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Compare GMHBA health insurance
How GMHBA rates for member complaints, out-of-pocket costs and ambulance cover.
Last updated: 13 May 2024
Who is GMHBA?
GMHBA is a member-based, nonprofit health fund. It began in Geelong in 1934 and has an extensive network of regional branches providing private health insurance to hundreds of thousands of members across Australia.
GMHBA also owns the health fund Frank, and in a joint venture with life insurer AIA, operates myOwn and RACQ. It 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 nonprofit and mutual health funds.
Phone: 1300 446 422
Website: gmhba.com.au
How to save on your GMHBA health insurance premium
You can review your private health insurance at any time to see if you’re getting the best deal (it’s good practice to do it at least once a year). With thousands of health insurance policies on the market, it can be hard to make sense of your options. So our insurance experts developed a tool that lets you compare health insurance policies so you can find cover that works for you, and potentially save yourself hundreds.
If you decide your current policy is good value for money and suits your needs, prepay your premium by 31 March. This is an excellent way to save money as it ‘locks in’ your current premium and means you’ll avoid the 1 April price increase for up to 12 months.
GMHBA discounts and promo offers
GMHBA offers a 2% discount if you pay by direct debit. There are also youth discounts available on some Basic and Basic Plus policies and these are not transferable.
Does GMHBA get many complaints from members?
GMHBA has a Medium complaints rating (this 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 hospitals for more than 20 funds.
- Frank doesn’t participate in this scheme, but will 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.
Text-only accessible version
Australian Capital Territory
Well below average.
New South Wales
Well below average.
Northern Territory
Average.
Queensland
Below average.
South Australia
Below average.
Tasmania
Well below average.
Victoria
Average.
Western Australia
Average.
How many hospital agreements does GMHBA have in each 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.
Text-only accessible version
GMHBA hospital agreements
In the Australian Capital Territory this fund has…
5 private hospital agreements out of an industry maximum of 6.
8 day hospital agreements out of an industry maximum of 9.
In New South Wales this fund has…
86 private hospital agreements out of an industry maximum of 92.
87 day hospital agreements out of an industry maximum of 105.
In the Northern Territory this fund has…
1 private hospital agreement out of an industry maximum of 1.
2 day hospital agreements out of an industry maximum of 2.
In Queensland this fund has…
50 private hospital agreements out of an industry maximum of 58.
44 day hospital agreements out of an industry maximum of 54.
In South Australia this fund has…
18 private hospital agreements out of an industry maximum of 20.
20 day hospital agreements out of an industry maximum of 31.
In Tasmania this fund has…
8 private hospital agreements out of an industry maximum of 8.
3 day hospital agreements out of an industry maximum of 9.
In Victoria this fund has…
68 private hospital agreements out of an industry maximum of 71.
67 day hospital agreements out of an industry maximum of 80.
In Western Australia this fund has…
21 private hospital agreements out of an industry maximum of 23.
19 day hospital agreements out of an industry maximum of 29.
Does GMHBA offer ambulance cover?
GMBHA doesn’t cover emergency ambulance in Victoria, South Australia, Western Australia or the Northern Territory on its hospital policies.
The following extras policies and combined hospital and extras packages offer a percentage refund on ambulance subscriptions (the 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.
- Queensland or Tasmania: Emergency ambulance services are covered by your state government.
- New South Wales and the Australian Capital Territory: All hospital policies come with emergency ambulance cover – so you’ll be covered with any hospital or combined policy you select.
- 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 Western Australia: 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 Western Australia: 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?
- Adult children are covered on family policies for free until they turn 21.
- Full-time students are covered on family policies for free until they turn 25.
Does GMHBA let you claim online or in-app?
You can claim online.
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