The Lifetime Health Cover (LHC) loading is a Government loading on your private hospital cover premiums. It was introduced on July 1, 2000 to encourage people to take out private hospital cover earlier, and to maintain their cover.
This determines what government rebate will be applied, find out more.
Hospital services
A waiting period is the time between when you first take out health insurance or upgrade your cover and when you're actually covered for a hospital treatment.
Hospital waiting period durations – when treatment or service is included on your cover – are as follows:
Waiting period: 0 days (accidents must occur after joining)
Accidents - bodily injuries resulting from accidents which occur after the date of joining GMHBA or upgrading to a higher cover.
Waiting period: 2 months
Any other benefit for hospital (or hospital substitution) treatment unless otherwise stated.
Waiting period: 12 months
Obstetrics and maternity, pre-existing ailment, illness or condition (other than psychiatric, rehabilitation and palliative care).
Extras services
A waiting period is the time between when you first take out health insurance or upgrade your cover and when you're actually covered for a treatment or service.
Waiting periods for extras services – when included on your cover – are as follows:
Waiting period: 0 days
Ambulance transport and subscriptions
Waiting period: 2 months
Any services that are not specified below
Waiting period: 6 months
Optical
Waiting period: 12 Months
Major dental, orthodontics, podiatry surgical procedures and orthotic appliances (foot), orthopaedic appliances (GMHBA approved), medical devices and aids including hearing aids, blood glucose monitor, extremity pump, nebuliser pump, pressure garments, prostheses (GMHBA approved, non-surgical), sleep apnoea monitor and tens monitor.
A pre-existing condition 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 insurance or upgraded to a higher level of hospital cover and/or benefit entitlement.
A special waiting period applies to obtain benefits for hospital treatment for new members who have pre-existing conditions. The waiting period also applies to existing members who have recently upgraded their level of hospital cover. If the ailment, illness or condition is considered pre-existing:
New members
New members must wait 12 months for any hospital benefits (other than psychiatric, rehabilitation and palliative care).
Existing members (transferring or upgrading)
Members transferring/upgrading to a higher hospital cover must wait 12 months to get the higher hospital benefits (other than psychiatric, rehabilitation and palliative care).
GMHBA extras can have several different types of benefit limits, depending on your cover. The limit type for applicable services is outlined in the fact sheet for each cover.
Annual limits – Most benefit limits are annual limits, which reset each calendar year on 1 January. Annual limits apply to each individual on the membership, unless otherwise specified. Keep in mind, some services also have a multi-year limit or lifetime limit.
Smart limits – Offered on SmartCare Extras covers only, a Smart Limit is a flexible annual limit that you can choose to spend across included services (excluding optical) each year, either with or without sub-limits depending on the cover.
Per person limits – The total amount an individual on the policy can claim on a service per calendar year.
Membership limits – The maximum amount that can be claimed in a calendar year per policy. This limit is shared between all people on the membership.
Sub-limits – The total amount you can claim on a particular service or treatment within the overall annual limit. These can vary from service to service.
Combined limits – This is a single limit that can be used across a collection of services.
Multi-year limit – The maximum amount you can claim, every few years.
Lifetime limit – This applies for orthodontic treatment only, per person on the membership, and is the maximum amount that can be claimed for the service during your lifetime.
Restricted services are limited to a minimum (default) benefit as set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. The benefit does not cover the cost of a private room in a public hospital or any room in a private hospital, and does not cover theatre costs. If you are admitted to a private hospital for treatment that is restricted by your policy, large out-of-pocket expenses will apply.
Services, procedures and treatments included in your health insurance cover.
Services, procedures, or treatments not included in your health insurance cover.
This information is important.
Please read and retain for future reference.
Full information about your chosen cover's applicable waiting periods, excess, 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 2026. | 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.
Price shown is inclusive of any discount entitlement. Premium may vary if your details change. Pricing and displayed product can change if details vary.
If you're 18-29, you will receive the below discount on your hospital cover as determined by your age. Learn more about how this works.
| Age when taking out cover | % age based discount |
|---|---|
| 18-25 years old | 10% |
| 26 years old | 8% |
| 27 years old | 6% |
| 28 years old | 4% |
| 29 years old | 2% |
| 30 years old | 0% |
Each year private health insurers review the cost of healthcare and use this information to adjust premiums. Any change must be reasonable and approved by the Federal Health Minister.
We want you to know now so you're not disappointed when you sign up today and see your premium change in April.
The amount of money a member agrees to pay for a hospital stay before GMHBA pay benefits. The excess is per person, calendar year based. Selecting a higher excess will lower the premium. No excess applies for child dependants under 21 on select GMHBA hospital covers. Please check your fact sheet for more information.
Some of your selected services may be excluded or restricted in this lower level of cover.
Included
Treatment or service is included on this cover as a private patient in a private or public hospital.
Excluded
Not included on this cover. Benefits not payable for this service, procedure or treatment.
Restricted
Service is limited to a minimum default benefit as set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. This may come with large out-of-pocket expenses when this service is provided in a private hospital. This does not cover things like theatre costs, a private room in a public hospital, or any room in a private hospital.
Available as hospital, extras or combined cover (to get the best of both hospital and extras), you get to choose what’s most important to you.
Hospital cover pays benefits towards medical treatment, services and accommodation provided when you’re admitted to hospital as a private patient.
Extras cover helps with the costs of everyday health care services provided outside of a hospital – things like dental, optical, chiro and other therapies.
We’ll take you through the different types of health insurance in more detail soon.
Here are some things to consider when choosing who to cover on your membership:
- If you have a partner, you can choose to take out two single policies or one couples policy.
- A “couple” can be married or in a de facto relationship with no minimum time requirement.
- Child dependants aged under 21 and eligible student dependants aged between 21 and 25 years can be included on single parent family and family policies.
- Different health care needs in the household? Some people can take out separate policies and hold a higher level of cover than others.
- Couples and family hospital covers cost the same, so eligible dependants can be added to a couples hospital cover without impacting premiums.
- If you include eligible dependants on a single parent or family extras cover, the good news is your premium is not impacted by the number of dependants on the membership.
- If you and/or your partner are high-income earners and your combined income falls above the government’s family threshold, all members of your household will need to hold eligible hospital cover for you to avoid having to pay the Medicare Levy Surcharge (MLS).
If you’re transferring your health insurance to GMHBA, we’ll contact your previous fund for you to cancel your cover and request a transfer certificate. This history of your health insurance helps us check whether you need to serve waiting periods, what limits remain, and whether any Lifetime Health Cover loading (LHC) or age-based discount applies to your new GMHBA cover.
Upgrading your cover? Waiting periods apply for newly included services, higher extras benefits or annual limits, or a reduced hospital excess on your new policy.
Depending on whether you’re new to health insurance, have had a gap in your cover or are currently insured but upgrading your cover, waiting periods may apply.
Hospital and extras have waiting periods that need to be served before you’re eligible to make a claim. These are outlined in the summary page and fact sheet for each cover.
When taking out hospital cover, Lifetime Health Cover loading – LHC for short – may apply to your premiums. Your LHC loading will be calculated during the sign-up process and if you’re switching to GMHBA or have previously held hospital cover, we’ll confirm this with your former health fund.
To help reduce pressure on the public health system, the Australian Government encourages people to take out hospital cover earlier in life and keep it as they age.
Lifetime Health Cover (LHC) loading adds 2% to hospital premiums for every year someone delays taking out cover after 1st July following their 31st birthday, until it’s capped at 70%. This loading – based on your Certified Age of Entry – applies for 10 continuous years before it’s removed.
Your age also affects the Australian Government Rebate for private health insurance. If the oldest person on the policy is 65 or over, you may receive a higher rebate. This can be applied as a premium reduction or claimed at tax time, and it applies to both hospital and extras cover.
GMHBA offers age-based discounts to encourage younger members to take out hospital cover before turning 30. The discount is based on your age when you first take out hospital cover, at a rate of 2% for each year you’re aged under 30. The highest age-based discount that can be applied to hospital premiums is 10% for 18- to 25-year-olds. If you maintain your hospital cover, you keep this discount until age 41. It’s then gradually reduced by 2% each year.
We need to work out if any discount, loading or rebate will apply to your premium – some of which are linked to your age.
If you’re eligible for the Australian Government Rebate on private health insurance or the age-based discount, these will be included in your quote. Any Lifetime Health Cover (LHC) loading will be confirmed during the sign-up process.
The income-tested Australian Government Rebate on private health insurance can help to cover the costs of hospital and/or extras cover. If you’re eligible, you can claim it as either a reduction on your GMHBA premium or a lump sum at tax time. And if you choose not to receive the rebate as a premium reduction, that’s up to you – you can always apply for it later if you change your mind.
If your income is over the government-set threshold and you don’t hold hospital cover – or you only had cover for part of the financial year – you may have to pay extra at tax time.
The Medicare Levy Surcharge, or MLS, is an additional tax of 1% to 1.5% of your income and may apply if you’re a high-income earner and don’t have eligible hospital cover.
Hospital cover helps with the costs of treatment, services and accommodation when you’re admitted to hospital as a private patient.
Some people choose it for tax purposes if they’re a high-income earner or to avoid additional costs – think Medicare Levy Surcharge or Lifetime Health Cover loading. Others enjoy the peace of mind that having hospital cover can bring.
The right cover can give you more choices in your hospital care including where you’re treated, who by, and potentially shorter wait times for elective surgery in a private hospital. Services can be included, restricted, or excluded, so it’s important to check what’s covered. Plus, you’ll need to be covered for the clinical category and have served all relevant waiting periods before you can claim. A hospital excess may apply.
Switching from another fund? You won’t need to serve waits on an equivalent or lower level of cover.
When choosing hospital cover, it helps to think about what you may need now – and what could matter more in the future.
If you have a current health concern or family history of specific illnesses, you may be after condition-specific cover. Other treatments – such as joint replacements, cataracts, or pregnancy and birth – can become more relevant at certain life stages.
Select I want to choose my own services to explore all 38 clinical categories and include what’s important to you. Hospital covers come with a fixed set of inclusions so if we don’t have an exact match, we’ll find the closest option(s).
Keep in mind, the higher the hospital tier (Basic, Bronze, Silver, Gold) generally the more services included, and the higher the premiums.
Pregnancy and birth and hospital psychiatric services are only included on our gold tier hospital cover. If you select either of these, we’ll guide you to this recommendation.
The hospital services you select determine the tier of cover – basic, bronze, silver or gold – recommended for you.
Each tier has a minimum set of clinical categories for treatment. The higher the tier, the more treatments covered and the higher the price. GMHBA also offers “plus” policies which meet the minimum requirements and include additional services.
Always check what’s covered as services can be included, restricted (limited benefits in public hospitals only) or excluded entirely.
Extras health insurance helps cover the cost of everyday health services delivered outside of hospital – things like dental, optical, physio, chiro and remedial massage.
What you get back for each claim depends on your cover and service limits.
Waiting periods may apply when you join or upgrade your cover.
Switching from another fund? We’ll take care of the paperwork and make sure you won’t need to re-serve waits on an equivalent or lower level of cover. Limits are adjusted based on previous claims.
Popular extras include general dental, optical for prescription glasses, and physio or massage.
Still not sure what you’re after? Click (?) to explore each service or ‘Next’ to jump ahead.