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Basic Extras 55%
We pride ourselves on providing great value health cover. That’s why all our products are backed by a 60 day money back guarantee. If for any reason your circumstances change and you have not claimed, we will fully refund your membership. *For new members.
Inclusions
General Dental:
Diagnostic services, simple extractions (not including surgical extractions of wisdom teeth) and restorative services (limited benefits apply to precious restorations).
Annual limit per person, per calendar year
$1,000
Combined annual limits for General dental and Preventative dental
Sub-limit of $300 applies for Preventative dental
Benefit - General dental
Periodic oral examination (012) - 55%
Scale & clean (114) - 55%
Fluoride treatment (121) - 55%
Excludes Major dental treatment
Waiting period
2 months
Includes prescription lenses, spectacle frames, and contact lenses. Non-prescription sunglasses and repairs are excluded.
Annual limit per person, per calendar year
$150
Benefit
55%
Waiting period
6 months
Treatment by a physiotherapist which uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to normal activities of daily living.
Hydrotherapy, involves the use of water for pain relief and treatment. The term encompasses a broad range of approaches and therapeutic methods that take advantage of the physical properties of water, such as temperature and pressure, for therapeutic purposes, to stimulate blood circulation and treat the symptoms of certain diseases.
Annual limit per person, per calendar year
$300
Annual limit per policy, per calendar year
$600
Combined annual limits for Physiotherapy, Hydrotherapy and Myotherapy
Benefit
Initial consult - 55%
Subsequent consult - 55%
Group attendance - 55%
Waiting period
2 months
Myotherapy is a branch of manual medicine which focuses on the treatment and rehabilitation of musculoskeletal pain and associated conditions. This involves an extensive physical evaluation and an integrated therapeutic approach to affected muscles, joints, nerves, and associated viscera (organs) and is used in the treatment of acute or chronic conditions and in the area of preventative management.
Annual limit per person, per calendar year
$300
Annual limit per policy, per calendar year
$600
Combined annual limits for Physiotherapy, Hydrotherapy and Myotherapy
Benefit
Initial consult - 55%
Subsequent consult - 55%
Waiting period
2 months
Benefits cannot be paid for PBS scripts, contraceptives, items not on the TGA register or items purchased overseas. Pharmaceuticals must be classed as either Schedule 4 or Schedule 8 for benefits to be paid. A sub-limit per script (after PBS co-payment deduction) applies.
Annual limit per person, per calendar year
$150
Annual limit per policy, per calendar year
$350
Benefit
Per script - 55%
Waiting period
2 months
Occupational therapy assists and supports people to participate in day to day life by enhancing their ability to engage in everyday activities.
Annual limit per person, per calendar year
$300
Annual limit per policy, per calendar year
$600
Benefit
Initial consult - 55%
Subsequent consult - 55%
Waiting period
2 months
Annual limit per person, per calendar year
$30
Benefit
Per repair - 55%
Waiting period
2 months
Refer to medical devices (such as a knee brace) fitted immediately following surgery or to heal an injury.
Must be custom made and GMHBA specified and approved.
A doctor's letter of recommendation is required prior to claiming.
Annual limit per person, every three years
$200
Benefit
Per appliance - 55%
Waiting period
12 months
Garment that applies continual pressure over large areas of skin.
Garments must be supplied through a private company or therapist in private practice. A doctor's letter recommending the appliance must accompany each claim for benefits.
A doctor's letter of recommendation is required prior to claiming.
Annual limit per person, every three years
$100
Benefit
Per garment - 55%
Waiting period
12 months
Fluoride benefits are payable towards the cost of dietary fluoride supplements (tablet or liquid form) when dispensed by a chemist or dentist in a private practice.
Annual limit per person, per calendar year
$45
Benefit
Per supplement - 55%
Waiting period
2 months
Melanoma survelliance photography and skin checks are a set of images taken of the body to use in the early detection of potential skin cancers such as melanoma.
Annual limit per person, per calendar year
$50
Annual limit per policy, per calendar year
$100
Combined annual limits for Melanoma surveillance photography, Quit smoking programs and Nicotine replacement patches
Benefit
1 per year
Waiting period
2 months
Patches impregnated with nicotine, which are worn on the skin by a person trying to give up smoking. Nicotine is gradually absorbed into the bloodstream, helping reduce the craving for cigarettes.
Annual limit per person, per calendar year
$50
Annual limit per policy, per calendar year
$100
Combined annual limits for Melanoma surveillance photography, Quit smoking programs and Nicotine replacement patches
Benefit
1 x 12 week course of patches per year
Waiting period
2 months
Programs that provide support and information to help quit smoking and vaping. A doctor’s letter of recommendation must accompany a claim.
Annual limit per person, per calendar year
$50
Annual limit per policy, per calendar year
$100
Combined annual limits for Melanoma surveillance photography, Quit smoking programs and Nicotine replacement patches
Benefit
1 per year
Waiting period
2 months
Extras FAQs
A waiting period is the time between joining GMHBA and when you're covered for a treatment or service. If you receive a service or treatment during a waiting period, you are not eligible to receive a benefit payable from us, regardless of when you submit the claim.
Extras waiting periods apply to:
New members to health insurance, existing members who have upgraded their cover or anyone who has transfered to GMHBA from a previous fund and:
- Still have waiting periods to finish serving
- Joined on a higher level of cover and haven't served waits on any new services or increased benefit limits
- Had a gap in their extras cover for more than 30 days
Waiting periods for extras services are as follows:
Waiting Periods - 12 Months
Major Dental including Orthodontics, Hearing Aids, Health Appliances and Foot Orthotics
Waiting Periods - 6 Months
Optical
Waiting Periods - 2 Months
All other services
Waiting Periods - 0 days
Ambulance transport and subscriptions
Our members have freedom of choice when selecting their preferred provider. For members to claim with GMHBA, providers must hold active accreditation, be operating in a private practice and considered an Australian Provider.
We've partnered with smile.com.au to make dental care more affordable and accessible for our members across Australia. This means lower out of pocket costs for all dental treatment, as smile.com.au dentists will reduce their fees by at least 15%.
With more than 2,500 approved dentists in the smile.com.au network, chances are there is one near you.
A extras policy can have four different types of limits:
- Policy limit - The total amount for a service that can be claimed for the policy in a calendar year.
- Person limit - The maximum amount a single person can claim towards a service within the calendar year.
- Membership limit - The maximum total between everyone on the policy, that can be claimed towards a service within the calendar year.
- Sublimit – A cap on benefits set by GMHBA towards a particular service or treatment within the overall annual limit.
Annual limits reset on 1 January each year for most services.
Some services such as hearing aids and health appliances have a benefit period of three years. This means that if you have claimed your full hearing aid benefit you will be unable to claim an additional benefit for three years from the date of the initial claim.
With set benefits you get the same benefit back each time you visit the provider up to your annual limits.
A percentage back allows you to get a percentage of the overall charge back up to your annual limits.
Our promise
Not the right cover for you? We'll refund your premium provided you haven't made a claim.
We’ve been helping Australians manage their health care for 90 years.
We’re not for profit, so we always put the health and wellbeing of our members first.
Find the right cover for you, join online and we'll take care of the rest. Plus, you'll serve no waiting periods if you switch to the same or lower level of cover.
Contact our friendly customer service team
1300 446 422
Disclaimer
This information is important.
Please read and retain for future reference.
Full information about your chosen cover's applicable waiting periods, excess, co-payments, exclusions, restrictions, limits, pre-existing conditions, accident protection and services covered is available within the policy factsheet. The price shown excludes any Lifetime Health Cover (LHC) loading.
Rates are effective 1 April 2025. | All contribution quotes by this calculator are subject to variation and should therefore be considered indicative contribution rates. | Weekly and fortnightly payment frequencies are only available for direct debits | Calculations include the 2% Direct Debit Discount available only via bank account direct debit | All prices include the Australian Government Rebate on Private Health Insurance as chosen | Hospital Cover contributions do not include any applicable Lifetime Health Cover loading.