GMHBA health fund

GMHBA extras health plans

You have six options with GMHBA Extras

GMHBA Extras Only health insurance gives you access to a wide variety of common and not-so-common treatments and offers up to 75% off of your treatment costs.

Top 3 features
  1. Good for people who want access to a wide variety of unique treatments and services.
  2. Good for Victoria residents who can visit a GMHBA dental or eye clinic to receive additional benefits on those services.
  3. Beware if you want cover for Chinese Medicine. None of GMHBA's policies cover it.

Compare more health insurance options

What GMHBA Extras Only policies are available?

GMHBA offers six Extras Only cover options.

  • Basic Extras Set Benefits. This basic policy covers general dental, optical, a range of therapies and a few extra benefits like travel vaccinations and melanoma surveillance photography. Most services have a set benefit meaning you'll get a specific dollar amount back for most treatments no matter how much the treatment costs.
  • Basic Extras 55%. This is exactly the same as Basic Extras Set Benefits. However, instead of a specific dollar amount, you'll get 55% of your costs back regardless of what your provider charges.
  • Mid Extras Set Benefits. This adds to the basic policies by including major dental, orthodontics ambulance cover and a wide variety of health aids like blood glucose monitor. You'll get a set benefit amount back for most treatments no matter how much the provider charges. .
  • Mid Extras 65%. This covers exactly the same services as Mid Extras Set Benefits except you get 65% of your treatment costs back for most services.
  • Top Extras Set Benefits. This is largely the same as the Mid Extras policies but with a few additional treatments like access to a weight management program and antenatal/postnatal classes. It also offers higher set benefit amounts.
  • Top Extras 75%. This is exactly the same as Top Extras Set Benefits but offering 75% back on most treatments instead of a set benefit amount.
Basic Extras Set Benefits / Basic Extras 55%Mid Extras Set Benefits / Mid Extras 65%Top Extras Set Benefits / Top Extras 75%
General Dental
Major Dental
Optical
Chiro & Osteo
Physio & Hydrotherapy
Myotherapy
Acupuncture
Orthodontics
Remedial Massage
Chinese Medicine
Ambulance Subscription
Ambulance Transport
Exercise Physiology
Psychology
Counselling
Pharmacy
Travel Vaccinations
Dietetics
Audiology
Antenatal/postnatal classes
Eye therapy
Speech therapy
Occupational therapy
Podiatry
Nursing
Non-surgical prostheses
Blood glucose monitor
Extremity pump
Nebuliser pump
Sleep apnoea monitor
Tens monitor
Hearing aids
Orthopaedic repairs
Orthotic appliances (foot)
Orthopaedic appliances
Pressure garments
Weight management program
Flouride dietary supplement
Swimming lessons
Flu vaccination
Cancer Council Australia UV Products
Melanoma Surveillance Photography
Nicotine replacement patches
HPV Vaccination

Other benefits of GMHBA Extras Cover

GMHBA members receive a few extra benefits including:

  • No gap dental. GMHBA runs its own dental practices in the Victorian towns of Geelong and Portland. If you visit those dentists, your policy will cover 100% of general dental expenses.
  • Extra eye benefits. GMHBA runs its own eye clinics in the Geelong and Ballarat regions of Victoria. If you use one of these providers, you're optical benefit will increase. The amount of increase depends on the policy you choose.

How do the costs work?

Your policy will refund a set amount per covered treatment or a percentage of the treatment cost. Each time you receive a refund on a particular treatment, that amount gets deducted from your yearly benefit limit for that treatment.

Waiting periods and limitations

Your waiting period for each treatment is as follows:

  • None. Ambulance subscription and ambulance transport.
  • 2 months. Antenatal/postnatal classes, audiology, dietetics, eye therapy, speech therapy, nursing, psychology, remedial massage, acupuncture, weight management programs, pharmacy, melanoma surveillance photography, quit smoking programs, nicotine replacement patch.
  • 12 months. Hearing aids, blood glucose monitor, extremity pump, nebuliser pump, pressure garments, non-surgical prosthesis, sleep apnoea monitor, tens monitor.

Your extras policy won't cover you for the following

  • Ambulance rides for those in states that provide state-based ambulance cover (Queensland and Tasmania).
  • Ambulance rides for pensioners and cardholders with access to ambulance schemes.
  • Treatments received by a provider that GMHBA does not recognise.
  • Orthopaedic and orthotic appliances that aren't approved by GMHBA and don't have a doctor's letter of recommendation.

How to make a claim

There are a few ways to make an extras claim with GMHBA:

  • On the spot. By swiping your membership card when paying for your treatment you can get an immediate refund.
  • Online. You can through the GMHBA online member portal.
  • At a GMHBA branch. You can take your itemised receipt to your nearest GMHBA branch.
  • Through the post. You can download a claim form from the GMHBA website, complete it and send it back to GMHBA with your itemised receipt.
  • At a Medicare office. You can also lodge your claim at your nearest Medicare branch and it will then be sent to GMHBA for processing.
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2 Responses

  1. Default Gravatar
    DianeApril 15, 2018

    I would like to know where to find the app to download onto my tablet, so that I can claim direct to gmhba. Is there one I can use to do that?
    Cheers,
    Diane

    • Default Gravatar
      JoelApril 16, 2018

      Hi Diane,

      Thanks for leaving a question on finder.

      GMHBA does not have a native iOS or Android app. However, there are a number of ways you can claim your extras benefits:

      Most claims can be processed on the spot when you have your appointment. Simply swipe your GMHBA membership card when paying for your appointment, and GMHBA pays the provider directly, so you just have to pay the difference. Please note, some providers may not have this facility.

      If you need to claim through GMHBA directly, you can do this easily in the online member self service centre, if you’re registered for online member services.

      If you prefer to claim in person, you can visit a GMHBA branch with an itemised receipt and/or account.

      Alternatively, you can complete a GMHBA claim form and post to GMHBA along with your itemized receipt and/or account, or lodge your claim at a Medicare office who will forward to GMHBA for processing. Please note that paper receipts will not be mailed back to members after a claim has been made. If you would like to retain a copy of your receipts for your records, you will need to make a copy prior to mailing your receipts to GMHBA. If you would like to keep your original receipt, no problem – you can make your claim online.

      Cheers,
      Joel

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