Gmhba claim form 2026

1. Click ‘Get Form’ to open the gmhba claim form in the editor.
2. Begin with Section 1: Member Details. Fill in your Member Number, Title, Surname, Given Name/s, and Address. Confirm if this is your permanent mailing address.
3. In Section 2: Claim Details, indicate if the claim is due to an accident and provide the Patient’s First Name and Date of Birth. Specify the Provider of Service and whether the account has been paid.
4. For inpatient claims in Section 3, enter the hospitalization dates and hospital name.
5. If applicable, add details for a newborn child in Section 4 by providing their Title, Surname, Given Name/s, Date of Birth, and gender.
6. In Section 5: EFT Details, choose whether you want your claim deposited directly into a bank account via EFT.
7. Complete Section 6: Agents Authority if someone else will collect benefits on your behalf. Ensure both signatures are provided before submission.
8. Finally, review all sections for accuracy before submitting your claim through our platform.

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