Are you in need of health insurance? Review your health insurance options from Budget Direct.
Budget Direct, one of the largest general insurance providers in Australia, offers a range of health insurance policy options to suit people with varying insurance requirements and also budgets.
With policies underwritten by Auto and General Insurance Company Limited, Budget Direct can provide you with a range of cover options, from basic hospital cover to a comprehensive hospital and extras policy.
What are the different levels of cover available with Budget Direct?
Budget Direct Public Hospital
The most basic level of cover available, Budget Direct Public Hospital covers you as a private patient in a public hospital for a wide range of treatments including accidents, cardiac surgery, delivery suite, intensive care, joint reconstruction and palliative care.
Public Hospital Cover is Budget Direct’s most basic and also affordable hospital cover option and includes cover for emergency ambulance cover no excess for your child dependants when they are admitted as private patients. If you're only after cover for the essentials, this might be the policy for you.
Budget Direct Mid Hospital
Combining a higher level of privileges with an affordable price, Mid Hospital Cover provides for the cost of treatment in a private hospital in a shared room. Hospital accommodation in a single room is also available if you’re willing to make a co-payment of $100 per day, while it also covers everything from psychiatric care and palliative care to cardiac surgery and intensive care.
Budget Direct Top Hospital
The highest level of hospital cover from Budget Direct is Top Hospital Cover, which is designed to offer policyholders the ultimate peace of mind. It provides cover for an extensive range of treatment types and lets you take advantage of a range of private privileges in public and private hospitals. Hospital accommodation, accidents and ambulance cover are all included, as are cardiac surgery, eye surgery, cataract surgery, intensive care, IVF, gastric banding, Medical Gap cover, obstetrics and a whole lot more.
Budget Direct Extras
Budget Direct also offers two extras cover options to help you tailor cover to suit your needs: Basic Extras and Top Extras. If you sign up for our Extras cover, no matter whether it's Basic or Top cover, you can choose how much you’ll get back from the provider: 55% or 85%.
- Basic Extras. This covers optical, dental, orthodontic, naturopathy, homeopathy, acupuncture, remedial massage, physiotherapy, hydrotherapy, myotherapy, chiropractic and osteopathic treatments.
- Top Extras. This is the highest level of extras cover available from Budget Direct and it covers all the same items as Basic Extras but to significantly higher annual limits. It also provides protection for the cost of psychology, orthotics, podiatry and travel vaccinations.
|Benefits||Public Hospital||Mid Hospital||Top Hospital|
|Accidents||Covered as a private patient in a public hospital||Yes||Yes|
|Cardiac surgery and coronary care||Covered as a private patient in a public hospital||Yes||Yes|
|Cataract surgery||Covered as a private patient in a public hospital||No||Yes|
|Cosmetic surgery (not medically necessary)||No||No||No|
|Delivery suite||Covered as a private patient in a public hospital||No||Yes|
|Dental implants done in hospital||Covered as a private patient in a public hospital||No||Yes|
|Emergency ambulance cover||Covered as a private patient in a public hospital||Yes||Yes|
|Eye surgery||Covered as a private patient in a public hospital||Yes||Yes|
|Intensive care||Covered as a private patient in a public hospital||Yes||Yes|
|IVF and related services||Covered as a private patient in a public hospital||No||Yes|
|Joint reconstruction||Covered as a private patient in a public hospital||Yes||Yes|
|Joint replacement||Covered as a private patient in a public hospital||No||Yes|
|Medical gap up to the Medical Benefits Scheduled fee||Covered as a private patient in a public hospital||Yes||Yes|
|No hospital excess for child dependents when admitted as a private patient||Covered as a private patient in a public hospital||Yes||Yes|
|Nursing home type patients||Covered as a private patient in a public hospital||Yes||Yes|
|Obstetrics||Covered as a private patient in a public hospital||No||Yes|
|Other agreed charges||Covered as a private patient in a public hospital||Yes||Yes|
|Palliative care||Covered as a private patient in a public hospital||Yes||Yes|
|Plastic and reconstructive surgery (medically required)||Covered as a private patient in a public hospital||Yes||Yes|
|Private hospital accommodation (private room)||Covered as a private patient in a public hospital||Covered with a $100 co-payment per night for a private room||Yes|
|Private hospital accommodation (shared room)||Covered as a private patient in a public hospital||Yes||Yes|
|Psychiatric care||Covered as a private patient in a public hospital||Yes||Yes|
|Public hospital accommodation (as a private patient)||Yes||Covered with a $100 co-payment per night for a private room||Yes|
|Rehabilitation||Covered as a private patient in a public hospital||Yes||Yes|
|Same-day treatment||Covered as a private patient in a public hospital||Yes||Yes|
|Surgically-implanted prosthesis||Covered as a private patient in a public hospital||Yes||Yes|
|Theatre||Covered as a private patient in a public hospital||Yes||Yes|
What isn't cover by Budget Direct Health Insurance?
Your Budget Direct Health Insurance claim will not be paid if:
- It is for an account that has been altered in any way
- It is for natural remedies or food supplements
- It is for dental procedures carried out by a dental mechanic, other than an advanced dental technician
- It is for a range of same-day dental procedures, such as a filling
- It is for a dental procedure where you have exceeded the limit on the number you can have
- It is for services or treatment for which you have the right to claim damages or compensation from another body
- It is for treatment where you are otherwise eligible for free treatment under any Government Act
- It is for services or treatment obtained more than 12 months previously
- It is for services or treatment given by a practitioner who is not in a private practice or is not recognised by official bodies recognised by Budget Direct
- It is for the hiring of equipment
- It is for services that were not rendered face-to-face
- Your claim is for benefits for lifestyle services that largely take the form of sport, recreation or entertainment
- It is for treatment or services received overseas
- It is for a vaccination not listed on Budget Direct’s Approved Travel Vaccinations list, or if it is for travel vaccinations that are listed on the Pharmaceutical Benefits Scheme.
How much will a policy from Budget Direct cost you?
The following factors can all influence the price you will have to pay to take out cover.
- The level of cover you choose. Top Hospital Cover is obviously going to cost you a lot more than Public Hospital Cover.
- Multi policy discount. If you’re already a Budget Direct Car, Roadside, Home, Travel or Life Insurance customer, you can receive a 10% discount on the cost of your health insurance.
- Standalone cover. Choose a standalone hospital or extras cover instead of taking out a combined policy – this will help you save money on the cost of cover.
- The age at which you take out cover. Due to Australia’s Lifetime Health Cover regulations, a loading applies for each year you are without cover from the age of 31.
- What cover you take out. Whether you select a single, couples or family policy.
Cost breakdown of Budget Direct Health Insurance by state
Below is a cost breakdown of the minimum, maximum and average monthly cost of a Budget Direct Health Insurance policy for a single across all Australian states.
Are there any excesses?
An excess applies to your Budget Direct Health Insurance policy – paying it entitles you to lower premiums for your health insurance. When you are admitted to hospital as a private patient you will need to pay an excess. The maximum amount you will pay in any calendar year is:
- $450 for singles
- $900 for couples and families
- $0 for child dependants
How does Budget Direct calculate benefit amounts?
The amount of benefit you are eligible for as a policy holder will be assessed by the type of medical service or procedure you claim for. The more life threatening your condition, and the more complex the procedure or surgery, the larger your benefit will be. For example, if you are insured by Budget Direct and you lodged a successful claim for a craniotomy you would be eligible for a payment of $2,420, while if you claimed for adenoid removal surgery you would receive $513.
To give you a better idea of the dollar amount Budget Direct attaches to medical services, this chart lists their benefit amounts for 22 treatments and procedures, and includes the Medicare (MBS) amounts for comparison. As Budget Direct is a member of the Australian Health Service Alliance (AHSA), they are included under that organisations title in the chart:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genetalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health
How to save on your Budget Direct Health Insurance policy
- Choose your extras cover. Budget Direct offers the choice of receiving 55% or 85% back on your extras cover, with the 55% option resulting in lower premiums.
- Choose a lower level of cover. The higher the level of cover you choose, the more you’ll have to pay for it.
- Rebates. People of all ages can take advantage of the government’s private health care rebate scheme.
- Sign up for cover. Due to the Medicare Levy Surcharge for those who don’t have private health insurance, signing up for cover can end up saving you money.
Budget Direct multi-policy discounts
|Car Insurance||Get 25% off Budget Direct Car Insurance when you add a new comprehensive car policy online using Policy Manager.||More info|
|Combined Smart Home & Contents Insurance||Receive a 35% discount when you buy a Smart Home & Contents Insurance policy online.||More info|
|Combined Home & Contents Insurance||Combine your regular Home & Contents policy and get 25% off if you you have an existing car insurance policy and buy your policy over the phone.||More info|
|Smart Home Insurance||Add Smart Home Insurance an existing policy online and get 20% off.||More info|
|Smart Contents Insurance||Go online and add Smart Contents Insurance to an existing policy and receive a 20% discount.||More info|
How do you make a claim with Budget Direct?
Budget Direct Health Insurance claims are designed to make paying for treatment as easy as possible. Budget Direct pays Hospital Cover claims direct to the hospital, all you have to do is present your membership card upon admission. In most cases you will not have to contact Budget Direct at all.
For Extras Cover claims, you can use your membership card to claim electronically at many health care providers. You can simply swipe your card and your claim will be processed in seconds. Once it has been authorised, you’ll have to pay the difference between the full fee for the service and the amount covered by Budget Direct.
If electronic claiming is not available, you’ll have to pay the service provider’s full bill and then claim online from Budget Direct.
Still have questions about your cover?
Question. Where can I find a list of Budget Direct’s participating hospitals?
- A. This can be accessed online through the Budget Direct website.
Question. I’ve received a bill for my stay in hospital – what should I do?
- A. While most hospitals will send their bills to Budget Direct, if you receive a bill simply contact Budget Direct to organise payment.
Question. What is the hospital excess I will have to pay?
- A. An excess applies when you are admitted to hospital as a private patient. The maximum excess you will have to pay each year is $450 for singles and $900 for couples and families. No excess applies to child dependants.
Question. Will I be covered for a cosmetic procedure?
- A. Budget Direct Health Insurance does not provide cover for cosmetic surgery that isn’t medically necessary.
Question. Can I sign up for cover if I have a pre-existing condition?
- A. Yes you can, but you will need to sit out a waiting period of 12 months before you will be covered for any hospital benefit.
Question. Is the cost of ambulance transportation covered under my policy?
- A. As long as you hold a Budget Direct Hospital Cover policy, you will be covered for any clinically necessary emergency ambulance services within Australia.