healthslips.com.au Policy Information

GMHBA Limited

GMHBA Silver Everyday Family Package (No Pregnancy) $250

$725.75 / month

(Before Rebate, Discount & Loading)

Available in WA

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: Two adults & dependants (3 or more people, only 2 of whom are adults).

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/J70A/WISC2D

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
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Joint reconstructions
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Rehabilitation
Skin
Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services
Cataracts
Dialysis for chronic kidney failure
Insulin pumps
Joint replacements
Pain management with device
Pregnancy and birth
Sleep studies
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 $250 per admission. This is limited to a maximum of $250 per person and $500 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
  • 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

Covers fund approved hospital-substitution & chronic disease management services. Rates disc. for premiums paid by direct debit.

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

$300 per person

combined limit for acupuncture & remedial massage

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Audiology 2

$300 per person

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Blood glucose monitors 12

$400 per person

combined limit for blood glucose monitors, hearing aids & other services

  • Per monitor: 65% of charge
Chiropractic 2

$300 per person

combined limit for chiropractic & osteopathy

sub-limits apply

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Dietetics/dietary advice 2

$300 per person

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Endodontic 12

$800 per person

combined limit for endodontic & major dental

  • Filling of one root canal: 65% of charge
Exercise physiology 2

$500 per person

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Eye therapy (orthoptics) 2

$300 per person

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
General dental 2

$800 per person

  • Fluoride treatment: 100% of charge
  • Scale & clean: 100% of charge
  • Periodic oral examination: 100% of charge
Hearing aids 12

$400 per person

combined limit for blood glucose monitors, hearing aids & other services

  • Hearing aid: 65% of charge
Major dental 12

$800 per person

combined limit for endodontic & major dental

  • Surgical tooth extraction: 65% of charge
  • Full crown veneered: 65% of charge
Non PBS pharmaceuticals* 2

$300 per person up to $35 per service

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per eligible prescription: 100% of charge
Occupational therapy 2

$300 per person

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Optical 6

$250 per person

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

$400 per person

$2,300 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 65% of charge
Orthotics (podiatric orthoses) 12

$300 per person

  • Orthotics supply & fit: 65% of charge
Osteopathy 2

$300 per person

combined limit for chiropractic & osteopathy

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Physiotherapy 2

$500 per person

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Podiatry 2

$300 per person

sub-limits apply

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Psychology 2

$300 per person

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Remedial massage 2

$300 per person

combined limit for acupuncture & remedial massage

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Speech therapy 2

$300 per person

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 65% of charge
  • Subsequent visit: 65% of charge
Vaccinations 2

$300 per person up to $35 per service

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: 65% of charge

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Per monitor: 65% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 65% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Periodic oral examination: 100% of charge}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Hearing aid: 65% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: 65% of charge}

{Full crown veneered: 65% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $35 per service}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: 100% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 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

{$400 per person}

{$2,300 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 65% of charge}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Orthotics supply & fit: 65% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

Examples of maximum benefits

{Initial visit: 65% of charge}

{Subsequent visit: 65% of charge}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $35 per service}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: 65% of charge}

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

Ante-natal/Post-natal classes
Chinese medicine
Health management / Healthy lifestyle
Home nursing

Other features of this general treatment cover: Exercise physiology, speech therapy, orthotics & preventative health benefits. Receive 100% of charge up to $500 p/p per year for preventative dental. Rates discounted for direct debit.

Ambulance cover

In WA 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: WA ambulance services depend on whether you live within the Perth metropolitan area or regional WA. Benefits for emergency transportations are available on hospital and selected eligible extras covers. To avoid unexpected out of pockets, we strongly recommend taking out a subscription to be covered Australia wide, regardless of your health insurance. If you have eligible extras cover, provide us with the subscription receipt to receive a benefit up to 100% of the subscription cost.

Insurer Details

GMHBA Limited

GMHBA Silver Everyday Family Package (No Pregnancy) $250

$725.75 / month

(Before Rebate, Discount & Loading)

Available in WA

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/J70A/WISC2D

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