Why GMHBA extras cover wins for value
Outstanding value extras cover
When comparing private health insurance extras, the best value cover is one that matches the services you use, helps you get more money back on claims, and makes claiming easy and flexible.
GMHBA has been recognised for member value with the 2026 WeMoney Award for Best for Flexibility and Canstar's 2025 Outstanding Value Award for Hospital & Extras Insurance (VIC, NSW, QLD, SA, WA). We’ve been delivering that value through our extras products and in 2025 introduced SmartCare Extras with a flexible annual limit model, allowing members to use their benefits across popular services.
About SmartCare Extras
How SmartCare Extras works: The flexible overall limit
With GMHBA's SmartCare Extras, you'll get 100% back on preventative dental at any recognised dentist and 60% back on other included services*, up to your annual limit or sub-limits. Per person limits give each person on the policy their own limit to spend their own way across included services. Combine SmartCare Extras with an eligible hospital cover to unlock a separate optical limit and annual limit rollover#.
#Annual limit rollover excludes optical. Available after 12 months of continuous cover on SmartCare Boost Extras at the same level (Starter, Everyday or Complete). Unused eligible annual limits roll over on 1 January and expire after 12 months *Includes 60% back on major dental and orthodontics when included on your cover.
| Feature | SmartCare Extras | SmartCare Boost Extras with hospital cover | ClassicCare Extras |
|---|---|---|---|
| Benefit model | Flexible limit model | Flexible limit model | Traditional extras model with separate service limits |
| Claim benefit |
100% back on preventative dental 60% back on other included services |
100% back on preventative dental 100% back on optical 60% back on other included services |
Set benefits or percentage back on included services |
| Limits | Per person limits across included services available with or without sub-limits | Per person limits across included services available with or without sub-limits | Individual service limits per person or policy |
| Annual limit rollover | No | Yes (excluding optical) | No |
SmartCare limits vs ClassicCare limits
Emma, 32, joined GMHBA on 15 August 2025 with SmartCare Everyday Boost Extras. Her cover includes a $1,000 flexible annual limit with no sub-limits, allowing her to use benefits across included services. She also gets 100% back on preventative dental with recognised providers. Because she also holds eligible GMHBA hospital cover, she receives 100% back on prescription glasses and contact lenses, up to her optical annual limit.
During 2026, Emma claims:
- $550 for two 6 monthly dental check-ups and cleans (preventative dental), receiving 100% back = $550
- $350 for physiotherapy, receiving 60% back = $210
In total, Emma received $760 in benefits.
Because she only used $760 of her $1,000 annual limit, she had $240 of unused limit remaining.
On 1 January 2027, that $240 will roll over, increasing the amount she could claim in the new year (subject to the product's rollover rules and maximum rollover balance). SmartCare product limits reset on 1 January each year.
Sarah, 32, joined GMHBA on 15 August 2025 with ClassicCare Mid Extras 65%. Unlike SmartCare, her benefits are divided into individual service limits.
During 2026, Sarah claims:
- Preventative dental treatment: $550 worth of check-ups, cleaning and fluoride treatment. With benefits paid at 65%, she received $357.50 back. Because preventative dental has a $400 sub-limit per person within the overall $1,500 annual limit for general dental, she still has $42.50 remaining under that sub-limit for the year.
- Physiotherapy: $350 in physiotherapy consultations. With benefits paid at 65%, she received $227.50 back.
In total, Sarah received $585 in benefits.
At the end of the year:
- $1,060 remaining in her general dental limit
- $42.50 remaining in her preventative dental sub-limit
- $172.50 remaining in her physiotherapy limit (combined with myotherapy and hydrotherapy)
However, Mid Extras 65% doesn't include annual limit rollover. Any unused benefits expire at the end of the calendar year and can't be carried over. Sarah's annual limits reset on 1 January each year.
Canstar approved, four years in a row!
GMHBA has done it again with Canstar’s 2025 Winner of Outstanding Value Award – Hospital & Extras Insurance: VIC. We are proud to provide Australians with 5 star health cover for our hospital and extras products.
GMHBA’s award recognised value
GMHBA has received industry recognition for delivering outstanding value, flexible cover options and high levels of member satisfaction, reflecting our commitment to putting members' needs first.
Extras cover value in practice – Extras cover for different life stages
SmartCare Everyday Extras
$1000 Smart Limit (no sub-limits)
Emma mainly uses extras cover for routine dental care and physiotherapy.
During the year, she had two dental check-ups and several physiotherapy appointments to help manage a sports injury.
Annual premium paid (extras only): $585^
Services claimed: Preventative dental and physiotherapy
Cost of services claimed:
Preventative dental: $400 (100% back up to available limits)
Physiotherapy: $850 (60% back)
Benefits received: $910
Net position: $325 ahead ($910 in benefits received compared to $585 in premiums paid)
With a $1,000 Smart Limit, Emma can use her annual benefit allocation across the services she needs most, rather than being restricted by separate service limits.
In this example, she used most of her annual limit on dental and physiotherapy, providing flexibility to match her healthcare needs. As SmartCare Everyday Extras does not include annual limit rollover (unless combined with hospital cover), any unused portion of the Smart Limit expires at the end of the calendar year.
^ Price based on based on Single, aged 32 living in VIC, earning $105,000 or less (Base Tier Australian Government Rebate). Excludes any Lifetime Health Cover loading. Premiums and benefits are indicative only and may vary depending on individual circumstances and claiming patterns.
Basic Plus Starter Hospital and SmartCare Everyday Boost Extras
$1,000 per person Smart Limit (no sub-limits)
The Nguyen family consists of two adults aged 35 and 38, and three children. During the year, they claimed for Mum and the children's dental check-ups, prescription glasses for one child, podiatry for another child, and physiotherapy treatment for Dad following a sporting injury.
Annual premium paid (combined hospital and extras): $3,456^
Services claimed: Preventative dental, physiotherapy and optical
Cost of services claimed:
Preventative dental for 3 x children & 1 x adult: $910 (100% back up to available per person limits)
Optical: $300 (100% back up to available per person limits)
Podiatry 3 x visits: $630 (60% back up to available per person limits)
Physiotherapy 8 x visits: $960 (60% back up to available per person limits)
Benefits received: $2,163
Net position: The family received $2,163 in benefits during the year. While their annual premium was $3,456, this included Basic Plus Starter Hospital cover, providing peace of mind that they're covered for eligible hospital treatments if they need care in the future.
The family benefits from SmartCare Everyday Boost Extras' flexible Smart Limit ($1000 per person, per year) and annual limit rollover, allowing them to use their available benefits across the services they need most rather than being restricted by separate service limits.
This can be particularly valuable for families, where healthcare needs can vary from year to year between dental, optical, and allied health services.
^ Price based on a couple aged 35 and 38 living in VIC, earning $210,000 or less (Base Tier Australian Government Rebate). Excludes any Lifetime Health Cover loading. Premiums and benefits are indicative only and may vary depending on individual circumstances and claiming patterns.
Bronze Plus Core Hospital and SmartCare Complete Boost Extras
$1,500 Smart Limit (no sub-limits)
Mike mainly uses extras cover for routine healthcare. In year 1, Mike only claims for preventative dental, leaving much of his Smart Limit unused. With annual limit rollover, Mike's unused benefits carry forward and help cover the cost of major dental treatment plus physio in Year 2.
Year 1
Annual premium paid (combined hospital and extras): $2,251^
Services claimed: Preventative dental
Cost of services claimed: $650
Benefits received: $650
$650 back on preventative dental (100% back)
Unused Smart Limit rolled over: $850
Year 2
Annual premium paid: $2,251^
Services claimed: Major dental (including crowns and restorative work) and physiotherapy
Cost of services claimed: $4,000
Benefits received: $2,250
$1,800 for major dental (using his $1,500 annual Smart Limit plus $300 rolled-over benefits)
$450 for physiotherapy (using $450 of rolled-over benefits)
Unused Smart Limit (Year 2): $100
$1,500 Smart Limit was used for major dental claim, and remaining $100 in rolled-over limits will expire at the end of year 2.
Two-year outcome
Total premiums paid: $4,502
Total benefits received: $2,900
Net position: Mike received $2,900 in benefits over two years, plus the security of hospital cover. Thanks to annual limit rollover, unused extras benefits from Year 1 helped cover the cost of major dental treatment in Year 2.
^Price based on Single, aged 52 and living in VIC, earning $105,000 or less (Base Tier Australian Government Rebate). Excludes any Lifetime Health Cover loading. Premiums and benefits are indicative only and may vary depending on individual circumstances and claiming patterns. Note annual premium in year 2 is subject to yearly premium review and likely to change.
Think about how often you use services such as dental, physiotherapy, chiropractic care or remedial massage. If you expect to make frequent claims, extras cover with a higher annual limit may provide better value. If you only use a few services each year, a lower limit may suit your needs.
Different extras products structure benefits in different ways. Some include set limits and sub-limits for specific services. SmartCare Extras gives you more flexibility to use your annual Smart Limit across a range of included services.
If you're planning future dental work, physiotherapy treatment or other ongoing health services, SmartCare Boost Extras combined with hospital cover may help you maximise your benefits. Eligible members can access annual limit rollover, after maintaining continuous cover for the required period, allowing you to carry over unused benefits for a further 12 months.
Many extras benefits reset annually on 1 January. Planning preventative health appointments and routine treatments earlier in the year can help you get the most value from your available limits and avoid missing out on unused benefits.
Your health needs can change over time. Whether you're single, growing your family, nearing retirement or managing new healthcare needs, it's worth doing a cover review annually to make sure it still suits your circumstances. Compare your options and benefit levels to ensure you're getting the right level of cover for your stage of life.
For over 90 years GMHBA has been delivering value to its members. As a not-for-profit health insurer, any profit made is reinvested back into improving our services, delivering value to our members, and strengthening the communities we serve, rather than going to shareholders or overseas investors.
GMHBA focuses on delivering value to members rather than shareholders. In 2026, GMHBA recorded the lowest average premium increase in the Australian private health insurance industry at 1.98%, compared to the industry average of 4.41%.
FAQs about extras cover
The best extras health insurance policy is the one that suits your health needs, budget and lifestyle. When comparing extras cover, it can help to consider:
- The services covered by the policy (such as dental, optical and physiotherapy)
- Benefit amounts and annual limits, and sub-limits.
- Waiting periods
- The cost of the premium
- Whether the policy provides value based on how often you expect to claim
- What matters most to you in a health insurer
GMHBA is a not-for-profit health insurer, meaning any surplus made is reinvested back into improving our services, delivering value to our members, and strengthening the communities we serve. We offer a range of extras cover options designed to support different healthcare needs and lifestyles, including our SmartCare Extras range which offers more flexibility in how members can use their cover.
There’s no single answer- it depends on your stage of life and the healthcare services you’re most likely to use. Younger singles may benefit from SmartCare Everyday Extras, using their flexible Smart Limit for services such as dental and physiotherapy. Young families may value the flexibility of Basic Plus Starter Hospital & SmartCare Everyday Boost Extras, helping cover preventative dental, and allied health services, with annual limit rollover. For mature singles or couples Bronze Plus Core Hospital and SmartCare Complete Boost Extras with annual limit rollover can help build benefits for future medical needs. See the life stage comparison table above for more guidance.