Overview

Based in Geelong Victoria, the GMHBA health insurance has an extensive network of regional branches, providing private health insurance to hundreds of thousands of members across Australia. It is a not-for-profit health fund.

GMHBA health insurance offers an extensive range of hospital and extras policies, and offers a number of additional allied health services such as dental and optical to regional Victoria.

Key Points

●       GMHBA offers 10 hospital policies and 6 extras policies.

●       Rewards and discounts through a partnership with AIA Vitality.

●       Members can get discounts at GMHBA Eye Care.

GMHBA isn't on our health funds panel but we're confident we can get you a great deal on your health insurance.

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Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover from a health insurance policy will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

With 9 plans to choose from, GMHBA has a wide range of hospital covers, from basic to comprehensive.

Some policies come with access to the AIA Vitality rewards program.

Basic Plus Hospital Cover

A low entry-level basic plus hospital plan aimed at younger, healthy Australians on a tight budget who want to avoid the Medicare Levy Surcharge.

Key inclusions:

  • Ambulance cover

  • Avoids the Medicare Levy Surcharge

Bronze Essential Hospital Cover

GMHBA's second cheapest policy with a wider range of hospital services than Basic, plus access to member rewards and private hospitals for some services.

Key inclusions:

  • Gynaecology

  • Ear, nose and throat

  • Hernia and appendix

Bronze Plus Hospital Cover

A more expensive but more comprehensive policy that covers a range of common procedures in private hospitals. It offers everything in the Bronze Essential policy, plus dental surgery.

Key inclusions:

  • Palliative care

  • Bones, joints, and muscles

  • Tonsils, adenoids, and grommets

Silver Plus Hospital Cover

GMHBA offers two versions of Silver Plus: a more expensive version that does not include pregnancy items and a cheaper version with a $500 excess.

Covers everything in the Silver Core policy, plus a few extras.

Key inclusions:

  • Implantation of hearing devices

  • Sleep studies

  • Palliative care

Silver Core Hospital Cover

Private hospital cover for a wide range of services, with some exclusions to keep medical costs down. Choose between $500 and $750 excess.

Key inclusions:

  • Back, neck and spine

  • Heart and vascular

  • Podiatric surgery

Silver Plus Premium Hospital Cover

A high level of cover with minimal exclusions. There are two Silver Plus Premium packages, with one that specifically excludes pregnancy and birth related services.

The $500 excess version does not include weight loss.

Key inclusions:

  • Insulin pumps

  • Cataracts

  • Kidney dialysis

Silver Plus Classic Hospital Cover

Gives you everything in the Silver Plus Premium policy, plus access to the AIA Vitality rewards program.

Doesn't include obstetrics, making it an option for older Australians.

Key inclusions:

  • Insulin pumps

  • Cataracts

  • Joint replacements

Gold Premium Hospital Cover

A top-level combined hospital coverage and extras package aimed at families.

No restrictions on hospital cover and includes limits of up to $1,000 per person on common extras, as well as generous rebates.

Key inclusions:

  • No restrictions on all hospital services

  • 100% back on general dental and optical

  • $1,000 limit on major dental treatments

Gold Ultimate Hospital Cover

Offers everything the Gold Premium policy does, plus access to the AIA Vitality program.

Key inclusions:

  • Pregnancy and birth

  • Weight-loss surgery

  • Access to the AIA Vitality rewards program

Ambulance Cover

All GMHBA extras, hospital and combined policies have emergency ambulance cover included (excluding air ambulance).

Extras cover

GMBHA’s extras reset on January 1 every year.

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with the health fund.

Take the time to work out what you need from GMHBA’s gap cover and what you're prepared to pay relevant to your personal circumstances.

If this feels a bit overwhelming, our experts are here to help. We will analyse the relevant product disclosure statement to provide you with the information you’re looking for.

Basic Extras Set Benefits

Low annual limits make this more suitable for budget-conscious singles and couples. Cover includes varying rebates on basics like preventative dental and physio, but does allow up to 80% back on frames and lenses.

Key inclusions:

  • Dental

  • Optical

  • Physiotherapy and hydrotherapy

Basic Extras 55%

Claim up to 55% on popular services like physio, optical and dental, plus travel vaccinations and occupational therapy. Limits of up to $300 on some extras.

Key inclusions:

  • Dental

  • Optical

  • Travel vaccinations

Mid Extras Set Benefits

More comprehensive extras package with set rebates across all extras. Includes remedial massage, osteo and chiro.

Key inclusions:

  • Orthodontics

  • Remedial massage

  • Psychology

Mid Extras 65%

Claim 65% back on an extensive range of services like general and major dental, optical and remedial massage. Comes with larger annual limits than the Basic Extras 55%.

Key inclusions:

  • Nursing

  • Speech therapy

  • Podiatry

Top Extras Set Benefits

Fully comprehensive set of extras, including hearing aids, acupuncture and podiatry. Higher annual limits than the Basic and Mid extras, and higher set rebates. 

Key inclusions:

  • Antenatal and postnatal classes

  • Eye therapy

  • Weight management program

Top Extras 75%

GMHBA's most expensive extras cover, giving you 75% back on hearing aids, sleep apnoea monitors, orthopaedic appliances, and much more. 

Key inclusions:

  • Antenatal and postnatal classes

  • Eye therapy

  • Orthodontics

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Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

  • 12 months for pre-existing conditions, obstetrics and maternity

  • 2 months for hospital psychiatric services, rehabilitation and palliative care as well as all other services

  • 0 days for ambulance services

Extra waiting periods

  • 12 months for major dental services, orthodontics, health appliances and hearing aids

  • 2 months for all other services, including optical, home and domestic aids and medical aids

Member benefits

Selected policies come with access to a rewards program called AIA Vitality, giving members access to rewards and discounts across a range of retailers.

This includes membership discounts at gyms, up to 50% off eligible Virgin Australia flights and up to 50% off endota spa e-gift vouchers.

How to claim

Claim online or by swiping your GMHBA membership card when you visit a participating HICAPS provider. You can also lodge a claim at your nearest GMHBA branch or through the post.

Hospital agreements

GMHBA has agreements with most hospital and day surgery providers across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

GMHBA received 3.3% of complaints in 2021, and has a market share of 2.1%^.

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FAQs

1. Is GMHBA a not-for-profit fund?

Yes, GMHBA is a not-for-profit fund.

2. Who can apply? Are there restrictions?

You’ll need to be 18 or over to apply for health insurance with GMHBA.

3. Is it easy to switch to GMHBA?

GMHBA is not on Compare Club’s panel, but we’re confident we can find you a good deal from the other funds we compare.

4. Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits

5. Can I change my level of cover?

Yes, you can choose a lower or higher level of cover.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

6. Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to read our rebate guide.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

8. Up to what age are children covered?

Generally, 23.

Children are covered on GMHBA family policy until the age of 21.

If they’re studying full time, dependents can be covered as a student under a family policy up to the age of 25.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

^Private Health Ombudsman,GMHBA, accessed 13 January 2022.