healthslips.com.au Policy Information

GMHBA Limited

GMHBA Basic Plus Starter Family Package $500

$424.10 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading, an Age-based Discount or an insurer discount. Check with your insurer for details.

This policy covers: One adult & dependants (2 or more people, only one of whom is an adult).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 24), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: Dependant from the age of 18 to 20

Policy ID: GMH/J69B/NHOQ1D

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy must be purchased with a general treatment (extras) policy.
  • This policy does not provide accident cover.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets

This policy does not include cover for

Dialysis for chronic kidney failure
Gynaecology
Insulin pumps
Weight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Private hospital cover for some services. For all other services, except exclusions you are covered as a private patient in a public hospital.

Extras Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for
Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$200 per person

combined limit for acupuncture & remedial massage

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Ante-natal/Post-natal classes 2

$200 per person

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Audiology 2

$200 per person

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Dietetics/dietary advice 2

$200 per person

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Endodontic 12

$600 per person

combined limit for endodontic & major dental

sub-limits apply

  • Filling of one root canal: 55% of charge
Exercise physiology 2

$300 per person

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Eye therapy (orthoptics) 2

$200 per person

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
General dental 2

$600 per person

  • Fluoride treatment: 100% of charge
  • Scale & clean: 100% of charge
  • Periodic oral examination: 100% of charge
Major dental 12

$600 per person

combined limit for endodontic & major dental

sub-limits apply

  • Surgical tooth extraction: 55% of charge
Optical 6

$200 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$300 per person

$1,100 lifetime limit

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 55% of charge
Physiotherapy 2

$300 per person

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Remedial massage 2

$200 per person

combined limit for acupuncture & remedial massage

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge
Speech therapy 2

$200 per person

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 55% of charge
  • Subsequent visit: 55% of charge

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: 55% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for eye therapy (orthoptics) & speech therapy}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Periodic oral examination: 100% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Surgical tooth extraction: 55% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{$1,100 lifetime limit}

{sub-limits apply}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 55% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for eye therapy (orthoptics) & speech therapy}

Examples of maximum benefits

{Initial visit: 55% of charge}

{Subsequent visit: 55% of charge}

This policy does not include General treatment (Extras) cover for

Blood glucose monitors
Chinese medicine
Chiropractic
Health management / Healthy lifestyle
Hearing aids
Home nursing
Non PBS pharmaceuticals
Occupational therapy
Orthotics (podiatric orthoses)
Osteopathy
Podiatry
Psychology
Vaccinations

Other features of this general treatment cover: $400 p/p per year for preventative dental, all other dental benefits pay 65% of the cost. Rates discounted for direct debit.

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: If you are a resident of NSW or ACT take out any hospital cover, you are automatically covered for emergency transportation within NSW. Ambulance NSW is a Levy Based Scheme which is why it operates under your hospital cover. If an ambulance is called, you will receive a bill. If you have a hospital product with us, you can send this bill on to us, and we’ll let the NSW/ACT Ambulance service know you’re covered.

Insurer Details

GMHBA Limited

GMHBA Basic Plus Starter Family Package $500

$424.10 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/GMH/J69B/NHOQ1D

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