Key facts
- GMHBA covers 337,720 Australians across its two brands, GMHBA and Frank, at 30 June 2026. GMHBA 2026 Annual Report, read 8 Oct 2026
- GMHBA returns 81.9% of contributions as benefits, below the 84.5% industry figure, and spends 14.5% of contribution income on management against 10.9%. PrivateHealth.gov.au, read 8 Oct 2026
- In 2023-24 GMHBA drew 0.9% of all private health insurance complaints on a 2.2% market share. Commonwealth Ombudsman, 2023-24
- GMHBA and Reserve Bank Health Society signed a binding merger agreement announced on 1 September 2026, with RBHS members expected to move across in early 2027. GMHBA, 1 Sep 2026
- Every GMHBA hospital cover on sale lists a A$750 excess, and emergency ambulance carries a 0 day waiting period. GMHBA, read 8 Oct 2026
GMHBA Limited is a not-for-profit mutual headquartered in Geelong, Victoria. PrivateHealth.gov.au lists it in all eight states and territories, and it sells policies under two brands: GMHBA and Frank. Its 2026 premium rise was, by GMHBA’s own statement, the lowest of any Australian insurer, which is the first thing most people hear about it. This page sets out what that means, and what the government’s other published figures show.
Plain Cover does not score or rank funds. The Plain Cover methodology does not yet set scoring weights, so no rating appears here.
What does GMHBA stand for, and who owns it?
GMHBA stands for Geelong Medical and Hospital Benefits Association, the name the fund adopted in 1958. GMHBA’s own history page dates the fund to 1934, when Australian Cement Company workers in Geelong set up a hospital benefits scheme, and records the change to GMHBA Limited in October 2000.
GMHBA is owned by its members, not shareholders. PrivateHealth.gov.au describes it as a mutual operating on a not-for-profit basis, and APRA’s register, updated 30 July 2026, lists GMHBA Limited as an open membership insurer. Its ABN is 98 004 417 092.
GMHBA’s 2026 Annual Report states it covers 337,720 Australians across both brands at 30 June 2026. Its release of 15 September 2026 adds that it paid A$425 million in hospital and medical claims and A$119 million in extras claims in 2025-26.
A merger is under way. On 1 September 2026 GMHBA announced a binding agreement for Reserve Bank Health Society’s insurance business to transfer to GMHBA, expected in early 2027 and subject to APRA and ACCC approval.
How much did GMHBA premiums rise in 2026?
GMHBA states its average premium increase across all GMHBA Limited products was 1.98%, effective 1 April 2026, and that this was “the lowest of all health insurers and lower than industry average for the fourth year in a row”. GMHBA’s release adds that Frank members share the same pricing. The Department of Health, Disability and Ageing approved an industry average of 4.41% for the same date.
On a stated A$2,400 a year policy, which is an example and not a GMHBA quote, a 1.98% rise adds A$47.52 a year against A$105.84 at the industry average, a difference of A$58.32 for that one year. Each fund’s figure is its own announced average, so a particular GMHBA policy can rise by more or less than 1.98%.
A small rise is not the same as a small premium. The increase applies to whatever the policy already cost, so the price table below is the more useful number.
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Compare coverWhat GMHBA hospital cover costs in 2026
GMHBA publishes a starting weekly price for each hospital cover on sale. Its stated basis is a single aged 30 in Victoria earning A$105,000 or less, so the price already has the base tier Australian Government Rebate of 24.118% taken off, with no Lifetime Health Cover loading.
| GMHBA hospital cover | From, per week | A year at that price | A year at Tier 1 (16.079% rebate), estimate |
|---|---|---|---|
| Accident Only Hospital (Basic) | A$19.35 | A$1,006.20 | A$1,112.80 |
| Basic Plus Starter Hospital | A$19.75 | A$1,027.00 | A$1,135.80 |
| Bronze Plus Core Hospital | A$25.85 | A$1,344.20 | A$1,486.61 |
| Bronze Plus Advantage Hospital | A$26.15 | A$1,359.80 | A$1,503.86 |
| Silver Plus Hospital | A$30.90 | A$1,606.80 | A$1,777.03 |
| Silver Plus Premium Hospital | A$43.80 | A$2,277.60 | A$2,518.89 |
| Gold Optimum Hospital | A$83.95 | A$4,365.40 | A$4,827.87 |
Weekly prices are GMHBA’s, read 8 October 2026. Yearly figures are Plain Cover arithmetic: the weekly price times 52, and for Tier 1 the price grossed up by the base rebate and reduced by the Tier 1 rebate. Last verified 8 October 2026.
Every product in the table lists a A$750 hospital excess. GMHBA waives it for same-day stays on most products, and for children under 21 on Silver Plus, Silver Plus Premium and Gold Optimum.
How GMHBA performs on the government’s own figures
| Measure | GMHBA | Industry |
|---|---|---|
| Member retention, hospital cover | 79.9% | 85.0% |
| Benefits paid as a share of contributions | 81.9% | 84.5% |
| Management expenses, share of contribution income | 14.5% | 10.9% |
| Ombudsman complaints, against a 2.1% market share | 1.8% | not applicable |
| Hospital related charges covered, nationally | 89.2% | 89.0% |
| Extras charges covered, nationally | 45.6% | 50.7% |
GMHBA draws fewer complaints than its size predicts and covers slightly more of hospital charges than the industry. It keeps fewer hospital members, returns a smaller share of contributions as benefits, and spends more on management than the industry figure. PrivateHealth.gov.au does not state the period these figures cover. Read 8 October 2026.
The same page lists 92 private hospital agreements in NSW out of an industry maximum of 97, and 69 of 74 in Victoria. The ACT is GMHBA’s weakest territory: 46.8% of medical services there had no gap, against 74.3% for the industry.
The Commonwealth Ombudsman’s State of the Health Funds Report 2023-24, published March 2025, put GMHBA at 0.9% of all complaints on a 2.2% market share. Across the industry the Ombudsman received 3,411 complaints in 2024-25, which its quarterly update for June 2025 states was a 19.5% fall on the year before.
Why AIA Vitality no longer comes with GMHBA cover
GMHBA members could join the AIA Vitality wellness program for several years, and two of the five review pages that rank for “gmhba” still list it as a GMHBA benefit. That ended on 1 April 2026. GMHBA’s premium review page states: “Access to the AIA Vitality program is no longer be available through GMHBA as of 1 April 2026.”
For anyone who chose GMHBA partly for Vitality discounts, the 2026 policy no longer carries them, whatever an older comparison page says. The program itself continues for AIA Health members, on AIA’s own terms.
What GMHBA offers instead sits under Member Plus, which GMHBA describes as its hub of “member health programs, everyday benefits, rewards and exclusive offers”. Member Plus is a benefits program, not a provider network. GMHBA’s dental partner network is smile.com.au, which GMHBA says has more than 4,000 approved dentists.
What GMHBA extras pay, and the clinics GMHBA runs
GMHBA sells two extras families. SmartCare puts all services under one flexible annual limit of A$500, A$1,000 or A$1,500. SmartCare Complete pays 60% back on most services and 100% back on preventative dental, up to A$1,500 per person per calendar year. GMHBA does not publish a separate SmartCare optical dollar limit on its product pages. Read 8 October 2026.
ClassicCare sets a limit per service. GMHBA’s Mid Extras Set Benefits page lists A$1,500 combined for general, major and orthodontic dental, an optical limit of A$200 with A$100 more at GMHBA Eye Care, and A$400 for physiotherapy.
GMHBA also owns clinics, which is what many “GMHBA dental” and “GMHBA eye care” searches are looking for. Its 2026 Annual Report counts 11 healthcare locations across the Geelong, Ballarat and Portland regions. GMHBA Eye Care lists four practices: Ballarat, the GMHBA Hub in Geelong, Leopold and Waurn Ponds. GMHBA Dental Care is in Belmont, Geelong and Portland. GMHBA offers members 20% off products at GMHBA Eye Care and 100% back on preventative dental at GMHBA Dental Care.
Does GMHBA cover ambulance?
GMHBA states that “Emergency Ambulance is covered under all hospital policies”, with a 0 day waiting period. How that works depends on your state:
- Queensland: residents are covered by the state scheme for emergency services Australia-wide.
- Tasmania: residents are covered by a state scheme, but not for emergency transport in Queensland, NSW and South Australia, where extras benefits may apply.
- Victoria, South Australia and the Northern Territory: GMHBA recommends a state subscription. On eligible extras it pays up to 100% of an Ambulance Victoria subscription.
- Western Australia: cover differs between metropolitan Perth and regional WA.
Read 8 October 2026. GMHBA’s page does not state a cap on the number of emergency trips.
How to claim with GMHBA
GMHBA lists five ways to claim: on the spot with your member card at a provider with a claiming terminal, in the GMHBA app by photographing the receipt, through the online member area, in a branch, or by post. GMHBA describes the member area as the fastest way to be paid for a manual claim. GMHBA does not publish a processing time. Read 8 October 2026. HBF and HCF both do.
Claims must be lodged within two years of the date of service. That is the rule worth knowing if an old receipt turns up.
What you actually pay after the rebate
The rebate is set by income and age, not by fund. From 1 July 2026 to 31 March 2027 a single under 65 earning A$105,000 or less gets 24.118% off any GMHBA premium, against 24.288% from 1 July 2025 to 31 March 2026. The rebate does not apply to a Lifetime Health Cover loading.
The Medicare Levy Surcharge starts at A$105,001 for a single in 2026-27, against A$101,001 in 2025-26. The surcharge guide has the full tables, and the rebate guide has every age band.
Who tends to weigh up GMHBA, and against what
People in this situation typically weigh up the smallest 2026 increase and a low complaint share against the lower retention and benefits figures. GMHBA rose by less than half the industry average and drew fewer complaints than its size predicts in both the 2023-24 report and the current government page.
Against that, it keeps 79.9% of hospital members against 85.0% for the industry, and returns 81.9% of contributions as benefits where HCF returns 87.8%. On the A$2,400 example, that 5.9 percentage point gap is about A$142 a year.
Members in Geelong, Ballarat and Portland also have GMHBA’s own dental, eye care and physiotherapy clinics. Elsewhere in Australia, that part of the offer is replaced by smile.com.au and the provider network.