GMHBA Health Insurance

GMHBA health insurance review

Our verdict: GMHBA is a reliable not-for-profit fund, with AIA Vitality on some hospital policies. It has good value Silver hospital coverage and some good extras policies for dental and hearing aids, but there are cheaper alternatives for Basic, Bronze and Gold policies.

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Pros

  • Access to AIA Vitality on some polices, so you can be rewarded for being healthy.
  • Good value at the Silver Plus tier. "Silver Plus Hospital" covers 34 treatments from around $154 a month, or from around $162 a month with AIA Vitality included ($500 excess).
  • The "Basic Extras" policies have a $1,000 limit for dental, from around $21 a month.
  • "Mid Extras" is one of the cheapest policies to cover hearing aids, from around $43 a month.

Cons

  • GMHBA's "Basic Extras" policies don't cover chiropractic services, psychology or remedial massage, which is covered by comparable policies from funds like Bupa and Frank.
  • AIA Vitality is not available on extras policies.
  • GMHBA had more ombudsman complaints than its market share, more than funds including nib, Bupa and HBF.

Good value GMHBA policies

These are some good value hospital policies from GMHBA, including 1 extras policy and 2 Silver tier policies.

Top Pick for

Mid Extras

GMHBA Mid Extras's 65% image


From $63.70 per month*

General and major dental ($1500 limit) | Hearing aids ($1200 limit) | Optical | Physio

More info

Top Pick for

Silver Hospital

GMHBA Silver Plus Hospital image


From $123.17 per month*

29 treatments covered | Back neck and spine | Dental surgery | Sleep studies | Blood | AIA Vitality

More info

*Quotes are based on a single individual with less than $90,000 income, $500 excess and living in Sydney.

GMHBA health insurance: Our verdict

GMHBA is a reliable not-for-profit fund that has a range of good value plans, especially if you're able to take advantage of the rewards offered through AIA Vitality.

GMHBA is good if:

  • You want a hospital policy with AIA Vitality, that rewards and motivates you to lead a healthy lifestyle.
  • You want a cheap extras policies with a high claim limit for dental. Either of GMHBA's "Basic Extras" policies will fit the bill.

GMHBA is not great if:

  • You want a cheap extras policy that has a benefit for chiropractic services, psychology or remedial massage.
  • You want a cheap Basic, Bronze or Gold hospital policy. In each of these tiers there are competitors that offer more coverage for a lower price.

Review by our insurance writer Gary Hunter.

Compare all policies from GMHBA

What types of health insurance does GMHBA offer?

Hospital icon

Hospital Coverage

  • Basic Plus. Starting at around $18 a week, this covers you as a private patient in a public hospital and comes with an excess of $500.
  • Bronze Essential with AIA Vitality. At around $21 a week, this policy covers everything included to qualify as bronze. It also comes with AIA Vitality, the health and wellbeing program that rewards healthy behaviours.
  • Bronze Plus. This policy includes everything the Bronze Essential policy covers plus dental surgery.
  • Silver Core with AIA Vitality. This policy covers all 26 clinical categories required to get the Silver designation, including cover for dental surgery, heart treatments and podiatric surgery. It also includes AIA Vitality.
  • Silver Plus. This covers everything the Silver Core policy does plus a few more like sleep studies and full instead of restricted cover for rehabilitation and palliative care.
  • Silver Plus Premium. For around $35 a week, this includes everything the Silver Plus policy covers plus additional services including cataracts, joint replacements, kidney dialysis and insulin pumps. It does not cover pregnancy and comes with a choice of excesses. This policy does not come with access to the AIA Vitality rewards program.
  • Silver Plus Classic with AIA Vitality. This policy covers you for exactly the same as Silver Plus Premium except that you also get access to the AIA Vitality rewards program.
  • Gold Premium. Gold Premium hospital comes with a $750 excess and can pay towards all 38 clinical services.
  • Gold Ultimate with AIA Vitality. This includes all 38 clinical categories required for a gold label including pregnancy, weight loss surgery, assisted reproductive services (like IVF) and pain management with device, but it also comes with 2 excess options, $500 or $750, and access to AIA Vitality.

Extras icon

Extras coverage

  • Basic Extras Set Benefits. This offers cover for preventative dental, optical, a range of therapies, some pharmaceuticals, health aids and preventative treatments. It gives you a set benefit that you'll get back per treatment, meaning you'll get the same dollar amount back for a specific treatment no matter how much the provider charges.
  • Basic Extras 55. Exactly the same as Basic Extras Set Benefits but instead of set benefits, you'll get 55% of your costs back regardless of what your provider charges.
  • Mid Extras Set Benefits. Gives you a bit more than Basic Extras including orthodontics, major dental, psychology and a wider variety of health aids. Each treatment type gives you back a set benefit amount no matter how much the provider charges.
  • Mid Extras 65. Exactly the same as Mid Extras Set Benefits except you get 65% of your costs back for most treatment types regardless of what the provider charges.
  • Top Extras Set Benefits. Covers most of what the Mid Extras policies cover with the inclusion of prenatal and antenatal services and exercise physiology. The benefit limits are higher than Mid and the set benefits for each treatment visit are also higher in most cases.
  • Top Extras 75. Exactly the same as Top Extras Set Benefits but instead of set benefits, you'll get back 75% of your costs on most treatments regardless of what the treatment provider charges.

GMHBA health insurance complaints

We looked at the 2020 Ombudsman health insurance complaints. Here's how GMHBA stacked up:

  • Among Australia's 19 biggest insurers, GMHBA had the fourth largest complaint ratio, which is a bad thing.
  • While GMHBA did have a proportionally large number of complaints, other health funds had more, including Australian Unity, HIF and Health.com.au (although Health.com.au is now owned by Frank, which is part of GMHBA).

This chart shows the weighted volume of complaints received by each health fund, according to the Commonwealth Ombudsman. The lower the number, the better. GMHBA is sixteenth overall in this ranking. The weighting ensures that funds are compared fairly; larger funds serve more customers so can potentially get more complaints.

GMHBA frequently asked questions

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8 Responses

    Default Gravatar
    MervynApril 1, 2019

    Could you please send more information on my policy, with the new gov surcharges /and the waiting time if I downgraded to pay either $250 OR $500 up front.

      Avatarfinder Customer Care
      MaiApril 2, 2019Staff

      Hi Mervyn,

      Thanks for reaching out to Finder.

      Just a gentle reminder that you have reached Finder and we do not represent GMHBA health insurance but we are happy to provide you general information. In your case, you may need to reach out to GMHBA directly so they can review your policy, give you more details that concerns about the new government surcharges and waiting time should you downgrade your policy.

      Hope this helps!

      Kind Regards,
      Mai

    Default Gravatar
    BasilAugust 4, 2017

    Can hearing aids be claimed on our private health cover

      Default Gravatar
      ArnoldAugust 5, 2017

      Hi Basil,

      Thanks for your inquiry.

      Some private health care plans cover the costs of audiological tests, a hearing aid evaluation, and even partial or full coverage of a hearing aid. Be sure to check with your health insurance company or your employer’s benefits manager to find out.

      Hope this information helped.

      Cheers,
      Arnold

    Default Gravatar
    SanFebruary 18, 2017

    What are the major eye surgeries that are covered under the
    GMHBA Gold Hospital Level 2 cover?

      Avatarfinder Customer Care
      ZubairFebruary 20, 2017Staff

      Hi San,

      Thank you for your inquiry.

      GMHBA Gold Hospital can provide cover for major eye surgery. However, it would be based on the given situation. Generally speaking, the gold cover will provide you with unrestricted cover for all medically necessary in-hospital treatments and procedures. With this in mind, it is best to get in touch with GMHBA directly to confirm and get more details.

      If in case you want to learn more, you can head to our eye surgery health insurance guide.

      While looking for insurers, please make sure you read the terms and conditions of the policy to learn more and know if it is the right policy for you or not.

      I hope this helps. Should you have further questions, please don’t hesitate to reach out again.

      Have a wonderful day!

      Cheers,
      Zubair

    Default Gravatar
    AnnieNovember 23, 2016

    Do you cover cosmetic surgery

      Avatarfinder Customer Care
      RichardNovember 23, 2016Staff

      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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