GMHBA has humble beginnings, founded nearly 100 years ago to provide healthcare for workers in Geelong. Over time, they’ve evolved to become one of Australia’s largest regionally based health insurers, providing private health insurance to thousands of individuals and families across Australia.
GMHBA health insurance offers its members a range of hospital, extras and combined cover policies for a variety of life stages and circumstances. Whether you’re single, a couple or a family, GMHBA has a policy for you.
With GMHBA hospital insurance, you’re covered for treatment in hospital as a private patient, provided the treatment is listed on the Medicare Benefits Schedule (MBS) and covered by your policy. GMHBA offers a full range of Basic, Bronze, Silver, Gold and Plus tiered policies.
GMHBA extras cover will pay a benefit for certain out-of-hospital treatments that aren’t covered by the MBS; this includes services like dental, optical and physiotherapy. GMHBA offers a range of low, medium and high-level set benefit and percentage benefit policies.
GMHBA’s percentage benefit policies range from 55-75% back on extras at any registered provider for healthcare services listed on your policy up to your annual limit. On their Basic Extras Set Benefit policy, you can claim up to $1,000 on dental services each year, while their high-level set benefit policy lets you claim up to $2,000 per year and much more on other services (sub-limits apply).
This information is current as of December 2022. For the full details of what’s covered on a GMHBA health insurance policy, refer to the relevant policy documents.
GMHBA offers cover for emergency ambulance services on their hospital products, but how their cover works will depend on your state of residence. If you live in a state with a subscription-based ambulance service, you can claim the cost of your subscription on eligible extras policies.
For states with a levy-based scheme (New South Wales and the ACT), you’ll need a hospital cover policy instead. When you receive your ambulance bill, you’ll need to send the bill to GMHBA, and they’ll take it from there.
Depending on your state, you may already be covered for ambulance services by your state government. See our guide to ambulance cover to learn more.
Yes, GMHBA will cover you for pre-existing conditions, although you may need to serve a 12-month waiting period before receiving hospital treatment relating to your condition. If you’ve already served a waiting period for your pre-existing condition with your previous fund, you may not need to serve it again, provided you’ve moved to an equal or lower level of cover.
Having a pre-existing condition won’t affect your waiting periods or eligibility for extras cover services.
Yes, waiting periods for hospital cover are standard across all Australian health funds. These are 12 months for pre-existing conditions (excluding rehabilitation, palliative care and psychiatric services) and pregnancy and birth, and 2 months for everything else.
Waiting periods for extras services will depend on your policy and the services covered, and typically range from 2-12 months.
To make a claim for extras services, you can claim on the spot by swiping your membership card at your healthcare provider’s HICAPS machine. Alternatively, you can pay upfront and submit a claims form online, at your local branch, by email or by post.
When you’re treated in a GMHBA-participating hospital for a treatment covered by your policy, the hospital will bill GMHBA directly, so you’ll only need to pay your excess, co-payments (if applicable) and other out-of-pocket costs.
GMHBA offers a wide range of payment options, although not all payment methods are available on all products. The options available to you include:
When you choose to pay by direct debit, you can receive a 2% discount on your premiums paid. While you won’t receive a discount for paying annually, you might still save by locking in a lower rate before the annual premium increase.
Yes, you will likely need to pay an excess when you’re admitted to hospital and claim on your hospital cover policy. When you take out a policy, you can choose your excess from a set of options. When you choose a lower excess, you’ll pay a higher premium and vice versa.
Depending on your policy, there’s a maximum excess payable per calendar year, and dependant children may not have to pay an excess on hospital admission.
To cancel your policy, you’ll need to notify GMHBA over the phone or in writing. GMHBA will provide you with your clearance certificate within 14 days of request. You will also be refunded any premiums paid in advance.
Want to see how GMHBA stacks up to their competition? With our free comparison tool, you can see policies from our panel of trusted Australian health funds side-by-side to compare their benefits, costs, exclusions and more to help you look for a health insurance policy that works for you.
