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Use this section of the website to find out how GMHBA is supporting your local community.
We are committed to keeping you informed about your health insurance cover.
This table gives you a quick comparison of what each hospital cover does and doesn't cover, along with whether it is covered in a public or private hospital. Please read this table in conjunction with the rest of the GMHBA Member Guide before making your decision about which cover is right for you.
a We will pay you $50 per day (up to a maximum of $150 for three days) if you stay in a shared room when you requested a single room. This is only available for overnight accommodation in a Private Hospital. Day stays are ineligible for this payment.
b A pre-existing condition (PEC) is one where signs or symptoms of your ailment, illness or condition, in the opinion of a medical practitioner appointed by GMHBA (not your own doctor), existed at any time during the six months preceding the day on which you purchased your hospital cover or upgraded to a higher level of hospital cover and/or benefit entitlement. Please refer to the important information section of the GMHBA member guide for more information.
c Limited benefits may apply to high cost drugs. Drugs purchased outside of the hospital are not included.
d If the fund believes that a patient, following a review of the case (on the basis of information provided by the hospital either internally or using an agreed independent source), is not receiving acute care after 35 days continuous hospitalisation, GMHBA benefits will be reduced to Nursing Home Type Patients benefits and will be paid in accordance with the default benefit determined by the Health Department. All Nursing Home Type Patients are required to pay part of the cost of hospital accommodation.
e During the first 24 months of cover (after the standard hospital waiting periods have been served), benefits payable for these services will be limited to Public Hospital benefits only. Please refer to the Member Guide for more information.
fBenefits are no higher than the No Gap Government prescribed benefit.
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This table provides a quick comparison of the main features of the hospital component of the Fit packages and must be read in conjunction with the detailed information in this member guide.
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