optical
Physiotherapy
Chiropractic & Osteopathy
Psychology
Occupational therapy
Antenatal & Postnatal classes
Non-PBS pharmaceuticals
Hearing aids
Audiology
Nursing
Blood glucose monitor
Acupuncture
Remedial massage
Dietetics
Weight management program

GMHBA eye care provides high-quality optometry services, including vision tests and management of eye-related diseases. Eye care practices are located within Geelong, Waurn Ponds, Leopold and Ballarat.

GMHBA dental care provides patients with personalised dental care, including cleanings and major dentistry. Branches can be found in Geelong and Portland. You’ll receive up to 1,000 AIA Vitality points when completing your annual dental check-up.

Waiting periods

  • Pre-existing conditions: 12 months.
  • Pregnancy and birth-related services: 12 months.
  • Major dental: 12 months.
  • Hearing aids: 12 months.
  • Blood glucose monitors: 12 months.
  • Optical: 6 months.
  • All other Hospital and Extras: 2 months.

GMHBA pros and cons

Advantages Disadvantages
Access to AIA Vitality with eligible Hospital plans. Ambulance cover is dependent on the state you reside in and might get a bit confusing.
Aged-based discounts for members younger than 30 purchasing a Basic or Bronze Plus Package. A higher than average premium rise. 3.31% on 1 April 2019, compared to an average of 3.25%.
Provides eye care, dental care, primary care and allied health services in Victoria.
Part of the Australian Health Services Alliance (AHSA) medical gap agreement, which helps you reduce out of pocket costs by implementing better financial agreements with private hospitals and day surgeries.

Frequently asked questions and answers

What does GMHBA stand for?

The abbreviation GMBHA stands for Geelong Medical and Hospital Benefit Association. However, in October 2000, they formally changed their name to GMHBA Limited.

Does GMHBA cover ambulance?

GMHBA offers different ambulance services, depending on the state you reside. For example, if you live in Victoria and have an Ambulance Victoria Subscription with any Mid or Top Extras cover from GMHBA, the insurer will pay a benefit towards your ambulance subscription each year to help you offset the cost of comprehensive ambulance cover.

Please contact GMHBA directly to enquire about the ambulance coverage available in your location.

Does GMHBA cover vaccinations?

Yes, eligible GMHBA Extras policies provides benefits for travel vaccinations, flu vaccinations and HPV vaccinations.

How to join GMHBA?

  1. Join online using the link in their Quote tool and complete the application form.
  2. Visit a GMHA branch and join in-person.
  3. Call their customer care centre on 1300 446 422.
  4. Post your application form to the company.
  5. Request a quote at the top of this page.

How do you claim GMHBA benefits?

When going to a public hospital or one of GHMBA's participating hospitals, your bill will be sent directly to the insurer. You only pay your agreed Excess and Co-payment (if applicable). Claim Extras by swiping your GHMBA card at the provider, online using the insurer’s member self-service centre, posting your completed GMHBA claim form with itemised receipts, or lodging your claim at Medicare, who’ll forward it to your insurer.

Are GMHBA and Frank the same company?

In October 2009, GMHBA launched a second health insurance brand called Frank Health Insurance. Frank offers low-cost private health insurance, with an easy to understand product range. Each brand has its own marketing style and different terms and conditions. GMHBA also owns Health.com.au.

Compare GMHBA with other major health brands

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Ask an Expert?

6 Comments

  • Dianne Taylor |

    I have been a gold extras customer for years. How much can I claim on chiropractic services and do you have a preferred provider near Dromana, Victoria?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Dianne,
      I’m not sure the exact health insurance policy you have with GMHBA, but according to the privatehealth.gov.au website, for GMHBA’s Gold Extras Set Benefits you can claim chiropractic services of $350 per person, up to $700 per policy.

      Regarding a preferred chiropractic provider, you’ll need to contact GMHBA directly for this information. You can call them on 1300 446 422.

  • Fiona Patterson |

    Hi There – I am wondering if your fund has any incentive type programs that cover mental health, health coaching or hospital in the home?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Fiona.

      Services provided by GMHBA health insurance depends on the type and level of cover you choose. For example, the GMHBA Silver Package with AIA Vitality provides a benefit for sessions with a psychologist, as well as restrictive coverage for psychiatric treatment in the hospital. Because you’ll have access to AIA Vitality, you’ll be able to enjoy the various health and wellness benefits that accompany it.

      However, whether this insurer and policy type is a good option for you, depends on your specific requirements and budget. Please call 1300 795 560 for assistance from a specialist or fill in the quote form above to request quotes from some of the largest health funds in Australia.

  • Janet Vanson |

    Are private rehab services either inpatient or outpatient for knee reconstruction claimable for clients with top hospital cover plus ancillary cover?

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Janet.

      It’s best to contact your health fund directly to inquire what you are and are not covered for, as well as the benefit limits.