Compare GMHBA health insurance


A member-based, nonprofit health fund which began in Geelong in 1934, GMHBA also owns Budget Direct and Frank health funds.

Fund information


GMHBA summary

Is GMHBA nonprofit? 

Does GMHBA get many complaints from members? 

How good is GMHBA's gap cover? 

How many hospital agreements does GMHBA have in my state? 

Does GMHBA offer any discounts?

Does GMHBA offer ambulance cover?

Does GMHBA let you claim online or in-app?

What CHOICE Community says about GMHBA

GMHBA
Budget
Frank

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 more than 280,000 members across Australia.

GMHBA also owns health fund brands:

  • Health.com.au
  • Budget Direct Health Insurance, a joint venture with insurance brand Budget Direct
  • Frank, launched in 2009.

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.

GMHBA contact details

Phone: 1300 446 442

Email: service@gmhba.com.au

Website: gmhba.com.au


Budget Direct contact details

Phone: 1800 234 004

Email: health@budgetdirect.com.au

Website: budgetdirect.com.au


Frank contact details

Phone: 1300 437 265

Email: frank@frankhealthinsurance.com.au

Website: frankhealthinsurance.com.au


Is GMHBA nonprofit?

GMHBA and Frank are both nonprofit, but Budget Direct is not.

Find better health cover with CHOICE. Compare health insurance now.

Does GMHBA get many complaints from members?

GMHBA complaints rating: Medium

(Includes Budget Direct and 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.
  • The infographic below shows the complaints about the fund to the Ombudsman as a percentage of all complaints. Complaints can be about benefits or customer service. The most serious complaints are escalated for investigation.
  • The higher the share of complaints a fund receives above its market share, the worse its performance compared to other funds. If its share of complaints is below its market share, that's a better result.

GMHBA accounts for...

2.3% of the health insurance market

3.1% of all complaints about benefit payments

0.8% of all complaints about service

1.8% of all complaints that are escalated to investigations.

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

  • 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, Budget Direct 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 and Budget Direct don'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.

GMHBA gap cover performance by state

New South Wales (NSW)

Below average

Australian Capital Territory (ACT)

Below average

Victoria (Vic)

Below average

Queensland (Qld)

Average

South Australia (SA)

Below average

Western Australia (WA)

Well below average

Tasmania (Tas)

Well below average

Northern Territory (NT)

Average

Percentage of medical services covered with no gap

New South Wales (NSW)

GMHBA – 76.3%

Industry average – 86.3%

Australian Capital Territory (ACT) 

GMHBA – 58.3%

Industry average – 76.7%

Victoria (Vic) 

GMHBA – 76.9%

Industry average – 85.0%

Queensland (Qld) 

GMHBA – 81.9%

Industry average – 85.1%

South Australia (SA) 

GMHBA – 77.0%

Industry average – 86.8%

Western Australia (WA) 

GMHBA – 71.5%

Industry average – 90.1%

Tasmania (Tas) 

GMHBA – 74.9%

Industry average – 83.0%

Northern Territory (NT) 

GMHBA – 74.1%

Industry average – 80.1%

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.

GMHBA has

ACT

6 private hospital agreements out of an industry maximum of 7

6 day hospital agreements out of an industry maximum of 8

NSW

100 private hospital agreements out of an industry maximum of 100

89 day hospital agreements out of an industry maximum of 100

NT

2 private hospital agreements out of an industry maximum of 2

1 day hospital agreements out of an industry maximum of 2

Qld

53 private hospital agreements out of an industry maximum of 58

48 day hospital agreements out of an industry maximum of 53

SA

27 private hospital agreements out of an industry maximum of 27

25 day hospital agreements out of an industry maximum of 28

Tas

5 private hospital agreements out of an industry maximum of 8

3 day hospital agreements out of an industry maximum of 6

Vic

78 private hospital agreements out of an industry maximum of 79

75 day hospital agreements out of an industry maximum of 79

WA

22 private hospital agreements out of an industry maximum of 23

23 day hospital agreements out of an industry maximum of 29

Find better health cover with CHOICE. Compare health insurance now.

Does GMHBA offer any discounts?

Discount for direct debit: 2%

Discount for annual prepay: None

Total discount for annual prepay via direct debit: 2%

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.

All Budget Direct hospital and combined policies cover emergency ambulance in all states.

Frank covers emergency ambulance on all hospital policies excluding Frank Basic, Frank Basic Some Private and Frank Starter Bundle. A refund on ambulance subscriptions is offered for these extras policies: Some Extras 50%, Some Extras 80%, Lots Extras 50% and Lots Extras 80% (up to the percentage depending on the product held).

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 let you claim online or in-app?

Online claiming.


Find better health cover with CHOICE. Compare health insurance now.

What CHOICE Community says about GMHBA

The CHOICE Community is the online forum for Australian consumers, open to CHOICE members and supporters. Join the conversation about GMHBA, Budget Direct and Frank to share your experiences or gain more insights into this health fund.