Private Health Information Statement - Combined policy

GMHBA Basic Plus Package

Monthly Premium

$341.00 #

(before any rebate, loading or discount)

Covers 2 adults (and no-one else)

Available in NSW & ACT

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.

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
Dental surgeryHernia and appendixHospital psychiatric services
Ear, nose and throatJoint reconstructionsPalliative care
Eye (not cataracts)Tonsils, adenoids and grommetsRehabilitation

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesDigestive systemMiscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPlastic and reconstructive surgery (medically necessary)
Brain and nervous systemImplantation of hearing devicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Breast surgery (medically necessary)Insulin pumpsPregnancy and birth
CataractsJoint replacementsSkin
Chemotherapy, radiotherapy and immunotherapy for cancerKidney and bladderSleep studies
Diabetes management (excluding insulin pumps)Lung and chestWeight loss surgery
Dialysis for chronic kidney failureMale 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 $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

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
  • 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.

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$600 per person up to $1,200 per policyPeriodic oral examination - $29.60
Scale & clean - $60.20
Fluoride treatment - $17.90
Optical6$150 per person up to $300 per policySingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Physiotherapy2$200 per person up to $400 per policy
(combined limit for physiotherapy, exercise physiology & other services)
Initial visit - $40.00
Subsequent visit - $40.00
Chiropractic2$200 per person up to $400 per policy
(combined limit for chiropractic & osteopathy)
Initial visit - $32.00
Subsequent visit - $32.00
Acupuncture2$200 per person up to $400 per policy
(combined limit for acupuncture, remedial massage, chinese medicine & other services)
Initial visit - $30.00
Subsequent visit - $30.00
Remedial massage2Initial visit - $25.00
Subsequent visit - $25.00
Chinese medicine2Initial visit - $30.00
Subsequent visit - $30.00
Exercise physiology2Combined limit - see PhysiotherapyInitial visit - $25.00
Subsequent visit - $25.00
Osteopathy2Combined limit - see ChiropracticInitial visit - $32.00
Subsequent visit - $32.00

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

General treatment legend
Blood glucose monitorsMajor dentalPodiatry
EndodonticNon PBS pharmaceuticalsPsychology
Hearing aidsOrthodonticOther treatments - check with your insurer

Other features of this general treatment cover

Excludes chiropractic x-rays.

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

If you are a resident of NSW or ACT take out any hospital cover, you are automatically covered for emergency transportation within NSW. Ambulance NSW is a Levy Based Scheme which is why it operates under your hospital cover. If an ambulance is called, you will receive a bill. If you have a hospital product with us, you can send this bill on to us, and we’ll let the NSW/ACT Ambulance service know you’re covered.

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.