Private Health Funds: GMHBA

GMHBA is a member-based not-for-profit that was established in 1934. The fund also owns the budget brand Frank Health Insurance. GMHBA and Frank are part of Members Own Health Funds, a group of not-for-profit and mutual health funds operating with a members-first focus. Over 230,000 Australians have GMHBA health insurance.

  • GMHBA is a not-for-profit health fund based in Geelong, VIC. It provides services to Australians across the country.
  • GMHBA has partnered with AIA Vitality to offer a range of health insurance policies with additional rewards benefits. Members can earn points for certain healthy living activities and spend them on rewards.
  • GMHBA holds 2.3% of the private health insurance market and makes up 2% of all complaints.

GMHBA categorises its policies into Bronze, Silver, and Gold levels. You can choose from hospital-only or extras-only cover, combine the two, or opt for a policy from the special V Plus range.

Hospital

Choose from low, medium, or high levels of hospital cover, with a no-pregnancy option at the top tier. Excess options for all levels are $0, $250, or $500.

  • Bronze Hospital: Entry level hospital cover.
  • Silver Hospital Plus: Moderate level of hospital cover with some exclusions.
  • Gold Hospital (No Pregnancy): High level of hospital cover excluding pregnancy.
  • Gold Hospital: Comprehensive hospital cover that includes pregnancy services.

Extras

Each level of extras is offered as either a set benefits policy or with a designated percentage back on eligible services.

  • Bronze: Basic cover for preventative dental and optical, set benefits or 55% back.
  • Silver: Medium cover for popular services including major dental and optical, set benefits or 65% back.
  • Gold: High cover, includes additional services such as orthodontics and physio, set benefits or 75% back.

Hospital + Extras

Mix and match the hospital and extras packages on offer to come up with one that suits you best. GMHBA makes suggestions based on your family type: single, couple, family, or single parent.

AIA Vitality V Plus

This is a special range of products offered in partnership with AIA Vitality. Members can enjoy access to exclusive benefits in addition to their health cover. All V Plus policies include emergency ambulance, no excess for kids, and general dental.

  • V Plus Bronze Package: Affordable hospital cover with some exclusions and 50%
    back on select extras.
  • V Plus Silver Package: Moderate hospital cover with some exclusions and 60%
    back on select extras.
  • V Plus Gold Package: Comprehensive hospital cover, including pregnancy, but
    with some exclusions and 70% back on select extras.

According to the Private Health Insurance Ombudsman (PIHO), here’s how GMHBA stacks up against other funds in the industry.

  • Hospital Related Charges Covered
    GMHBA is below industry average
  • Medical Services with No or Known Gaps
    GMHBA is below industry average
  • Medical Services with No Gaps
    GMHBA is below industry average
  • General Treatment (Extras) Covered
    GMHBA is below industry average

GMHBA Compared to Industry

Share of Private Health Insurance Ombudsman complaints

Reference: http://www.ombudsman.gov.au/publications/state-of-the-health-funds-report

GMHBA member claim options depend on the type of claim you are making.

Claiming for extras

  • Swipe your card: Use your GMHBA membership card with eligible providers to bill GMHBA directly.
  • Claim online: Visit the GMHBA member website to claim.
  • Visit a branch: Bring an itemised receipt and/or account.
  • Post your claim: Complete a claim form and post it with your receipt or account.
    Medicare office: Visit a Medicare office to have them forward your claim on for processing.

Claiming for hospital services

  • Private hospitals: If at a participating hospital and covered by your policy, you’ll only pay an excess and co-payments. The rest is billed directly to GMHBA.
  • Public hospitals: As a private patient in a public hospital (shared room), you’ll only have to pay your excess. The rest is billed directly to GMHBA.

Claiming for medical costs

  • If your doctor participates in GMHBA’s Gap Cover Scheme, you’ll receive a bill for whatever costs are not covered by Medicare or GMHBA
  • If your doctor does not participate in the scheme, take your paperwork to Medicare, then send statements to GMHBA. Once you receive cheques from both, send them on to your doctor. You’ll receive a bill for any remaining costs.

GMHBA offers a rewards program depending on the type of policy you have. The AIA Vitality program offers member rewards and discounts.

AIA Vitality

GMHBA partnered with AIA Vitality to offer a special range of ‘V Plus’ insurance policies that offer extra health rewards. AIA Vitality is a system where you earn points for doing healthy things, and those points can be spent on rewards.

New members start at Bronze status and can work their way up through Silver, Gold, and Platinum status. The higher your status, the more rewards you can earn. Earn points by tracking your activity, eating, and sleep patterns as well as through dental or optical checkups. Conditions apply.

Examples of AIA Vitality rewards include:

  • Up to $650 in rewards at Woolworths, Myer, JB HI-FI, Rebel, and DYMOCKS
  • Up to 50% off flights
  • Up to 50% off endota spa vouchers
  • Membership discounts at Anytime Fitness, Fitness First, Virgin Active, and Step Into Life
  • 50% off movie vouchers
  • 1 x $5 voucher per week to Boost Juice, iTunes, HOYTS, or Woolworths
  • Up to 25% off Fitbit and Garmin devices

Address:
60-68 Moorabool St, Geelong
VIC 3220

Phone:
1300 446 422

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