Using your hospital and extras cover

A waiting period is the time between joining GMHBA and when you're covered to start claiming on a service. Hospital cover and extras cover both have waiting periods before you can start claiming, you may also have to serve a wait for a pre-existing condition before using your hospital cover.

If you have upgraded your level of cover and have a new service or increased service limit, you will need to serve a waiting period before you can start using your new limit or start claiming.

Learn more about waiting periods here.

An annual limit is the amount you have to spend on an extras service each year. At GMHBA, your annual limit amount resets on 1 January (we reset in line with the calendar year, some health fund follow the financial year and reset in July). If you go over your annual limit early into the year, we recommend calling our customer service team for a cover review. They’ll ensure you’re on the right level of cover for your needs.

The easiest way to check your annual limits on popular services is by logging into the member area, you can also contact our customer service team and they will assist you.

If you go over your annual limit for an extras service, you're no longer able to claim on that item until your limit resets. If this happens early into the year, we recommend giving our customer service team a call to review your cover, they can help make sure you're on the right level of cover for your needs.

There are a number of ways you can claim your extras benefits. 

On the spot - Most claims can be processed when you have your appointment using a HICAPS machine. Simply swipe your GMHBA membership card and we'll pay the provider directly, so you just have to pay the difference. Please note, some providers may not have this method available.

Online claiming – The member area is the fastest way to receive your benefits if you need to manually claim. Benefits will be put directly into your nominated bank account.

In a branch - Visit your local branch to make a claim.

Photo claiming - You can make a claim using our easy photoclaiming tool, it's simple to use but takes a little longer for our team to process.

Please note GMHBA members have two years from the date of service to submit a claim.

No, you have the freedom to use your extras with the provider of your choice, as long as they are recognised to legally practice in Australia.

Our members can get special offers with a number of providers nationwide, but choosing a provider is up to you.

We understand that going to hospital can be a scary time, that's why we've made a step-by-step guide to help you. From asking the right questions, to finding the right specialist and costs, we walk you through what to expect. 

There are a number of ways you can pay your premiums, learn more here.