GMHBA health insurance

GMHBA Health Insurance

Compare health insurance reviews from GMHBA and find a suitable option for your needs.

When you’re faced with expensive medical and hospital bills, Medicare can only provide a limited level of cover. For increased protection and the ability to choose your doctor and where you are treated, private health insurance is a must.

GMHBA Health Insurance was founded in 1934 in Geelong by a group of workers from the Australian Cement Company. Today, this not-for-profit, member-based organisation offers a choice of health insurance policy options to suit the cover needs of a wide range of Australians.

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December update: GMHBA prides itself on providing great value health cover. That’s why all GMHBA products are backed by a 60 day money back guarantee. If for any reason your circumstances change and you have not claimed, GMHBA will fully refund your membership.

*Join GMHBA in November and receive a $200 gift for families, $100 for singles

Join GMHBA on combined cover before 30 November and receive a debit gift card for $200 for families and $100 for singles. Simply organise your payments through direct debits and pay your first month to receive your gift card.

*Disclaimer

*For new members on direct debit, must pay first month to receive gift card. $200 gift card for families, couples and single parent memberships, $100 for singles. Gift card will be issued within 14 days from receipt of first payment. If the policy is cancelled within 60 days of joining and the gift card activated, the value of the gift card will be deducted from your premium refund. Not available in conjunction with any other offer.

GMHBA Health Insurance options

If you take out cover through GMHBA Health Insurance, you have the option of choosing either standalone hospital cover or extras cover. In terms of hospital cover, Bronze, Silver and Gold Membership options are all available to offer a choice of excesses and cover to suit a range of budgets.

When it comes to extras cover, Bronze, Silver and Gold options are once again available. Cover starts out with the essentials like dental, physio and optical and then upgrades with each different membership level until treatments including major dental, hydrotherapy, naturopathy and more are all covered.

Members can choose to mix and match hospital and extras cover to create a combined policy to suit their needs, and GMHBA also offers four packaged covers to customers: FIT Ultra Package, FIT Top Package, FIT Standard Package and FIT Entry Package.

GMHBA Health Insurance Levels of Cover

Hospital and extras

Depending on your personal situation and budget, GMHBA allows you to combine elements of both Hospital and Extras cover to achieve the balance you want. For example, if you are looking for low cost cover or you are earning over $90,000 as a single and are looking to minimise tax, you can choose Bronze Hospital and Bronze Extras for basic combined cover. If you are planning a family, Gold Hospital and Silver Extras (with pregnancy and IVF) would be a good choice. While for full comprehensive cover, Gold Hospital (no pregnancy) and Gold Extras would provide total peace of mind.

GMHBA also offers FIT Hospital and Extras packages for those wishing to maintain their active lifestyles. These include FIT Entry, FIT Standard, FIT Top and FIT Ultra.

  • FIT Entry. Provides basic cover in a public hospital as a private patient and includes knee, shoulder and ankle reconstructions plus surgery to repair a fractured collarbone, wrist, hand or finger. It also includes a great range of extras including, optical, dental, physio, chiro, osteo, dietetics, naturopathy and ambulance.
  • FIT Standard. Cost-effective cover that includes everything in FIT Entry, but with higher benefit amounts and with the addition of a preventative health assessment.
  • FIT Top. Top cover in a shared / single room in a private hospital, with same day treatment, higher benefit amounts for injuries more likely to occur playing sport, plus all the extras offered in FIT Standard.
  • FIT Ultra. Comprehensive cover for the everyday athlete, this includes everything in the FIT Top package, but with higher benefit amounts.

Hospital only

GMHBA is a not-for-profit fund offering a range of cover levels to its members. These include Bronze, Silver and Gold Hospital and Bronze, Silver and Gold Extras; all of which can be combined according to needs and budget. They also offer FIT Hospital and Extras packages for active sports enthusiasts.

  • Bronze Hospital. Entry level cover that covers treatment resulting from an accident in a public hospital as a private patient and includes knee and shoulder reconstructions.
  • Silver Hospital. Moderate cover with some exclusions covering treatment resulting from an accident in a shared / single room in a private hospital and including knee and shoulder reconstructions.
  • Gold Hospital. High level hospital cover (with or without pregnancy and IVF services) covering treatment in a shared / single room in a private hospital and including knee and shoulder reconstructions.

Extras only

  • Bronze Extras. Covers the three most popular extras; optical, general and preventative dental and physio.
  • Silver Extras. Covers general, preventative and major dental, optical, physio plus chiro, osteo, naturopathy, ambulance, psychology, pharmacy, dietetics, audiology, eye and speech therapy, occupational therapy, podiatry, prostheses, hearings aids, orthotics and more.
  • Gold Extras. Top level extras cover with higher benefit amounts and including everything in Silver Extras plus additional extras such as exercise physiology, antenatal and postnatal classes and weight loss programs.

GMHBA Family Cover

GMHBA’s family health insurance packages are specifically designed to meet the needs of Australian families. None of the policies charge a hospital excess for children under the age of 21, while all three levels of cover also include an ambulance subscription and 100% back on preventative dental. There are three family packages available:

  • Starter Family Package. This entry-level package covers public hospital treatment as a private patient following an accident, and offers 100% back on the cost of optical and preventative dental. It also covers 55% of the cost of a range of basic extras.
  • Everyday Family Package. GMHBA’s Everyday Family Package offers a high level of health cover and treatment in a single or shared room in a private hospital. Pregnancy and birth-related services are included in cover, along with 65% back on a range of extras.
  • Premium Family Package. This is the most comprehensive family package and it includes a pregnancy option, a single-room guarantee, and cover for 75% of the cost of a huge range of extras services.

GMHBA policy exclusions

Your GMHBA Health Insurance claim will not be paid if:

  • You are claiming treatment provided to you by a family member or business partner
  • It is for services or treatment received overseas
  • It is for services that would generally be classed as sport, recreation or entertainment
  • It is for services not rendered face to face, for example if they were rendered over the phone
  • It is for a medical service rendered by a medical practitioner employed full-time in the public health sector
  • You do not provide itemised and original receipts
  • It is for food supplements
  • It is for pharmacy items that can be purchased over the counter with or without a prescription
  • It is for a dental procedure where you have exceeded a limit on the number you can have
  • It is for services or treatment rendered more than two years prior to you lodging a claim
  • It is for services or treatment rendered while your membership is suspended.

How much cover will I get for my condition?

This chart outlines the benefit amount you can expect from GMHBA for a range of commonly claimed treatments and conditions, and includes Medicare's (MBS) amounts for comparison:

ProcedureMBSGMHBA
Appendicectomy$445.40$534.40
Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia$221.35$265.65
Breast, benign lesion surgical biopsy of excision$260.05$312.10
Carpal Tunnel Release$276.80$332.20
Cataract Surgery$760.55$912.80
Cholecystectomy$739.35$887.25
Colonoscopy$334.35$401.22
Complicated Delivery (of baby)$1,629.35$1,955.25
Coronary Artery Bypass$2,200.00$2,640.00
Craniotomy$1,586.75$1,904.10
Cytotoxic Chemotherapy$97.95$117.55
Femoral on Inguinal Hernia$464.50$557.40
Haemorrhoidectomy$367.75$441.30
Hip Replacement$1,317.80$1,581.40
Knee Replacement$2,047.60$1,581.40
Overnight investigation for sleep apnoea$588.00$705.60
Tonsils or Tonsils and Adenoid$295.70354.85
Uncomplicated Delivery (of baby)$693.95$832.74
Vaginal Hysterectomy$674.70$809.65
Varicose Veins$109.80131.80
Vasectomy$229.85$275.85

*NSW, #AHM

I recognise most of these funds except for the AHSA, what is that?

The Australian Health Service Alliance is a management services organisation that represents a number of small to medium sized health insurance funds, allowing them to combine resources to deliver a higher quality of service to their members.

The funds represented by the ASHA are:

  • ACA Health Benefits Fund
  • Australian Unity Health Limited
  • CBHS Health Fund Limited
  • CUA Health Limited
  • Defence Health
  • GMF Health
  • GMHBA
  • Budget Direct Health Insurance
  • Frank Health Insurance
  • GU Health
  • HBF Health Ltd
  • Health Care Insurance Limited
  • health.com.au
  • Health Insurance Fund of Australia Limited
  • Health Partners
  • Navy Health
  • onemedifund
  • Peoplecare Health Insurance
  • Phoenix Health Fund
  • Police Health Limited
  • Queensland Country Health Fund Limited
  • Reserve Bank Health Society Ltd
  • rt health fund
  • Teachers Health Fund > UniHealth Insurance
  • Teachers Union Health
  • The Doctors' Health Fund Pty Ltd
  • Transport Health
  • Westfund

How much does health insurance cost?

The following factors will affect your GMHBA Health Insurance premium:

  • The level of cover you choose. A high-level policy will obviously cost more to take out than one that simply offers the most basic level of cover.
  • Whether you combine cover. Choosing standalone hospital or extras cover is much cheaper than a policy that offers combined cover for more comprehensive protection.
  • Number of people on the policy. Whether you take out a single, couples or family policy.
  • Your age when you take out cover. A premium loading may apply under the Lifetime Health Cover scheme.
  • Your income. Your annual income influences your eligibility for private health insurance rebates.
  • The excess you choose. A higher excess means lower premiums.

GMHBA Health Insurance excess

Hospital cover from GMHBA features an excess, which is the amount you pay to contribute to the cost of your hospital admission. By paying an excess, you can enjoy lower insurance premiums.

GMHBA members have the flexibility of choosing from a $0, $250 or $500 excess which will be deducted from the benefit amount they receive. The excess you choose will be reflected in the cost of your premiums and if you have a family policy, the choice of maximum annual excesses includes $0, $500 or $1,000. 

How to save on your GMHBA policy

  • Choose a higher excess. You will have to pay a cheaper premium as a result.
  • Choose a lower level of cover. Bronze Cover is cheaper than Silver Cover, which in turn is more affordable than Gold Cover. As with most other things in life, you get what you pay for.
  • Choose standalone hospital or extras cover. This will be much cheaper than a combined policy.
  • Avoid premium loadings. Signing up for private health insurance cover before you turn 30 will save you money under the Lifetime Health Cover scheme.
  • Use rewards points. Members can use reward points they earn as part of the Connect Rewards Plus member loyalty program to reduce out-of-pocket expenses for things like dental and optical, while they can also claim the inpatient medical gap and reduce their hospital excess.

How can I make a claim?

If you have extras cover you can use your GMHBA membership card to take advantage of electronic claiming. Simply swipe your card when you visit your provider and any benefit you receive will be automatically deducted from your bill.

If electronic claiming is not available, you can claim online via the GHMBA Online Member Service area after paying the provider’s bill. Alternatively, you can download and complete a claim form which you can then post to GHMBA along with your receipt. 

GMHBA FAQs

What extras providers can I visit?

You can use the services of any extras provider as long as they are registered with the appropriate board for their field and operate a private practice.

How can I pay my premiums?

GMHBA allows you to pay your premiums online (credit card or BPAY), over the phone (credit card) or by mail (cheque, money order or credit card). Direct payroll deductions are also available.

I’ve just celebrated my 31st birthday – do I need to take out cover?

While it’s not compulsory to take out private health insurance cover, a 2% premium loading will apply to the cost of your cover for each year you are past the age of 31.

Where can I find a list of things that are excluded from cover?

This can be found in the policy documents that apply to your health insurance plan.

What does the term ‘inpatient’ mean?

You are classified as an inpatient if you are admitted to hospital and stay there overnight. 

Is there an option for overseas visitors?

If you’re a temporary Australian resident and do not have full Medicare eligibility, phone GMHBA or visit a branch to discuss your health insurance needs. You can also consider Frank Overseas Visitor Health cover, which is a brand offered by GMHBA Limited.

Are there any additional benefits?

GMHBA members can also access the following benefits:

  • Bowel Cancer Risk Identification Program
  • GMHBA Farmer Health Clinics
  • Chronic Disease Management Program
  • Strong Knees Program
  • Best Doctors Network
  • New Family Program
  • Midwifery Group Practice Program

Speak with an adviser about taking out cover with GMHBA

If you’re looking competitive health insurance cover that meets your budget, GMHBA offers a range of options to suit. Just make sure to check how its cover stacks up against that offered by other private health funds before you decide on the right health fund for your needs.

Compare GMHBA Health Insurance with the help of an adviser

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2 Responses to GMHBA Health Insurance

  1. Default Gravatar
    Annie | November 23, 2016

    Do you cover cosmetic surgery

    • Staff
      Richard | November 23, 2016

      Hi Annie,

      Thanks for getting in touch. Depending the level of benefits provided by your policy, you may be covered for cosmetic surgery if it’s deemed to be medically necessary. You should contact GMHBA directly about the specifics of your cover. You may also find our article about cosmetic surgery and health insurance helpful.

      All the best,
      Richard

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