I’m looking for cover

On 25 May 2018, Budget Direct stopped offering health insurance to new customers.

We apologise for any inconvenience this change may cause you.

I’m a member

Though we’ve stopped offering cover to new customers, existing members will continue to be covered.

You can keep using your Budget Direct Health Insurance membership card to claim hospital and/or extras expenses.

To view and change your policy details, log into the Member Area; and if you have any questions, please contact us:

Document and forms

Member guide Important information about Budget Direct Health Insurance, including benefit limitation periods, restrictions, waiting periods, claims procedure, excess, exclusions, and more. Download
Key facts sheets The key facts sheets summarise the important features of each of the Budget Direct Health Insurance covers. For more details about a particular cover, please read the Member Guide.

Young singles and couples cover
Starter Package Key Facts Sheet
Starter Package Plus Key Facts Sheet


Families cover
New Family Package Key Facts Sheet
Family Value Package Key Facts Sheet
Established Family Package Key Facts Sheet


Older singles and couples cover
Freedom Package Key Facts Sheet


Hospital-only cover
Top Hospital Key Facts Sheet
Mid Hospital Key Facts Sheet
Public Hospital Key Facts Sheet


Extras-only cover
Top Extras 55% Key Facts Sheet
Top Extras 85% Key Facts Sheet
Basic Extras 55% Key Facts Sheet
Basic Extras 85% Key Facts Sheet

Participating private hospitals list Budget Direct Health Insurance has negotiated special agreements with a number of private hospitals, including cover for private-hospital members’ accommodation (shared & private room), theatre, delivery suite, intensive/coronary care, etc. Download
Direct-debit service agreement The terms and conditions of our direct-debit scheme. Download
Approved travel vaccinations A list of the travel vaccinations we’ll pay for under our Top Extras cover Download
Claim form Use this form only if your claim relates to an extras treatment or service you received more than six months ago or to orthodontic treatment. Download
Privacy statement Explains the type of personal information we collect and how we handle your information. Download

Make a claim

Claiming on your Budget Direct Health Insurance is quick and easy. In most cases, you can claim on the spot, by giving your healthcare provider your membership card.

Make a claim on your health insurance policy.

Frequently asked questions

What am I covered for?

That depends on your level of cover and the treatment you're receiving. To find out what you’re covered for, visit the Member Area.

Where are Budget Direct Health Insurance's participating hospitals?

See Budget Direct Health Insurance's list of participating hospitals.

What if I receive treatment from a hospital that's not on your participating list?

Budget Direct Health Insurance's participating hospitals charge agreed rates because of our contracts with them.

Being admitted to a non-participating hospital could result in significant out-of-pocket expenses.

For more information, please contact us.

What are waiting periods?

To stop people joining when they're sick and immediately claiming medical expenses, health funds impose waiting periods on certain treatments.

These waiting periods apply to new members and existing members who increase their level of health cover.

When do waiting periods apply?

Waiting periods apply if:

  • you've never had health insurance before
  • you've had health insurance before, but haven't had any cover in the past 30 days
  • you're switching to Budget Direct Health Insurance from another insurer and upgrading your cover
  • you're already a Budget Direct Health Insurance member and are upgrading your cover.

How long you have to wait can depend on:

  • the type of treatment
  • whether it involves a pre-existing condition
  • whether you've been insured before
  • the type of cover you had
  • how long you had the cover for.
What is a co-payment?

A co-payment is what you'll pay for a single room when you go into hospital or day surgery. (You don't pay it if you stay in a shared room.)

If you're on Budget Direct Health Insurance's Mid Hospital cover you'll pay $100 per night, capped at 7 nights per admission.

We use co-payments to share health care and keep premiums low.

What happens if I receive a bill for my stay in hospital?

Most providers send accounts directly to Budget Direct Health Insurance; if they send one to you, contact us and we'll tell you the best way to submit your claim.

How will my medical account be paid?

Once we’ve received and processed the information about your treatment and charges from the hospital, we’ll pay your account.

What is the ‘medical gap’?

The ‘medical gap’ is the difference between what your doctor charges for your in-hospital treatment and what Medicare and Budget Direct Health Insurance will pay towards this cost.

Between them, Medicare and Budget Direct Health Insurance will cover the Medical Benefits Schedule (MBS) fee.

If your doctor charges only the MBS fee, there will be no gap for you to pay.

Anything your doctor charges above the MBS fee – the ‘known’ medical gap – will need to be paid by you.

You should discuss any potential out-of-pocket expenses with your doctor prior to treatment.

What is medical gap cover?

Medical gap cover (which is included in all Budget Direct Health Insurance hospital covers) helps reduce your medical gap.

If your doctor charges more than the MBS fee, we’ll pay you a higher benefit, up to 120% of the MBS fee.

Anything your doctor charges above 120% of the MBS fee will be payable by you.

You should discuss any potential out-of-pocket expenses with your doctor prior to treatment.

What is a hospital excess?

A hospital excess is a fee you pay in return for lower membership costs.

The most excess you'll have to pay each year is $450 for singles and $900 for couples and families (hospital-only cover) or $500 for singles and $1,000 for couples and families (hospital-and-extras cover).

There is no excess for child dependants.

Will I have to pay an excess every time I go to hospital?

No – once you've paid the maximum amount of excess for the calendar year, you won't have to pay any more excess, no matter how many times you're admitted to hospital.

There is no excess for child dependants.

Which extras providers can I claim on?

Budget Direct Health Insurance members can access thousands of extras providers.

Make sure your practitioner works in a private practice that's registered with bodies recognised by Budget Direct Health Insurance.

If you're not sure, please contact us.

How do I make an extras claim?

In most cases, you'll just need to get your Budget Direct Health Insurance membership card swiped through your healthcare provider’s electronic claims terminal.

If your provider doesn't have a terminal, you'll need to pay your account and then claim online as follows:

  1. Log into the Member Area
  2. Enter your account/receipt details.

We’ll deposit your benefit into your bank account the next business day.

Please keep your receipts safe for two years, in case our audit team request them (please don't send the receipts to us unless we ask for them.)

For claims that can't be processed online (e.g. orthodontic), please send your receipts to:

Budget Direct Health Insurance
PO Box 761

You can also lodge claims at any Medicare office – they’ll pass them on to us.

Read more

Are GP visits covered by private health insurance?

No – Budget Direct Health Insurance only covers doctors you see in hospital.

What is the Australian Government rebate on private health insurance?

The rebate is a payment from the federal government for taking out private health insurance and helping to free up the public health system.

The size of the Private Health Insurance Rebate – which applies to hospital, extras, and ambulances policies – varies according to your or your family’s income (see table below).

Private Health Insurance Rebate (1 April 2018 to 31 March 2019)


$90,000 or less



$140,001 or more


$180,000 or less



$280,001 or more


Base Tier

Tier 1

Tier 2

Tier 3

Under 65










Over 70





1. ‘Families’ include single parents and couples (including de facto couples). For families with children, the thresholds are increased by $1,500 for each child after the first.
Sources: www.privatehealth.gov.au; Australian Government Department of Health

The easiest way to claim the rebate is to complete Medicare form MS006 when you apply for Budget Direct Health Insurance.

If you’re eligible for the rebate, we'll deduct it from your premiums so you pay less.

You can also claim the rebate when you lodge your annual tax return, or as a direct payment from the government through any Medicare office.

What is the Medicare Levy Surcharge?

Medicare is partly funded by taxpayers who pay a levy of 2% of their taxable income.

The Medicare Levy Surcharge (MLS) is an additional charge placed on individuals and families on higher incomes who don't have private hospital cover (see table below).

The MLS encourages Australians who can afford it to take up private health insurance and reduce the burden on the public health system.

 Medicare Levy Surcharge (1 April 2018 to 31 March 2019)


$90,000 or less



$140,001 or more


$180,000 or less



$280,001 or more

All ages





1. ‘Families’ include single parents and couples (including de facto couples). For families with dependent children, the thresholds are increased by $1,500 for each child after the first.
Sources: www.privatehealth.gov.au; Australian Taxation Office.

What is the Lifetime Health Cover loading?

The Lifetime Health Care (LHC) loading is an Australian Government initiative to encourage people to take out private hospital insurance earlier in life.

If you don't join a health fund by July 1 after your 31st birthday, you'll pay a loading on top of your membership premium.

The LHC loading adds 2% to your normal health insurance premium for every year you're over 30 when you join a fund, up to a maximum of 70%.

For example, if you're 40 when you join, you'll pay 20% more in membership premiums each year than people who joined before they turned 31.

Important note: The answers to these questions are general in nature and do not take into account your personal objectives, financial situation, and needs. For more details about Budget Direct Health Insurance, including the terms, conditions, limits and exclusions that apply, please read the Member Guide.