GMHBA health insurance

GMHBA offers cover for emergency ambulance services on their hospital products, but how their cover works will depend on your state of residence. If you live in a state with a subscription-based ambulance service, you can claim the cost of your subscription on eligible extras policies.

For states with a levy-based scheme (New South Wales and the ACT), you’ll need a hospital cover policy instead. When you receive your ambulance bill, you’ll need to send the bill to GMHBA, and they’ll take it from there.

Depending on your state, you may already be covered for ambulance services by your state government. See our guide to ambulance cover to learn more.

Yes, GMHBA will cover you for pre-existing conditions, although you may need to serve a 12-month waiting period before receiving hospital treatment relating to your condition. If you’ve already served a waiting period for your pre-existing condition with your previous fund, you may not need to serve it again, provided you’ve moved to an equal or lower level of cover.

Having a pre-existing condition won’t affect your waiting periods or eligibility for extras cover services.

To make a claim for extras services, you can claim on the spot by swiping your membership card at your healthcare provider’s HICAPS machine. Alternatively, you can pay upfront and submit a claims form online, at your local branch, by email or by post.

When you’re treated in a GMHBA-participating hospital for a treatment covered by your policy, the hospital will bill GMHBA directly, so you’ll only need to pay your excess, co-payments (if applicable) and other out-of-pocket costs.

GMHBA offers a wide range of payment options, although not all payment methods are available on all products. The options available to you include:

• Direct debit
• Credit card
• Payroll deduction
• GMHBA branch
• Australia post
• Pay online
• Pay by phone.

When you choose to pay by direct debit, you can receive a 2% discount on your premiums paid. While you won’t receive a discount for paying annually, you might still save by locking in a lower rate before the annual premium increase.

Yes, you will likely need to pay an excess when you’re admitted to hospital and claim on your hospital cover policy. When you take out a policy, you can choose your excess from a set of options. When you choose a lower excess, you’ll pay a higher premium and vice versa.

Depending on your policy, there’s a maximum excess payable per calendar year, and dependant children may not have to pay an excess on hospital admission.

To cancel your policy, you’ll need to notify GMHBA over the phone or in writing. GMHBA will provide you with your clearance certificate within 14 days of request. You will also be refunded any premiums paid in advance.