GMHBA Health Insurance | Common Questions

Generally the contributions and benefits for family health insurance policies are the same as for couples. So if you are a couple, all our family health insurance covers are suitable for you.

However if you're not planning a family you may want to take out Silver Hospital cover. This cover is more affordable because no benefits are payable for obstetrics, IVF and related services, cataract surgery, joint replacement and cosmetic surgery. There's more information about Silver Hospital cover on the Silver Hospital cover page.

When do I need family health insurance cover?

If you've chosen a cover for yourself only, or one that has obstetrics excluded, you need to upgrade your cover 12 months before you have a child. This is to ensure you've served all your waiting periods at the time you and your newborn need the upgraded cover. In most cases, obstetrics and additions of dependants to be covered on a family membership will be subject to waiting periods. Please call our customer service centre on 1300 4 GMHBA (46422) or visit a branch for advice on when you should upgrade.

You must advise GMHBA when a dependant ceases full-time study, or a full-time traineeship/apprenticeship, or fails to meet any of these requirements for any other reason. If you remove your partner, children and/or dependant/s from your membership, GMHBA will contact the affected person/s and offer continuation of cover under a separate membership.

Who can my family health insurance membership cover?

Our family health insurance memberships cover you, your partner, and your children under the age of 21 years (includes step, adopted and permanent foster children).

Your family membership also covers your dependants who are under the age of 25 years, single, full-time apprentices, full-time trainees or full-time students at a school, college, university or institution recognised by GMHBA and when they are primarily reliant on you for maintenance and support.

Hospital excesses for child dependants under 21 listed on a family Gold Hospital or a single parents Silver Hospital membership are not payable on GMHBA hospital covers with the exception of Great Value Gold Hospital cover (EK) and Bronze Hospital Cover.

What is Lifetime Health Cover?

Please refer to Lifetime Health Cover loading.

What is the Medicare Levy Surcharge?

The Medicare levy surcharge is a surcharge on individuals and families on higher incomes who don't have eligible private patient hospital cover (eligible cover). The surcharge is 1% of taxable income in addition to the normal 1.5% Medicare Levy. People may have to pay the Medicare levy surcharge if they or any of their dependants do not have eligible cover and they are:

A single person - without dependent children - with a taxable income (including any reportable fringe benefits of $1,000 or more) greater than $77,000.
A family - including a couple and single parent - with a combined taxable income (including any reportable fringe benefits of $1,000 or more) greater than $154,000 (increasing by $1,500 per dependent child, after the first child).

Eligible private patient hospital insurance

Since the 24th of May 2000 the maximum annual amount of excess permitted to avoid the Medicare levy surcharge is $500 for singles and $1,000 for families, couples and single parents. It means people who join a hospital cover after the 24th of May 2000, for which the excess is above these amounts, and who earn incomes higher than the threshold amounts (including reportable fringe benefits) are still subject to the Medicare levy surcharge. Contact your tax adviser or GMHBA for further details.

There is more information about the MLS on the Medicare Levy Surcharge page.

What are the Federal Government rebates on private health insurance?

If you have health cover and all people covered by the membership are eligible for Medicare, you are eligible for a Federal Government rebate. The rebate is 30% for people aged up to 64 years, 35% if one or more people covered on the membership are aged 65 to 69 and 40% if one or more people covered are aged 70 or more. You can claim the rebate as a reduction to your premiums, as a tax rebate when you lodge your annual tax return or as a direct payment from the Government through any Medicare office.

The rebate applies to hospital cover, extras cover and combined hospital and extras cover.

The easiest way to receive your rebate is to register with GMHBA. We will then deduct the rebate from your premiums... and you pay less.

How do I pay my GMHBA health insurance premiums?

GMHBA offers you a variety of options for you to pay your health insurance premiums, and you can change the way you pay your premiums at any time.

Please refer to Payment and Claiming Options for more information.

How do I make a claim on my health insurance?

Please refer to Payment and Claiming Options for this information.

What if I change my mind about my health insurance cover?

If you manage to find better value for money health insurance elsewhere or wish to cancel your membership for any reason within 60 days of joining GMHBA and haven't made a claim, simply cancel your membership and we'll refund your money.

Does GMHBA pay Health Insurance Brokers a commission?

Health Insurance Brokers generally provide an independent service to help consumers compare a choice of products.

GMHBA uses select health insurance brokers as a sales channel for their products. Brokers receive commissions directly from GMHBA for recommending GMHBA products and these commissions are built into GMHBA's cost structure, not added to the premium of members that choose to use such services.

There is not currently a requirement for the mandatory disclosure of Broker commissions, although GMHBA encourages such an activity for the industry in the future.

Why does GMHBA use Health Insurance Brokers?

We use selected health insurance brokers because they can produce new members for the fund at a cost of acquisition that is at least comparable to the cost of attracting and winning that new customer through conventional marketing.

GMHBA seeks to be very cost effective in its attraction of new members because it does not wish to, nor should it, match the multimillion dollar marketing budgets of the major funds.

New members are important to the overall financial performance of the fund and it is in the interests of all members to offset the lost margin from members that leave us each year (and of these there are relatively few) and more significantly to offset the annual cost of health care inflation.

GMHBA Health Insurance | Simply Great Value Health Insurance

GMHBA is a not-for-profit health fund offering a range of hospital, extras and combined health insurance covers to suit a family, a couple or an individual

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Common Questions

Why get private health insurance?

What is Hospital cover?

What is Extras Cover?

What are health insurance waiting periods?

Is family health insurance the same as couples?