Information for Budget Direct Health Insurance members moving to GMHBA

The following information is for Budget Direct Health Insurance members who will become members of GMHBA Health Insurance from 6 December 2019.

What’s changing?

GMHBA’s partnership with Budget Direct Health Insurance is ending and private health insurance will no longer be delivered under the Budget Direct brand. As a result, current Budget Direct Health Insurance members will be automatically moved onto a comparable product with GMHBA Health Insurance as of 6 December 2019.

Time for a cover review?

Before 6 December 2019, members can review our full product range and select a policy of their choice if the one we have chosen doesn’t suit them. We encourage you to review your cover to ensure you’re on the right health insurance product to suit you, and your family.  

Important information for new GMHBA members

Member card and online member area

Your Budget Direct Health Insurance member card will still work until you receive your new GMHBA member card. This will be mailed to you in December.   

The GMHBA online member area is the easiest way to manage your health cover by making extras claims, paying your premiums online and accessing a range of other services when it suits you.

Your member number will remain the same and you can utilise the same login details to log into the GMHBA member area. If you did not previously register for the Budget Direct member area, that’s ok. You can register for the GMHBA member area here.

How to contact GMHBA

Our call centre is open 8am – 6pm Monday to Friday. You can call us on 1300 446 422. For other enquiries or any quick questions, we recommend completing the online contact form.

Handy links

Information about product changes

Ambulance cover

There may be some differences to how your ambulance cover works on your new GMHBA policy. Ambulance coverage in Australia is also different from state to state, so we encourage you to read this information find out what you need to do to be fully covered.

Travel and accommodation benefits for rural and regional members

Rural and regional members on selected GMHBA hospital products will be eligible to receive benefits towards travel and accommodation for specialist hospital treatment that is not available within 100kms of where they live. For additional details, refer to your new product fact sheet.

Access Gap Cover

GMHBA members have access to the Australian Health Service Alliance (AHSA) Access Gap Cover scheme, a billing system that provides higher benefits than the Government’s scheduled fee. It can reduce or even eliminate any gap for medical fees when treated as an inpatient in hospital.

Find out more information about medical gap cover.

FAQs

  • We chose a product for you that was most closely aligned with your Budget Direct Health Insurance policy. Unfortunately, GMHBA does not have a product that is exactly the same.
  • We can review your needs and find a suitable product for you if you don’t believe the one we have chosen will be suitable.
  • Feel free to review our product range online or contact our customer service team on 1300 446 422 if you need help finding a policy that is right for you.

The Australian Government introduced a wide-ranging package of reforms to private health insurance designed to make it simpler and more affordable for all Australians. These reforms are being introduced across the private health insurance industry and there are a number of mandatory changes which will affect all health funds. More information about the reforms is available here.

A higher excess can help to reduce the cost of your premium. However, if you want a lower hospital excess, you will need to choose a different policy.

If you have already paid an excess this year, you will only need to pay the difference between what you have already paid and your new excess before the end of the year.

For example, if your previous excess was $250 and you have paid this in 2019, but your new excess is $500, you would pay the remaining $250 for any further admissions in 2019. Your excess is payable per calendar year.

Restricted services are hospital claims which are limited to a minimum (default) benefit – a minimum dollar amount set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. A restricted service does not pay towards the cost of intensive and coronary care, or theatre fees in a private hospital or private day centre, therefore you may incur a large out-of-pocket expense.

If your policy has restricted psychiatric service, you can use a one-off waiver to upgrade your cover and get immediate access to applicable services. This waiver is available only once per person, per lifetime and if you have held hospital cover for at least two months.

If you are happy with the new GMHBA policy we have selected for you, you won’t need to serve waiting periods, even for newly included services. 

If you decide to select a different policy, you have until 31 January 2020 to do this without re-serving waiting periods for existing services if you have already served the waiting periods under your current Budget Direct policy. Waiting periods will apply for services that were previously restricted or not covered.

If you decide to select a different policy after 31 January 2020, then:

  • Waiting periods may apply for services that are covered under the policy you have chosen if they were excluded on the new GMHBA policy that we selected for you, even if these services were originally covered under your current Budget Direct policy.
  • If the new GMHBA policy that we selected for you has a higher excess or co-payment than the policy you have selected, the higher excess or co-payment may continue to apply for a period of time.

If you require cover for services that are covered on your Budget Direct policy but are not covered on your new GMHBA policy, you will need to choose a different policy. You have until 31 January 2020 to make this change without needing to serve waiting periods.

If you have a hospital admission booked prior to 6 December 2019 (for an admission after 6 December 2019) for services no longer covered on your new GMHBA policy, you are still able to claim benefits for that admission.

The admission needs to be booked with a participating hospital prior to 6 December 2019. To confirm coverage, you must provide pre-admission paperwork or a confirmation letter from the hospital, or an eligibility check must have taken place before 6 December 2019.

If you decide to select a different policy than what we’re suggesting for you after 6 December 2019, the effective date of this change must be backdated to 6 December 2019 to give you continuity of cover. You will have until 31 January 2020 to make this change.