COVID-19 information for GMHBA members

• GMHBA has introduced new support measures, which mean existing members with hospital cover will be covered for all COVID-19 related hospital treatments as a private patient, as long as you have served your initial two-month waiting periods.
• This COVID-19 coverage will be provided initially until the end of September 2020, with the intent to review and consider any possible further extension prior to 30 September 2020.
• We have added wording to hospital eligibility checks to confirm coverage for all of our members with hospital cover so the hospitals are aware that you will be covered. 

• Coronavirus does not have its own clinical category or MBS item number.
• If you are admitted into hospital to determine the root cause of the presenting illness, this is covered the same way as it would for any other medical admission, eg. flu/pneumonia.
• If you are admitted to hospital as a result of a condition developed following contracting coronavirus, the condition will come under the applicable clinical category, eg. Lung and Chest.

• We don't cover outpatient appointments such as GP appointments, blood tests etc.
• These rules will continue to apply as normal, including for coronavirus.

• If you buy health insurance now to be covered for coronavirus, the standard two-month hospital waiting periods will apply before you are able to claim benefits.
• For members who are new to private health insurance, the standard two-month hospital waiting periods will apply.
• The rules in relation to pre-existing conditions for hospital cover will not apply.

Yes. You may be able to suspend your cover due to financial hardship if you've had an active GMHBA health insurance policy for at least six months. 

During a suspension period, you won't need to pay your premium, but you also won't be able to claim on services for this period of time.

Additional suspension measures we have put in place for members who may be experiencing financial hardship as a result of the COVID-19 pandemic include:

• Suspension for up to 12 months.
• Waiving the minimum suspension period so you can reactivate at any time you need.  

Talk to one of our customer service representatives about your situation and they can guide you through the things to consider, ensure you have the right level of affordable cover and answer any questions.

As with any other type of suspension, you are not able to claim benefits while your cover is suspended.

• The Federal Government has advised all non-urgent elective surgery will be suspended until further notice from midnight on 26 March due to the coronavirus.
• If you have a pre-booked hospital admission or ongoing hospital treatment, we would recommend to regularly check in with your doctor and hospital before your admission for the most up-to-date information.

• For members who have paid in advance via direct debit or credit card, these payments were for your pre-1 April rate, so the premium increase would not have been applied to these payments.
• If you have paid in advance and are now experiencing financial hardship, get in touch with our customer service team and we can partially refund your account. Please be aware that this will also affect your paid-to date, so you won’t then be paid as far in advance.

No, this won’t be affected by the deferral. Any premium decreases will still apply from 1 April 2020.  

• By 1 October, GMHBA will reassess the deferral of premium increase to determine if it should be extended.
• We will take into consideration the pandemic situation at that point in time, what our members need and what we can provide for them.
• We will inform members of our position and keep the lines of communication open to ensure you are aware of support available.

No, you will not be required to backpay the difference in premium amounts once the premium increases that were planned for 1 April 2020 come into effect on 1 October 2020 (or later).  

No, changes to the Government Private Health Insurance Rebate have been deferred until April 2021.

You will need to pay for the service up front and then lodge your claim for benefits to be paid back into your nominated bank account. You can lodge your claim:

• Online via the member area
• Using our online photo claiming tool – contact us to obtain access to this
• Email your claim through to us

GMHBA will provide coverage for teleconsultations provided by physiotherapists from Tuesday 14 April 2020 subject to the conditions listed below:

• The customer is undergoing an existing course of treatment and the customer has seen the physiotherapist over the past six months, or
• For new patients, the tele-physiotherapy service has been recommended by their general practitioner or relevant medical specialist, and the primary condition being treated is one of:
  • Post orthopaedic surgery rehabilitation (e.g. Total hip or knee replacement)
  • Chronic musculoskeletal condition (e.g. osteoarthritis)
  • Cardiac rehabilitation
  • Pulmonary rehabilitation, or pelvic floor muscle training,
• The service is delivered before 30 September 2020, and
• The service is undertaken in accordance with Australian Physiotherapy Association guidelines.

One on one Psychology consultations will be covered where:

• The patient is undergoing an existing course of treatment, and has seen the psychologist providing the teleconsultation over the past six months.
• For new patients, the telepsychology service has been recommended by their general practitioner.
• The service is delivered on or after 01 April 2020 and before 30 September 2020.
• The service is undertaken in accordance with Australian Psychological Society guidelines.