Private Health Information Statement - General treatment policy

GMHBA Ultra Extras

Monthly Premium

$299.00 #

(before any rebate or insurer discount)

Covers 2 adults (and no-one else)

Available in Western Australia

Closed to new members

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include an insurer discount. Check with your insurer for details.

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Non PBS Pharmaceuticals must be a private Schedule 4 or Schedule 8 and dispensed via a provider in private practice. PBS contribution applies to Travel Vaccinations
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$2,000 per person
(combined limit for general dental, major dental, endodontic, orthodontic & other services - Sub-limits apply)
$2,900 lifetime limit for Orthodontic
Periodic oral examination - $56.00
Scale & clean - $120.00
Fluoride treatment - $45.00
Major dental12Surgical tooth extraction - $101.15
Full crown veneered - $300.00
Endodontic12Filling of one root canal - $86.45
Orthodontic12Braces for upper & lower teeth, including removal plus fitting of retainer - $400.00
Optical6$300 per person
(combined limit for optical & other services)
Single vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals*2$350 per person up to $550 per policy
(combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply)
Per eligible prescription - 80% of charge
Physiotherapy2$700 per person up to $1,000 per policy
(combined limit for physiotherapy & other services - Sub-limits apply)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Chiropractic2$700 per person up to $1,000 per policy
(combined limit for chiropractic, osteopathy & other services - Sub-limits apply)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Podiatry2$350 per person
(combined limit for podiatry & other services - Sub-limits apply)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Psychology2$500 per person up to $800 per policy
(Sub-limits apply)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Acupuncture2$600 per person up to $900 per policy
(combined limit for acupuncture, remedial massage & other services - Sub-limits apply)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Remedial massage2Initial visit - 80% of charge
Subsequent visit - 80% of charge
Hearing aids12$800 per person
1 appliance(s) every 3 years
Hearing aid - 100% of charge
Blood glucose monitors12$650 per policy
1 appliance(s) every 3 years
(combined limit for blood glucose monitors & other services)
Per monitor - 80% of charge
Audiology2$350 per personInitial visit - 80% of charge
Subsequent visit - 80% of charge
Dietetics/dietary advice2$350 per person
(combined limit for dietetics/dietary advice & other services)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Eye therapy (orthoptics)2$500 per person
(combined limit for eye therapy (orthoptics) & speech therapy)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Occupational therapy2$500 per person up to $800 per policyInitial visit - 80% of charge
Subsequent visit - 80% of charge
Orthotics (podiatric orthoses)12$230 per person up to $115 per service up to $460 per policyOrthotics supply & fit - 80% of charge
Osteopathy2Combined limit - see ChiropracticInitial visit - 80% of charge
Subsequent visit - 80% of charge
Speech therapy0Combined limit - see Eye therapy (orthoptics)Initial visit - 80% of charge
Subsequent visit - 80% of charge
Vaccinations*2Combined limit - see Non PBS pharmaceuticalsPer service - 80% of charge

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

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

Annual sub-limit up to $450 per person, per calendar year applies for preventative dental. Rates discounted for direct debit payment.

Ambulance cover

Aged Pensioner concession holders are entitled to free ambulance transport services. If you are not eligible for a concession and want to be covered, you can purchase insurance from a private health fund or a subscription through the state ambulance service.

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.