About health insurance
At GMHBA we are committed to explaining the ins and outs of health insurance so that you are fully informed about your cover.
In this section of the website we have included information that explains some of the key health insurance terms and principles.
Health insurance terms explained
GMHBA’s range of hospital covers often feature an excess to let GMHBA members share some of the cost of hospital admissions in return for lower premiums. The excess is calendar year based. Read about this topic.
A waiting period is the time between joining GMHBA and when you can start claiming. Waiting periods exist to protect members’ funds from those who wait until they are sick to join a health fund claiming large sums immediately. Read about this topic.
Silver Hospital cover provides the same single room coverage as Gold Hospital, but co-payments of $100 per day up to a maximum of $700 per admission apply. Co-payments are not the same as hospital excess. Please note: Some private hospitals only have single rooms and co-payments will apply.
Medical Gap Cover
A schedule of fees has been set by the Federal Government for eligible services by doctors in a hospital or day surgery. Medicare pays 75% of this schedule fee for in-patient medical treatment and GMHBA pays the other 25% up to 100% of the Medical Benefit Schedule (MBS) fee. Read about this topic.
Lifetime Health Cover Loading
The Lifetime Health Cover (LHC) loading is a Government loading on your private hospital cover premiums. It was introduced on July 1, 2000 to encourage people to take out private hospital cover earlier, and to maintain their cover. Read about this topic.
Rebate and Medicare levy surcharge
The Medicare Levy Surcharge (MLS) is an additional tax which Australians may need to pay if they are without private health insurance hospital cover and have a taxable income greater than $90,000 as a single or $180,000 as a couple/family. Read about this topic.
Why buy health insurance?
The benefits of private health insurance
We understand that the decision to get private health insurance can be challenging. So many questions: ‘When do I need it?’ and ‘What does it cover?’ Read about this topic.
Private versus Public
Australian residents are automatically covered for many hospital-related costs under the Government’s Medicare scheme, however many Australians prefer to take out additional cover to give them access to be treated in the private health care system. Read about this topic.
Dependants and health insurance
Child dependants: are covered up until they turn 21 years of age if they no longer meet the criteria for student dependants. Read about this topic.
Other useful information
Switching from another fund
Switching to GMHBA from another health fund may be easier than you think. Not only is it a simple process, but we can help make sure that you aren't left without cover for any period of time, or have to re-serve any waiting periods. Read about this topic.
Payments and claiming
Pay your GMHBA premiums and see how easy it is to claim for extras, hospital, and medical costs. Read about this topic.
Non-residents, migrants and overseas travel
GMHBA hospital covers are designed for people who have full Medicare eligibility. These covers will not meet the cost of public hospital treatment, medical treatment or diagnostic services for people who do not have full Medicare eligibility. Read about this topic.
Ambulance cover explained
Ambulance cover is important as you never know when an emergency may happen.
Ambulance coverage in Australia is different from state to state, so we encourage you to find out what you need to do to be fully covered. Read about this topic.