GMHBA health fund

GMHBA Health Insurance Hospital Cover

Choose from 3 levels of hospital cover to find the option that meets your needs with GMHBA

GMHBA is a popular not-for-profit health fund, founded as a small group in 1934 and now focused on providing healthcare for more than 230,000 members around Australia.

GMHBA is dedicated to offering value for money, and the right healthcare options for all Australians. You may want to consider GMHBA for your hospital cover thanks to the wide-ranging benefits and exceptional features that you can find even with the most basic plan.

Compare GMHBA's policy range and get covered

The GMHBA hospital plans

The three cover levels are Bronze, Silver and Gold. You can get the Gold level with or without pregnancy cover to help keep costs down while still accessing a range of other family-related benefits.

  • Bronze Hospital. Wide-ranging cover that is more typical of a high-level policy at a low price. It’s so affordable because it’s for shared rooms in public hospitals only, letting you access important services while keeping gap costs and out-of-pocket expenses down. It’s a pragmatic plan and might be a good choice when affordability and effective cover are the priorities.
  • Premium Hospital: Providing a high level of hospital cover for public or private accommodation, treatments, rehabilitation and surgery. Pregnancy related services and obesity surgeries are excluded to reduce your premiums. Getting you the best from a hospital for a low premium, this policy may suit those who are not looking to start a family, and would like the best bang for their buck.
  • Premium Hospital with AIA Vitality. Offering the same high level of hospital cover, this policy also includes AIA Vitality, which means you can enjoy such benefits as up to $6500 in shopping rewards. Premium Hospital with AIA Vitality gets you the best from your hospital and a range of benefits for healthy living.
  • Bronze Essential Hospital with AIA Vitality. Keep the low cost of Bronze Essential Hospital cover with the added benefits from AIA Vitality, including up to 50% off eligible flights. Offering a wide range of services with out of hospital extras from AIA Vitality, this policy might be all you need, plus a little more.
  • Silver Hospital Plus. Providing a private room where available, as well as select services such as general and preventive dental cover, Silver Hospital Plus is a good middle of the road policy, giving you quality coover without burdening your premiums with unnecessary extras.
  • Silver Core Hospital with AIA Vitality. If you enjoy your extras but don't want to pay for services you don't need, Silver Cor Hospital with AIA Vitality provides additional benefits for you to enjoy out of hospital, such as up to 50% off endota spa e-Gift Cards. If you want moderate cover with a few extra perks, this might be your policy.
  • Silver Plus Premium Hospital with AIA Vitality. Get more from Silver cover with Silver Plus Premium Hospital with AIA Vitality. For a slightly higher premium, you can access additional services such as cancer treatment, intensive and coronary care, as well as AIA Vitality out of hospital extras, like cashback on Cancer Council products.
  • Gold Ultimate Hospital with AIA Vitality. Cover from head to toe, Gold Ultimate Hospital with AIA Vitality provides access to all kinds of services, from psychology, dental, and optical treatments, to joint investigations and reconstructions. AIA Vitality extras, such as cashback on Anytime Fitness & Fitness First memberships, with Gold Ultimate Hospital policy, is as comprehensive as hospital cover can get.

What are the additional benefits and special features of GMHBA?

All GMHBA hospital plans include special features that help deliver value for money, while raising the quality of medical care you might access.

No matter which hospital plan you get, you’ll access some important features. These can be found with many other providers, but will often only be available with the more expensive plans. With GMHBA, everyone with hospital cover can get them.

  • Choice of excess. If you’re unlikely to need to go to hospital, you can choose a higher excess to keep premiums down. This is the amount you need to pay per hospital visit, up to once per year with singles policy and twice per year with couples and family cover.
  • Best Doctors Program. This lets you access some of the best doctors and specialists in their field, as nominated by their peers, from all over the world. You can get a review of your medical records, answers to any questions you might have and written reports on your current diagnosis. This is available with even basic cover, letting everyone get a high standard of medical care.
  • Gap Cover. Gap cover lets you keep out-of-pocket expenses to a minimum no matter which GMHBA hospital cover you have. This can help cover gaps that exist when providers charge amounts above the set MBS fees.
  • At-home hospital and rehabilitation. Helps cover the cost of at-home hospital and rehabilitation services, letting you get further treatments in the comfort of your own home and leave from hospital sooner to reduce the chance of infection and promote active recovery.

Pregnancy and family advantages

If your policy covers pregnancy (Gold with pregnancy cover and Bronze policies), medical cover is just the start. You also get access to the following benefits:

  • Healthy Start. An additional benefit of up to $500 to help cover any out-of-pocket expenses that might be incurred for inpatient obstetric and childbirth-related costs in hospital.
  • The New Family Program. GMHBA has partnered with early childhood experts, Safe Sleep Space, to deliver this program. It includes phone consultations with a trained “baby consultant” and a range of resources to help you out, including what to expect from a new baby and much more.

Limitations and waiting periods to be aware of

When you transfer to GMHBA from another health fund where you had the same cover, GMHBA will recognize any served waiting periods. The hospital waiting periods are as follows:

  • 12 months. Pregnancy, fertility treatments or pre-existing conditions.
  • 2 months. All other treatments, as well as psychiatric, rehabilitation and palliative care, even when for a pre-existing condition.

How to claim

Before commencing hospital treatments, it’s a good idea to call GMHBA or visit a branch to get an estimate of what costs, if any, there will be.

To claim hospital expenses, lodge a two-way claim through Medicare, which will then be forwarded to GMHBA for processing. This will need to include a completed claims form and the fully itemised account or the original itemised receipt if you’ve already paid for it.

Receive quotes for GMHBA Hospital Cover

Andrew Munro

Andrew writes for finder.com, comparing products, writing guides and looking for new ways to help people make smart decisions. He's a fan of insurance, business news and cryptocurrency.

Was this content helpful to you? No  Yes

Related Posts

You might like these...

Ask an Expert

You are about to post a question on finder.com.au:

  • Do not enter personal information (eg. surname, phone number, bank details) as your question will be made public
  • finder.com.au is a financial comparison and information service, not a bank or product provider
  • We cannot provide you with personal advice or recommendations
  • Your answer might already be waiting – check previous questions below to see if yours has already been asked

Finder only provides general advice and factual information, so consider your own circumstances, or seek advice before you decide to act on our content. By submitting a question, you're accepting our Terms of Use, Disclaimer & Privacy Policy and Privacy & Cookies Policy.
Ask a question
Go to site