get more with Budget Direct Health Insurance
Greater control over when and where you are treated.
Choice of doctor
Choose your own medical specialist, who can provide you with follow-up care after you leave hospital.
Easy to switch
Switching to Budget Direct is easy, and you won’t have to re-serve waiting periods for equivalent or lower levels of cover.
We’ve teamed up with GHMBA, a not-for-profit health fund with over 80 years’ experience and covering more than 230,000§ Australians nationally.
You’ll know the most you’ll pay in hospital excess each year; your dependent children won’t be charged an excess.
Choose any registered extras provider you like (e.g. physio, chiro, dentist, optometrist).
You could get a tax rebate on your premium and avoid or minimise the Lifetime Health Cover loading and Medicare Levy Surcharge.
Based on your profile, we’ll recommend one or more hospital and/or extras covers for you to choose from.
When you get a quote, we’ll ask you to tell us a little bit about yourself, including the level of cover you need: low, medium or high.
Based on your profile, we’ll recommend one or more of the following for you to choose from:
Hospital and extras cover
You can buy hospital only or extras only cover or a combination of both:
Pre-packaged hospital and extras bundles
Our pre-packaged bundles are designed with different life stages or circumstances in mind:
Young singles and couples
Starter Package Plus
Families, including single parents
New Family Package
Family Value Package
Affordable cover for accommodation and treatment in a private hospital (though some services, such as pregnancy, are only covered in a public hospital), with some exclusions; and 60% back on a range of extras services, up to the annual limits.
Established Family Package
Cover for accommodation and treatment in a private hospital, with some exclusions like pregnancy; and 60% back on a range of extras services, with higher annual limits for physiotherapy and dental, including orthodontics.
Older singles and couples (55+)
Cover for accommodation, and treatment – including cardiac surgery, cancer care, and hip and knee replacements – in a private hospital, with some exclusions; and 60% back on a range of extras services, including dental and optical – up to the annual limits.
How to switch
Switching to Budget Direct from another health fund is as easy as 1-2-3:
Select a Budget Direct health insurance product that suits you.
No waiting periods for services you were already covered for.
Switch today and get immediate cover#
# Switch to Budget Direct Health Insurance and you won’t re-serve waiting periods on equivalent or lower levels of cover. Benefits paid by your previous fund will count towards lifetime and annual limits on extras. If your new level of cover is higher than your old policy, the lower benefit (including excess level) will apply. You will be eligible for new benefits or services once waiting periods have been served.
When you take out private health insurance for the first time or increase your level of cover, you’re required to serve a waiting period before you can start claiming benefits.
The following table shows the waiting periods that apply to certain services or conditions.
(If you’re transferring to Budget Direct health insurance from another health fund, you will not have to re-serve waiting periods for equivalent or lower levels of cover.)
|12 months||Pregnancy, and pre-existing conditions (except psychiatric treatment, rehabilitation, and palliative care)|
|2 months||Psychiatric treatment, rehabilitation, and palliative care|
|1 day||Accidents, and ambulance cover|
|2 months||All other services|
|12 months||Major dental and orthodontics podiatric surgery, and orthotics|
|2 months||Any other extras benefit|
An excess is a set amount of money you pay if you’re admitted to hospital.
The following table shows the maximum excess you’ll pay each calendar year – regardless of how often you or another family member is admitted.
|If you have Hospital-only cover, your Hospital excess is…|
|Couples & Families||$900|
|If you have Hospital & Extras cover, your Hospital excess is…|
|Couples & Families||$1,000|
In other words, if one person with Couple or Family cover goes to hospital, his or her maximum hospital excess will be $450 (Hospital-only cover) or $500 (Hospital & Extras cover).
It’s only when more than one person on the same Couple or Family cover is hospitalised that the maximum excess is $900 (Hospital-only cover) or $1,000 (Hospital & Extras cover).
Find out more
How to 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.
Hospital substitute programs
While sometimes your condition means you must be treated as an inpatient in a hospital, given a choice many people would prefer to be treated as an outpatient in the comfort of their own home.
That’s why we offer Hospital in the Home (HITH) and Rehabilitation in the Home (RITH) – programs eligible members can access at no extra cost.
Members who wish to receive treatment at home must:
- be clinically stable
- have adequate home support, such as a carer
- live in a home that’s safe for them, e.g. one with ramps and handrails, if required
- be contactable by phone.
For more information, please call us on 1800 234 004.
Frequently asked questions
What is private health insurance?
Private health insurance is an arrangement whereby, in exchange for a premium, your health fund agrees to cover some or all of your private (or public) hospital and/or non-hospital healthcare, or ‘extras’, costs.
(The cost of most general practitioners and specialists you visit outside of hospital are fully or partly covered by Medicare.)
What expenses are there if I go into hospital?
There are usually two types of bills: the hospital’s (for your accommodation, food, etc.) and your medical specialists’, for example your treating doctor’s, radiologist’s, pathologist’s and/or anaesthetist’s charges
How will my hospital bill be paid?
If you’re treated as a private patient in one of our participating private hospitals or in a public hospital and your cover does not exclude the treatment, all you’ll need to pay is the excess and – if applicable – the co-payment.
All other agreed costs will be billed to us after you’ve gone home.
You may need to pay extra for items like newspapers and pay TV; the hospital will let you know this when the items are offered to you.
How will my medical specialists’ bills be paid?
Medicare will generally pay 75% of the Medicare Benefits Schedule (MBS) fee for the in-hospital treatment provided by your specialist doctor; we’ll pay the remaining 25%.
If your doctor charges the MBS fee, there will be no ‘medical gap’ for you to pay.
If your doctor charges more than the fee, we’ll cover you for 20% of the additional cost, as long as they are one of the more than 14,000 doctors participating in our medical gap cover scheme.
If your doctor charges more than 120% of the MBS fee, you’ll be required to pay the ‘gap’ – the amount over and above what’s covered by Medicare and us.
To avoid surprises, you should discuss your potential out-of-pocket expenses with your specialist doctor before being admitted to hospital.
§ Represents Australians covered with health insurance within GMHBA Limited.