GMHBA health fund

GMHBA extras health plans

Choose from 3 levels of extras health insurance for general dental, optical, chiro and loads more with GMHBA

GMHBA was founded in 1934 with the aim of providing effective and affordable healthcare to a small group of Australians. It clearly succeeded because it now has more than 230,000 members all around the country.

With standalone hospital cover and extras cover plans, as well as combined cover options, GMHBA is all about quality, affordability and flexibility in healthcare.

Available extras plans from GMHBA

The three straightforward cover levels are Bronze, Silver and Gold. For each, you have the option of claiming set benefits or a certain percentage back. The percentage policies have slightly higher premiums, but may end up being more cost-effective for those who plan on claiming a lot of extras or have specific health needs.

With higher cover levels, you can claim back a higher percentage of the costs or get higher set amounts for services. The total limits, sub-limits and range of services covered also increase with policy comprehensiveness.

Bronze (55% back)Silver (65% back)Gold (75% back)
General dental (check-ups, simple tooth extractions and other basic services)
  • yes
  • yes
  • yes
Major dental (dentures, crowns and bridges, endodontics and other complex dentistry)
  • no
  • yes
  • yes
Orthodontics
  • no
  • yes
  • yes
Optical$150$200$250 (includes laser eye surgery)
Chiropractic and osteopathy
  • no
  • yes
  • yes
Physiotherapy, myotherapy and hydrotherapy
  • yes
  • yes
  • yes
Naturopathy, homeopathy, acupuncture and remedial massage
  • no
  • yes
  • yes
Ambulance subscription
  • no
  • yes
  • yes
Ambulance transport
  • no
  • yes
  • yes
Exercise physiology
  • no
  • no
  • yes
Psychology
  • no
  • yes
  • yes
Pharmacy and travel vaccinations
  • yes
  • yes
  • yes
Dietetics
  • no
  • yes
  • yes
Audiology
  • no
  • yes
  • yes
Antenatal and postnatal classes
  • no
  • no
  • yes
Eye therapy and speech therapy
  • no
  • yes
  • yes
Occupational therapy
  • yes
  • yes
  • yes
Podiatry
  • no
  • yes
  • yes
Nursing
  • no
  • yes
  • yes
Preventative health benefits
  • yes
  • yes
  • yes
Non-surgical prostheses
  • no
  • yes
  • yes
Blood glucose monitors
  • no
  • yes
  • yes
Extremity pump
  • no
  • yes
  • yes
Nebuliser pump
  • no
  • yes
  • yes
Sleep apnoea monitor
  • no
  • yes
  • yes
TENS monitor
  • no
  • yes
  • yes
Hearing aids
  • no
  • yes
  • yes
Orthopaedic repairs
  • yes
  • yes
  • yes
Orthotic appliances
  • no
  • yes
  • yes
Orthopaedic appliances
  • yes
  • yes
  • yes
Pressure garments
  • yes
  • yes
  • yes
Weight loss program
  • no
  • no
  • yes
Fluoride dietary supplements
  • yes
  • yes
  • yes

Additional benefits available with GMHBA

GMHBA Silver and Gold extras policies are an effective way of covering your ambulance needs without spending more on standalone cover. They include cover for ambulance transport as well as money back for subscriptions to your state ambulance service, which lets you get non-emergency ambulance transport free of cost.

Meanwhile, the wide range of services covered by the Silver policy means it may be an good choice if you want wide-ranging protection just in case, but don’t need the higher Gold policy limits that come with regularly claims for chronic or ongoing health needs.

At the gold level, you can also claim laser eye surgery on your extras plan under optical cover. While the cost of this procedure will exceed the optical sub-limits, you can help defray the cost by using the GMHBA Connect Dollar rewards program, which is available if you also have hospital cover or combined GMHBA health insurance.

The rewards program accentuates your extra policy and gives you growing loyalty reward points that you can redeem for services over your limits, such as laser eye surgery.

All policies will also let you receive the following preventative health benefits, with the limits depending on your cover level:

  • FOBT (bowel cancer screening) kits: 1 every 2 years
  • Melanoma surveillance photography: 1 per year
  • Quit smoking programs: 1 per year
  • Nicotine replacement patches: 1 x 12 week patch course per year

With Bronze Extras, singles and couples/families can claim up to $50 or $100 a year, respectively, for these. With Silver and Gold, the limits are twice this amount.

Waiting periods and limitations

The more inexpensive set benefit options for each plan may let you claim the total cost of a service, but for longer or more expensive sessions, your plan will often end up reimbursing a lower percentage of the costs.

Conversely, in some cases, such as with ambulance subscription reimbursement, the set benefit option will simply refund you 100% of the subscription cost, while the percentage policy option will only refund you a percentage of the costs, such as 65% with the Silver policy.

Note that in order to claim certain services, such as health appliances, it will need to have been medically recommended by a registered treatment provider. The practitioner may need to fill out part of a claims form for you to get reimbursed for these.

The following waiting periods also apply:

  • None. Ambulance transport and subscription reimbursement
  • 12 months. Orthodontics, major dental and health appliances
  • 2 months. Most other services

How to claim

After the waiting periods, you can start claiming. If you’re switching from a different fund, GMHBA will recognize any waiting periods fully served on cover you had before switching.

  • Electronic claiming. Swipe your membership card to claim on the spot and pay any difference yourself.
  • Online. Sign into the online member service area on the GMHBA Online Member Service area. Here you can make quick claims for services received in the last two months and already paid for. Note that you will need to keep your receipts as they may be audited later.
  • By post. To claim for services received more than two months ago, you can claim by post. Complete a claims form and send it in along with an itemised receipt.

You can also head into a GMHBA branch to claim in person, provided you have all the right documentation. Here you can get reimbursed in cash for claims of less than $500.
Receive quotes for GMHBA Extras Cover

Andrew Munro

Andrew writes for finder.com.au, comparing products, writing guides, sniffing out deals and looking for new ways to help people get the most out of their money.

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