Tell us your experience with GMHBA health insurance

Do you have something to say about GMHBA? Tell us your good experiences, bad experiences or otherwise and help inform the CHOICE Community.

Read our GMHBA health insurance review

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I signed with GMHBA in 2002. I have found their premiums to be middling to moderately low (gold cover+extras), their payouts for medical OK, their extras ordinary, and their service good.

They do not have preferred specialist networks so you can freely chose your own providers (good) since most are contracted in some manner, but they don’t offer help finding those who subscribe to their no-gap and put it on us to ask the specialists or negotiate directly with each to determine out of pocket and so on (not so good, especially when in need and referrals have to be in place).

The ability to lodge extras claims online is very limited noting many are paid by Hicaps at point of sale. Never had any administrative dispute save for one year when they provided some bad information regarding pre-payments, timing, and the tax laws. After some months of back and forth they finally took some responsibility and to their credit changed their systems so nobody else could get caught up by accident, as was I.

Although they are a non-profit they recently started sponsoring the Geelong Cats in (from 2018?) GMHBA Stadium… They claim this supports a healthy community and attracts more members making the fund more efficient. That might play well in Victoria but that is not something I expect to pay for as part of my “non-profit” health dollar. It must make their executives and marketeers chuffed to have their corporate box and name in lights. Rates up with the rest of the industry, sponsorships up, but benefits steady. I am actively shopping because I am not confident they put their insured as priority 1 any more despite their slick presentation.

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The current campaign by the ADA (Time2switch) prompted me to look at the options. I was previously with a publicly listed health fund, and was not happy with the fact that they provide different rebates for different providers under their Extras scheme, which is the norm for all for-profit health funds.

As an independent dentist, I am also unhappy with the fact that many of my patients receive a lesser rebate when they see me. This is grossly unfair. My optician and physiotherapist (who are both also independent operators ie theyhave not signed any restrictive contracts with health funds) have the same concerns.

Bottom line: After fairly thorough research I moved my family to GMHBA. I have been very happy with them, and recommend them to those of my patients who find themselves receiving unreasonable rebates at the end of their appointments.

GMHBA provides higher extras cover for routine dental checks than at least one of its not-for-profit peers, but quite a bit less for restorative work. Likewise they pay about 30% less for things like chiro.

I found my alternative via the privatehealth.gov.au site.

FWIW I received an email from GMHBA extolling how wonderful their sponsorship of the Geelong Cats is and the many benefits that accrue and a related contest. A snippet is


That reinforced to me it was time to go, and “went” I have.

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Received the following email this morning about another change from
my private health insurer.

Dear/
Best Doctors will no longer be available to GMHBA members

We are writing to advise you that we have made the decision to end our contract with Best Doctors, the second opinion medical service, at the end of 2019.

This means from 1 January 2020, the Best Doctors service will not be covered under your health insurance membership.

Why are we making this change?

Making changes to our private health insurance products is a difficult decision. However, as a not for profit health insurer, we believe this service is no longer the best use of member funds.

Should you believe you require a second opinion on a medical matter, we encourage you to contact your specialist or general practitioner, who will be able to address your questions and address any concerns you may have.

There is nothing further you need to do.

If you have any questions regarding this change, we encourage you to contact us.

Yours sincerely,

Tony Hall
General Manager Private Health Insurance
GMHBA

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