Private Health Information Statement - Combined policy

GMHBA Gold Premium Family Package $250

Monthly Premium

$855.55 #

(before any rebate, loading or discount)

Covers one adult & dependants (2 or more people, only one of whom is an adult)

Available in Tasmania

Closed to new members

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.

This policy covers children and other dependants up to and including the age of 20, students up to and including the age of 24, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).

This policy includes cover for

Hospital Cover Legend
Assisted reproductive servicesEye (not cataracts)Miscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hospital psychiatric servicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
CataractsImplantation of hearing devicesPregnancy and birth
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestWeight loss surgery
Ear, nose and throatMale reproductive system

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person and $500 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Covers fund approved hospital-substitution & chronic disease management services. Rates discounted for premiums paid by direct debit.

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.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$1,000 per person up to $2,000 per policy
(combined limit for general dental & other services)
Periodic oral examination - 100% of charge
Scale & clean - 100% of charge
Fluoride treatment - 100% of charge
Major dental12$1,000 per person up to $2,000 per policy
(combined limit for major dental & endodontic)
Surgical tooth extraction - 75% of charge
Full crown veneered - 75% of charge
Endodontic12Filling of one root canal - 75% of charge
Orthodontic12$700 per person
$3,200 lifetime limit
Braces for upper & lower teeth, including removal plus fitting of retainer - 75% of charge
Optical6$250 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals*2$400 per person up to $40 per service up to $800 per policy
(combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply)
Per eligible prescription - 100% of charge
Physiotherapy2$600 per person up to $1,200 per policy
(combined limit for physiotherapy, exercise physiology & other services - Sub-limits apply)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Chiropractic2$400 per person up to $800 per policy
(combined limit for chiropractic, osteopathy & other services - Sub-limits apply)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Podiatry2$400 per person up to $800 per policy
(combined limit for podiatry & other services - Sub-limits apply)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Psychology2$400 per person up to $800 per policy
(Sub-limits apply)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Acupuncture2$400 per person up to $800 per policy
(combined limit for acupuncture & remedial massage)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Remedial massage2Initial visit - 75% of charge
Subsequent visit - 75% of charge
Hearing aids12$600 per person up to $1,200 per policy
(combined limit for hearing aids, blood glucose monitors & other services)
Hearing aid - 75% of charge
Blood glucose monitors12Per monitor - 75% of charge
Audiology2$400 per person up to $800 per policyInitial visit - 75% of charge
Subsequent visit - 75% of charge
Ante-natal/Post-natal classes2$400 per personInitial visit - 75% of charge
Subsequent visit - 75% of charge
Dietetics/dietary advice2$400 per person up to $800 per policyInitial visit - 75% of charge
Subsequent visit - 75% of charge
Exercise physiology2Combined limit - see PhysiotherapyInitial visit - 75% of charge
Subsequent visit - 75% of charge
Eye therapy (orthoptics)2$400 per person up to $800 per policy
(combined limit for eye therapy (orthoptics) & speech therapy)
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Occupational therapy2$400 per person up to $800 per policyInitial visit - 75% of charge
Subsequent visit - 75% of charge
Orthotics (podiatric orthoses)12$400 per person up to $800 per policyOrthotics supply & fit - 75% of charge
Osteopathy2Combined limit - see ChiropracticInitial visit - 75% of charge
Subsequent visit - 75% of charge
Speech therapy2Combined limit - see Eye therapy (orthoptics)Initial visit - 75% of charge
Subsequent visit - 75% of charge
Vaccinations2Combined limit - see Non PBS pharmaceuticalsPer service - $100.00

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

100% back up to $600 per person/$1200 per membership per year for preventative dental, all other dental benefits pay 75% of the cost. Rates discounted for direct debit.

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover

Tasmanian residents are covered by a State based scheme. Please contact Ambulance Tasmania for more details regarding coverage.

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.