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Compare GMHBA health insurance

How GMHBA rates for member complaints, gap cover and ambulance.

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GMHBA summary

GMHBA is a member-based, nonprofit health fund which began in Geelong in 1934. It has an extensive network of regional branches providing private health insurance to hundreds of thousands of members across Australia.

GMHBA also owns health fund brands:

And, in a joint venture with life insurer AIA, also operates:

GMHBA previously administered the Budget Direct health insurance brand, but these policies were closed to new members in May 2018. 

GMHBA and Frank belong to Members Own Health Funds, an alliance of 15 nonprofit and mutual health funds that promotes the benefits of funds that reward members rather than investors or overseas owners.

Phone: 1300 446 422

Website: gmhba.com.au

Is GMHBA nonprofit?

Yes.

Does GMHBA get many complaints from members?

GMHBA complaints rating: High

(Includes Frank complaints.)

When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don't get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.

How good is GMHBA's gap cover?

A medical gap is the difference between Medicare's recommended fee and what your doctor actually charges for a treatment or service.

Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called 'no gap agreements', or part of that gap, which are called 'known gap agreements' (these will have lower out-of-pocket costs, usually less than $500).

Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.

Rating scale

  • Well above average
  • Above average
  • Average
  • Below average
  • Well below average

We also display the percentage of medical services that GMHBA covers with no gap, and compare it to the industry average. The higher the percentage, the more effective the fund's gap scheme is in a state or territory. 

There are differences between GMHBA and Frank in their gap cover. 

  • GMHBA participates in the Australian Health Service Alliance Ltd (AHSA) Access Gap Cover Scheme, which negotiates gap cover agreements with doctors, providers and hospital for more than 20 funds. 
  • Frank doesn't participate in this scheme, but pay the gap as long as your doctor doesn't charge more than 120% of the MBS – a fee set by Medicare for this service.

How many hospital agreements does GMHBA have in my state?

The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you're treated. 

The table below shows how many hospital agreements GMHBA has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don't have agreements with specific funds and are generally treated as though they're agreement hospitals.

Does GMHBA offer any discounts?

Discount for direct debit: 2%

Discount for annual prepay: None

Total discount for annual prepay via direct debit: 2%

Youth discounts: Offered on some Basic and Basic Plus policies; these aren't transferable.

Does GMHBA offer ambulance cover?

GMBHA doesn't cover emergency ambulance in Victoria, WA, NT, SA on its hospital policies.

The following extras policies and combined hospital and extras packages offer a percentage refund on ambulance subscriptions (percentage depends on the product held): 

  • Silver Extras 65%
  • Silver Extras Set Benefits
  • Gold Extras 75%
  • Gold Extras Set Benefits
  • Fit Entry Package 50%
  • Fit Standard, Top and Ultra Packages 80%, 
  • GMHBA Starter, Everyday and Premium Packages (with and without pregnancy) 100%. 

There's also a transport benefit of $300 per trip up to an annual per person limit of $500 (less the cost of the subscription). There are no benefits payable for Bronze Extras 55% or Bronze Extras Set Benefits.

Do you need ambulance cover?

Depending on where you live, you may not need a policy with ambulance cover. 

  • In Queensland or Tasmania, emergency ambulance services are covered by your state government. 
  • In NSW and the ACT, all hospital policies come with emergency ambulance cover – so you'll be covered with any hospital or combined policy you select. 
  • In South Australia, Victoria and the Northern Territory you can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover. 
  • Rural WA: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover. 
  • Metropolitan WA: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.

Does GMHBA offer family policies that cover adult children?

Yes, adult children are covered up to age 21 and up to age 25 if in full-time study

Does GMHBA let you claim online or in-app?

Online claiming.

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