GMHBA health insurance

Is it a good health insurer?

GMHBA has 7 hospital and 14 extras policies in our comparison, from $145.24 a month for hospital cover (Single · NSW · $500 hospital excess, after rebate).

Issued by GMHBA Limited. Hospital, extras or both.

Explore 7 hospital and 14 extras products, or find cover by treatment. Sources for GMHBA

Reviewed, Edited and Designed by

Grace Connolly

Created with AI assistance

Our editorial process

Page updated 26 October 2026 · Prices effective 21 September 2026

I need cover for…

Compare cover across all Australian health funds.

GMHBA cover: the main choices.

If you claim dietetics every year

Mid Extras Set Benefits has a $400 dietetics limit. Check the extras benefits for shared pools and claim conditions.

See the benefit differences

Before you pay for Gold

Gold Optimum Hospital adds assisted reproductive services and other categories compared with Silver Plus Premium Hospital. What the hospital cover step costs depends on your household, state and excess.

Compare hospital inclusions

If you claim general dental every year

SmartCare Complete Boost Extras has a $1,500 general dental limit that it shares with other services and can only be bought with certain GMHBA hospital policies. Check the extras benefits for shared pools and claim conditions.

GMHBA policies and example prices.

The profile you choose updates the GMHBA price tables, hospital shortlist and alternative-policy comparison below.

Who needs cover?

SingleCoupleFamilySingle parent

State or territory

Hospital excess

Single · NSW · $500 hospital excess · example premiums after rebate.

Monthly examples include the 24.118% government rebate, the maximum for adults under 65. Your rebate and final quote may differ.

Price assumptions

Need a GMHBA price for your circumstances? Compare GMHBA with cover across all Australian health funds.

Compare my options

Hospital cover

7 product lines

GMHBA hospital policies: monthly example premiums after rebate for Single · NSW · $500 hospital excess
Tier	Product	Monthly premium after rebate	Explore
Basic	Accident Only Hospital (Basic)Accident Only Hospital (Basic)	$85.33/monthat $750 excess	Policy details: Accident Only Hospital (Basic)
Basic Plus	Basic Plus Starter HospitalBasic Plus Starter Hospital	$87.53/monthat $750 excess	Policy details: Basic Plus Starter Hospital
Bronze Plus	Bronze Plus Core HospitalBronze Plus Core Hospital	$107.50/monthat $750 excess	Policy details: Bronze Plus Core Hospital
Bronze Plus	Bronze Plus Advantage HospitalBronze Plus Advantage Hospital	$108.59/monthat $750 excess	Policy details: Bronze Plus Advantage Hospital
Silver Plus	Silver Plus HospitalSilver Plus Hospital	$145.24/month	Policy details: Silver Plus Hospital
Silver Plus	Silver Plus Premium HospitalSilver Plus Premium Hospital	$189.40/month	Policy details: Silver Plus Premium Hospital
Gold	Gold Optimum HospitalGold Optimum Hospital	$355.13/month	Policy details: Gold Optimum Hospital

$165.73 more per month for Gold Optimum Hospital versus Silver Plus Premium Hospital after rebate for the selected example profile.

Assisted reproductive services is an additional inclusion, not the complete list of differences.

Extras cover

14 product lines

GMHBA sells its six Boost extras policies only with certain GMHBA hospital policies.

GMHBA extras policies: monthly example premiums after rebate for Single in NSW, with no hospital excess
Product	Monthly premium after rebate	Explore
SmartCare Starter Extras with sub-limitsSmartCare Starter Extras with sub-limits	$22.12/month	Policy details: SmartCare Starter Extras with sub-limits
SmartCare Starter Boost Extras with sub-limitsSmartCare Starter Boost Extras with sub-limits	$22.12/month	Policy details: SmartCare Starter Boost Extras with sub-limits
SmartCare Starter Boost ExtrasSmartCare Starter Boost Extras	$28.42/month	Policy details: SmartCare Starter Boost Extras
SmartCare Starter ExtrasSmartCare Starter Extras	$28.42/month	Policy details: SmartCare Starter Extras
SmartCare Everyday Extras with sub-limitsSmartCare Everyday Extras with sub-limits	$43.44/month	Policy details: SmartCare Everyday Extras with sub-limits
SmartCare Everyday Boost Extras with sub-limitsSmartCare Everyday Boost Extras with sub-limits	$43.44/month	Policy details: SmartCare Everyday Boost Extras with sub-limits
Mid Extras Set BenefitsMid Extras Set Benefits	$46.93/month	Policy details: Mid Extras Set Benefits
SmartCare Everyday ExtrasSmartCare Everyday Extras	$51.33/month	Policy details: SmartCare Everyday Extras
SmartCare Everyday Boost ExtrasSmartCare Everyday Boost Extras	$51.33/month	Policy details: SmartCare Everyday Boost Extras
SmartCare Complete Boost Extras with sub-limitsSmartCare Complete Boost Extras with sub-limits	$67.91/month	Policy details: SmartCare Complete Boost Extras with sub-limits
SmartCare Complete Extras with sub-limitsSmartCare Complete Extras with sub-limits	$67.91/month	Policy details: SmartCare Complete Extras with sub-limits
Mid Extras 65% BenefitsMid Extras 65% Benefits	$75.09/month	Policy details: Mid Extras 65% Benefits
SmartCare Complete ExtrasSmartCare Complete Extras	$82.94/month	Policy details: SmartCare Complete Extras
SmartCare Complete Boost ExtrasSmartCare Complete Boost Extras	$82.94/month	Policy details: SmartCare Complete Boost Extras

JavaScript is off. Prices show Single / NSW / $500 excess; the shortlist shows cataracts and the alternatives show GMHBA Silver Plus Hospital comparisons. All policy links remain available.

All GMHBA policy pages

What does GMHBA hospital insurance cover?

Choose a treatment

2 GMHBA hospital policies fully cover cataracts

Tier	Product	Monthly premium after rebate	Explore
Silver Plus	Silver Plus Premium HospitalSilver Plus Premium Hospital	$189.40/month	Check policy details: Silver Plus Premium Hospital
Gold	Gold Optimum HospitalGold Optimum Hospital	$355.13/month	Check policy details: Gold Optimum Hospital

Single · NSW · $500 hospital excess. Only policies that fully include cataracts are shown. How we read hospital categories

Compare selected treatment categories across all 7 hospital policies

Selected GMHBA treatment categories.

Treatment	Accident Only Hospital (Basic)Basic	Basic Plus Starter HospitalBasic Plus	Bronze Plus Core HospitalBronze Plus	Bronze Plus Advantage HospitalBronze Plus	Silver Plus HospitalSilver Plus	Silver Plus Premium HospitalSilver Plus	Gold Optimum HospitalGold
Cataracts	Not included	Not included	Not included	Not included	Not included	Included	Included
Joint replacements	Not included	Not included	Not included	Not included	Not included	Included	Included
Heart and vascular system	Not included	Not included	Not included	Not included	Included	Included	Included
Pregnancy and birth	Not included	Not included	Not included	Not included	Not included	Not included	Included
Assisted reproductive services	Not included	Not included	Not included	Not included	Not included	Not included	Included
Hospital psychiatric services	Restricted	Restricted	Restricted	Restricted	Restricted	Restricted	Included
Insulin pumps	Not included	Not included	Not included	Not included	Not included	Included	Included

How we read hospital categories

More premium does not mean more back on everything.

GMHBA extras limits per 12 months unless the statement says otherwise

Selected benefit	SmartCare Starter Extras with sub-limits	SmartCare Starter Boost Extras with sub-limits	SmartCare Everyday Extras with sub-limits	SmartCare Everyday Boost Extras with sub-limits	Mid Extras Set Benefits	SmartCare Complete Boost Extras
Optical / physio benefit examples	Optical: Not included. Physio: 60% of eligible charge	Optical: 100% of eligible charge. Physio: 60% of eligible charge	Optical: Not included. Physio: 60% of eligible charge	Optical: 100% of eligible charge. Physio: 60% of eligible charge	Optical: 80% of eligible charge. Physio: $38.00 set benefit for an initial visit	Optical: 100% of eligible charge. Physio: 60% of eligible charge
Optical limit	Not included	$150.00	Not included	$200.00	$200.00	$250.00
Physiotherapy limit	$250.00within a $500.00 shared limit. Shared with general dental, chiropractic & osteopathy	$250.00within a $500.00 shared limit. Shared with general dental, chiropractic & osteopathy	$500.00within a $1,000.00 shared limit. Shared with general dental, major dental, endodontic and 7 more services	$500.00within a $1,000.00 shared limit. Shared with general dental, major dental, endodontic and 7 more services	$400.00sub-limits apply. Shared with other services	$1,500.00Shared with general dental, major dental, endodontic and 11 more services
Major dental + endodontic limit	Not included	Not included	$500.00within a $1,000.00 shared limit. Shared with general dental, physiotherapy, chiropractic and 6 more services	$500.00within a $1,000.00 shared limit. Shared with general dental, physiotherapy, chiropractic and 6 more services	$1,500.00sub-limits apply. Shared with general dental, orthodontic & other services	$1,500.00Shared with general dental, orthodontic, physiotherapy and 10 more services
Psychology included?	No	No	Yes	Yes	Yes	Yes
Optical waiting period	Not included	6 months	Not included	6 months	6 months	6 months
Source statement	Single-policy example	Single-policy example	Single-policy example	Single-policy example	Single-policy example	Single-policy example

Single-policy examples. Each links to its policy statement.

About these examples

SmartCare Everyday Boost Extras with sub-limits → Mid Extras Set Benefits

Both single-policy examples have a $200 optical limit. But Mid Extras Set Benefits pays 80% rather than 100% for the optical example.The reason to upgrade is the wider benefits you need, not an assumption that every cap rises.

SmartCare Complete Boost Extras: higher benefit examples

The optical examples stay at 100%, with a $250 optical limit and $1,500 shared physio limit for the Single-policy example.Compare these benefits with the premium.

Why GMHBA's shared limits and waiting periods matter

Every optical benefit shown has a standard waiting period of 6 months.

How shared limits work

GMHBA vs. Peoplecare vs. nib

How GMHBA compares with similar hospital policies.

These are selected Silver Plus examples from Peoplecare and nib, not identical policies or a search for the cheapest cover across the market.

Compare alternatives to

Comparing GMHBA Silver Plus Hospital with Peoplecare Silver Plus Essentials Hospital and nib Silver Secure Hospital Plus. Single · NSW · $500 hospital excess · Silver Plus hospital cover

Change price profile ↑

GMHBA and selected alternatives: monthly prices and verified coverage differences.

Compare	GMHBASilver Plus HospitalReference policy	Peoplecare Silver Plus Essentials Hospital$0.82 less a month than GMHBA	nib Silver Secure Hospital Plus$1.25 less a month than GMHBA
Monthly premium after rebate	$145.24/month	$144.42/month	$143.99/month (lowest price in this row)
Cataracts	Not included	Not included	Not included
Joint replacements	Not included	Not included	Not included
Pregnancy and birth	Not included	Not included	Not included
Hospital psychiatric services	Restricted	Restricted	Restricted
Heart and vascular system	Included	Included	Included
Policy details	View GMHBA Silver Plus Hospital	View Peoplecare Silver Plus Essentials Hospital	View nib Silver Secure Hospital Plus

Price assumptions

What the differences mean for you

All 38 treatment categories have the same status for these policies. That does not mean the policies have identical terms or out-of-pocket costs.

These alternatives match GMHBA Silver Plus Hospital on tier, cataracts and joint replacements. How we choose alternatives

Compare all 38 hospital treatment categories

GMHBA and the alternatives: all 38 treatment categories, policy information as at 26 October 2026.

Compare	GMHBASilver Plus Hospital	Peoplecare Silver Plus Essentials Hospital	nib Silver Secure Hospital Plus
Rehabilitation	Included	Included	Included
Insulin pumps	Not included	Not included	Not included
Pain management with a device	Not included	Not included	Not included
Dialysis for chronic kidney failure	Not included	Not included	Not included
Cataracts	Not included	Not included	Not included
Joint replacements	Not included	Not included	Not included
Hospital psychiatric services	Restricted	Restricted	Restricted
Pregnancy and birth	Not included	Not included	Not included
Assisted reproductive services	Not included	Not included	Not included
Heart and vascular system	Included	Included	Included
Back, neck and spine	Included	Included	Included
Blood	Included	Included	Included
Bone, joint and muscle	Included	Included	Included
Brain and nervous system	Included	Included	Included
Breast surgery (medically necessary)	Included	Included	Included
Chemotherapy, radiotherapy and immunotherapy for cancer	Included	Included	Included
Dental surgery	Included	Included	Included
Diabetes management (excluding insulin pumps)	Included	Included	Included
Digestive system	Included	Included	Included
Ear, nose and throat	Included	Included	Included
Eye (not cataracts)	Included	Included	Included
Gastrointestinal endoscopy	Included	Included	Included
Gynaecology	Included	Included	Included
Hernia and appendix	Included	Included	Included
Implantation of hearing devices	Included	Included	Included
Joint reconstructions	Included	Included	Included
Kidney and bladder	Included	Included	Included
Lung and chest	Included	Included	Included
Male reproductive system	Included	Included	Included
Miscarriage and termination of pregnancy	Included	Included	Included
Pain management	Included	Included	Included
Palliative care	Included	Included	Included
Plastic and reconstructive surgery (medically necessary)	Included	Included	Included
Podiatric surgery (provided by a registered podiatric surgeon)	Included	Included	Included
Skin	Included	Included	Included
Sleep studies	Included	Included	Included
Tonsils, adenoids and grommets	Included	Included	Included
Weight loss surgery	Not included	Not included	Not included

Compare GMHBA with cover from every Australian health fund.

Compare all funds

GMHBA against the industry.

GMHBA members had no gap on 86.3% of in-hospital medical services in the 2024-25 financial year, against 87.1% across the industry. State of the Health Funds Report 2024-25 · accessed 26 October 2026
GMHBA paid 45.6% of members' extras (general treatment) charges in the 2024-25 financial year, against 50.7% across the industry. State of the Health Funds Report 2024-25 · accessed 26 October 2026
GMHBA increased premiums by an average of 1.98% in 2026, against 4.41% across the industry. Government premium-increase figures · accessed 23 October 2026

Google

3.3 / 5

48 Google reviews

Voluntary customer reviews · GMHBA Head Office

Snapshot: 26 October 2026. This is the Google listing for GMHBA Head Office, not a rating of GMHBA as a whole or a representative survey. This small sample may not reflect the experience of most members.

Read GMHBA Head Office reviews at the source

Complaint share is close to market share, but investigated complaints are lower

Share of all complaints, 2024-251.8%

Market share, 30 June 20252.1%

0%12%

State of the Health Funds Report 2024-25 · checked 26 October 2026

GMHBA's share of complaints the Ombudsman received in 2024-25 is close to its market share at 30 June 2025. Its share of complaints the Ombudsman investigated that year is 0%, below its market share.

Latest quarter, January to March 2026. The Ombudsman referred 20 complaints about GMHBA Limited to it to resolve, 3% of those it referred about all insurers, and investigated none. Ombudsman Quarterly Update · checked 26 October 2026

Read the State of the Health Funds Report 2024-25

App Store

3.1 / 5

38 App Store ratings

GMHBA Health Insurance app · GMHBA Limited

Snapshot: 22 October 2026. GMHBA Health Insurance is GMHBA's own app. This rates the app on the Australian App Store, not GMHBA's cover or claims. This small sample may not reflect the experience of most members.

See GMHBA Health Insurance on the App Store

Google Play

3.2 / 5

37 Google Play reviews

GMHBA Health Insurance app · GMHBA Limited

Snapshot: 22 October 2026. GMHBA Health Insurance is GMHBA's own app. This rates the app on Google Play, not GMHBA's cover or claims. This small sample may not reflect the experience of most members.

See GMHBA Health Insurance on Google Play

What review and complaint figures mean

Check the practical details.

Check your provider
Confirm that GMHBA recognises your provider. Ask for a treatment plan and item numbers so GMHBA can estimate your benefits and out-of-pocket costs.
Make or track a claim
Use GMHBA's website for claims guidance and member login: receipts, claim tracking and remaining benefits are handled there.
Official website

Contact GMHBA

For customer service, call 1300 446 422. Monday to Friday 8:30am to 5pm (AEDT).Contact details checked 22 October 2026.Official contact details and messaging options

Before you choose GMHBA.

Who owns GMHBA?

GMHBA is owned by its members and operates as a not-for-profit fund. That does not make every policy the best value for your needs.

Source: Government insurer profile, checked 22 October 2026.

Can younger adults get a discount with GMHBA?

GMHBA offers age-based discounts to eligible younger adults. Check the discount on your quote and how it changes as you get older.

Source: GMHBA fund rules, checked 26 October 2026.

What is the cheapest GMHBA hospital policy?

Silver Plus Hospital is the cheapest GMHBA hospital policy for a single person in NSW with a $500 hospital excess, at $145.24 a month after the 24.118% government rebate for adults under 65 (prices effective 21 September 2026). This compares all 7 GMHBA hospital policies, not the whole market. Check what it excludes before choosing on price.

Source: How we compare prices, checked 26 October 2026.

What changes if I move from Silver Plus Hospital to Silver Plus Premium Hospital?

GMHBA Silver Plus Premium Hospital adds cover for insulin pumps, pain management with a device and 3 more categories compared with Silver Plus Hospital. For the Single / NSW / $500 excess example it costs $44.16 more a month, so check what each policy covers before you upgrade.

Source: Private Health Information Statements, checked 26 October 2026.

Sources for GMHBA.

Policy information retrieved 26 October 2026. Prices effective 21 September 2026.

Private Health Information Statements · GMHBA · checked 26 October 2026
State of the Health Funds Report 2024-25 · GMHBA · checked 26 October 2026
Government insurer profile · GMHBA · checked 22 October 2026
Government premium-increase figures · GMHBA · checked 23 October 2026
Government rebate rates and eligibility · Australian Government · checked 26 October 2026
Google listing for GMHBA Head Office · GMHBA · checked 26 October 2026
App Store listing for GMHBA Health Insurance · GMHBA Limited · checked 22 October 2026
Google Play listing for GMHBA Health Insurance · GMHBA Limited · checked 22 October 2026
Official contact details · GMHBA · checked 22 October 2026
GMHBA fund rules · GMHBA · checked 26 October 2026

How we compare health insurers

Compare GMHBA policies Sources for GMHBA Back to top

All policies by cover type

Hospital (8)

Extras (15)

Show 3 more

Browse all 23 policies →

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