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| Why have Private Health Cover? |
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Reassurance
People eligible for Medicare can enjoy the peace of mind from knowing that should one of life’s unexpected events occur to you or someone in your family, you can choose your doctor, hospital and time of hospital treatment. And you can be reassured that you’re covered for services Medicare excludes, such as dental, ambulance, acupuncture, chiropractic, physiotherapy, optical and much more.
Financial protection
Some claims amount to more than $100,000. Last year GMHBA paid over $98,700 in benefits between two members, aged just 10 and 22. It’s comforting to know GMHBA health cover can also protect you from financial hardship.
A healthier future
Whether you play sport, visit the dentist, wear glasses, need treatment for aches and pains, want to avoid public hospital waiting lists, are planning a family or just want peace of mind – GMHBA can help you avoid waiting lists and minimise disruptions so you can enjoy a healthy future.
Join us. It’s easy
Whether you’ve had health cover before or not, becoming a valued GMHBA member is easy.
For immediate cover join us by phone, at a branch or by clicking on the Join Us link on the home page or return the forms in our member guide.
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| What is Lifetime Health Cover? |
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This Federal Government initiative encourages people to take out hospital cover earlier in life. By taking out hospital cover by the 1st of July after your 31st birthday, you’ll pay base contribution rates. However if you don’t, you’ll pay a loading of 2% on this base rate for every year you are over 30 when you join, up to a maximum of 70% at the age of 65.
Please call our customer service centre on 1300 4 GMHBA (46422) or visit a branch if you require help in calculating your loading.
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| What are the Federal Government Rebates? |
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If you have health cover and all people covered by the membership are eligible for Medicare, you are eligible for a Federal Government rebate. The rebate is 30% for people aged up to 64 years, 35% if one or more people covered on the membership are aged 65 to 69 and 40% if one or more people covered are aged 70 or more. You can claim the rebate as a reduction to your contributions, as a tax rebate when you lodge your annual tax return or as a direct payment from the Government through any Medicare office.
The rebate applies to hospital cover, extras cover and combined hospital and extras cover.
The easiest way to receive your rebate is to register with GMHBA. We will then deduct the rebate from your contribtions… and you pay less. Click on the downloads button to go to our downloads area.
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| How can I pay my GMHBA contributions? |
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By authorising us to direct debit your Bank, Credit Union or Building Society Account, or make a direct charge to your credit card you can save a lot of time and hassle.
Direct debits from your Bank, Credit Union or Building Society Account each fortnight, month, quarter, half year or yearly.
Automatic payments from credit cards are available each month, quarter, half year or yearly.
Please note that we cannot accept payments from Diners Club or American Express cards.
To get the ball rolling, download and complete the appropriate form and return to us.
Click on the Downloads button to go to the area and download a direct debit or credit card form.
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| What exactly is Hospital Cover? |
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As the name suggests, hospital cover will cover some or all of your expenses while you are in hospital. How much is covered depends on your level of cover, the procedure or care given and the hospital you choose to stay in. The higher the level of cover, the greater your level of protection. You can call GMHBA for a detailed list of hospitals we have agreements with. Alternatively you can download a list from this website or search for your nearest participating hospital in Our Products.
Hospital membership for non-residents of Australia
GMHBA hospital covers are designed for people who are eligible for Medicare. These covers will not meet the cost of public hospital treatment, medical treatment or diagnostic services for people who
are not eligible for Medicare. Temporary residents of Australia
who are not eligible for Medicare benefits should contact GMHBA to discuss appropriate health cover arrangements.
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| What is Dental/Ancillary Cover? |
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Extras is separate to hospital cover and can be taken on its own or combined with hospital cover for more complete protection. Extras cover items not found in hospital cover such as dental, optical (glasses and contact lenses), physiotherapy and chiropractic. There are several GMHBA extras covers available to suit your needs.
Focusing on simplicity and value, we’ve grouped benefits into covers that match lifestyles and budgets. To make things simpler, members can make claims on the spot using their GMHBA membership card at dentists, optical dispensers, physiotherapists, chiropractors, psychologists, occupational therapists and podiatrists using electronic claiming systems. If you’re in any doubt, please contact GMHBA to find out if your extras provider is recognised by GMHBA.
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| How do I make a claim? |
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Health care providers who bulk bill or use electronic claiming systems such as HICAPS or IBA will usually settle the matter on the spot.
Otherwise, you can present your receipt and/or account for the treatment to your nearest GMHBA office or mail a completed claim form and your account/receipt to GMHBA.
Claims can also be lodged at any Medicare office in Australia, who will then forward them on to GMHBA for processing. Click here to search for a HICAPS provider
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| What are waiting periods? |
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If you are new to health cover or increasing your cover, waiting periods will apply to benefits. This is to protect existing members’ funds from those who wait until they are sick and then join a health fund just to claim large sums immediately. However, you can rest assured that you are covered for bodily injuries resulting from accidents from day one.
Waiting periods will apply to:
• New memberships (previously uninsured),
• Additions to a membership (unless the addition/s has already served all waiting periods with GMHBA or another fund) except newborns, adopted and permanent foster children where the family membership has been in existence for at least 2 months, and where the addition/s has already served all waiting periods with GMHBA or another fund,
• Existing GMHBA memberships, and transfers to GMHBA from another fund where the level of cover and/or benefit entitlement is upgraded or increased and/or where the waiting periods have not been completed.
For new memberships (no previous extras cover) or where 12 months continuous dental cover has not been in existence, all dental benefits will be limited to $200 per person/single membership and $400 per family membership during the first 12 months of membership with GMHBA.
Limited benefits may apply on hospital covers for cosmetic surgery, depending on the medical justification for the surgery.
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| When do I need family cover? |
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If you’ve chosen a cover for yourself only, or one that has obstetrics excluded, you need to upgrade your cover 12 months before you have a child. This is to ensure you’ve served all your waiting periods at the time you and your newborn need the upgraded cover. In most cases, obstetrics and additions of dependants to be covered on a family membership will be subject to waiting periods. Please call our customer service centre on 1300 4 GMHBA (46422) or visit a branch for advice on when you should upgrade.
You must advise GMHBA when a dependant ceases full-time study, or a full-time traineeship/ apprenticeship, or fails to meet any of these requirements for any other reason. If you remove your partner, children and/or dependant/s from your membership, GMHBA will contact the affected person/s and offer continuation of cover under a separate membership.
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| Who can my family membership cover? |
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Our family memberships cover you, your partner, and your children under the age of 21 years (includes step, adopted and permanent foster children).
Your family membership also covers your dependants who are under the age of 25 years, single, full-time apprentices, full-time trainees or full-time students at a school, college, university or institution recognised by GMHBA and when they are primarily reliant on you for maintenance and support.
Hospital excesses for child dependants under 21 listed on a family or a single parents membership are not payable on GMHBA hospital covers with the exception of Great Value Gold Hospital cover (EK).
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| What if I change my mind about my cover? |
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If you manage to find better value for money health cover elsewhere or wish to cancel your membership for any reason within 30 days of joining and haven’t made a claim, you’ll receive a full refund of your contributions.
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| What is the Medicare Levy Surcharge? |
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The Medicare levy surcharge is a surcharge on individuals and families on higher incomes who don’t have eligible private patient hospital cover (eligible cover). The surcharge is 1% of taxable income in addition to the normal 1.5% Medicare Levy. People may have to pay the Medicare levy surcharge if they or any of their dependants do not have eligible cover and they are:
• A single person - without dependent children - with a taxable income (including any reportable fringe benefits of $1,000 or more) greater than $50,000.
• A family - including a couple and single parent - with a combined taxable income (including any reportable fringe benefits of $1,000 or more) greater than $100,000 (increasing by $1,500 per dependent child, after the first child).
Eligible private patient hospital insurance
Since the 24th of May 2000 the maximum annual amount of excess permitted to avoid the Medicare levy surcharge is $500 for singles and $1,000 for families, couples and single parents. It means people who join a hospital cover after the 24th of May 2000, for which the excess is above these amounts, and who earn incomes higher than the threshold amounts (including reportable fringe benefits) are still subject to the Medicare levy surcharge. GMHBA’s EK Great Value Gold Hospital cover ($1,000 single/ $2,000 family maximum annual excess) is not an eligible cover for Medicare levy surcharge purposes. Contact your tax adviser or GMHBA for further details.
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