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Changes to optical claiming process for GMHBA Limited funds – GMHBA Health Insurance and Frank Health Insurance
GMHBA Limited regularly reviews optical claims to ensure consistency of benefits to members. We wish to clarify the claiming process when a member is claiming benefits for the purchase of only a spectacle frame separately from purchase of lenses (not complete frames and lenses in a single transaction).
Claiming frame only – lenses purchased separately
GMHBA Limited members cannot claim frames without a prescription lens through electronic systems such as HICAPS/HealthPoint.
To receive an eligible benefit, on a frame only purchase, the member must submit their itemised receipt(s), including evidence that prescription lenses have been fitted, directly to the fund through:
GMHBA Health Insurance or Frank Health Insurance member app
GMHBA Health Insurance www.gmhba.com.au/mobile-app
Frank Health Insurance www.frankhealthinsurance.com.au/get-the-app
Online member area
GMHBA Health Insurance www.gmhba.com.au/members
Frank Health Insurance www.frankhealthinsurance.com.au/members
Through their local GMHBA branch: www.gmhba.com.au/find-a-branch
Changes to optical item numbers eligible for benefits paid
From 1 September 2025 there will be changes to the item numbers claimable by GMHBA Limited members.
No change: Claiming lens only
When a frame is being reglazed, there has been no change to the way “lens only” purchases are entered in HICAPS, with the existing codes remaining.
Ie 212, 222, 312, 412,512,
This information has been provided by GMHBA Limited funds. For any further information, the GMHBA provider team can be contacted on 1300 301 437 or service@gmhba.com.au.
GMHBA Health Insurance Frank Health Insurance gmhba.com.au frankhealthinsurance.com.au Level 3, 60 Moorabool St, Geelong VIC 3220 Level 3, 60 Moorabool St, Geelong VIC 3220 PO Box 761 Geelong VIC 3220 PO BOX 69 Geelong VIC 3220 T 1300 446 422 T 1300 437 265 ABN 98 004 417 092 ABN 98 004 417 092