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cover details

Ultimate Health Cover

 
30-DAY COOLING OFF PERIOD
?

30-day cooling off period

We're confident you'll be happy with your cover, however if you decide to cancel, we'll refund any premiums you have paid within the first 30 days of your membership commencing provided you haven't made a claim.

Payment

Excess/Co-payment:

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Excess/Co-payment

An excess is a set amount you pay upfront before your benefit is paid. The excess is paid each time a person on your membership is admitted into hospital, to a maximum of once per person and twice on the entire membership each calendar year unless otherwise specified.
A co-payment is an amount you agree to pay towards the cost of your daily hospital bill. A co-payment is charged per day and capped after five days for each hospital admission.

Extras Paid Back*:

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Extras Paid Back

You can budget how much you'd like to pay for your monthly premium by choosing how much you want to claim back from your visits for most items at Members First providers covering dental, optical, physio and chiro. Annual maximums and waiting periods apply.

See detailed pricing

Includes:

  • Hospital $0.0
  • Extras $0.0
  • Pharmacy Saver (weekly) $0.45

Features at a glance

Hospital Cover
      TOP
Extras Cover
      TOP
back on extras*
Price is based on cover for: Family00 years old, StateChange
Assumes no Lifetime Health Cover loading and [rebate] government rebate included. Price may vary if details change.

*For most items at Members First providers, covering dental, physio and chiro services. Annual maximums and waiting periods apply.

Are you eligible for the Government Rebate?

Are you registered with Medicare?

Have you held continuous hospital cover since July 1, 2000your 31st birthday? help

When did you last begin continuous health cover

Is your partner registered with Medicare?

Has your partner held continuous hospital cover since July 1, 2000their 31st birthday? help

When did your partner last begin continuous health cover

Apply the Australian Government Rebate (30%) to reduce cover costs?

Do you or your partner hold any of these concession cards? help

Cancel

About this cover

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A premium packaged option for those wanting top quality private hospital and extras cover.

When you choose Ultimate Health Cover, you'll get our best hospital cover without any exclusions and no excess or co-payments to pay combined with our highest extras benefits.

It also offers various additional features including special benefits to help pay for a partner or family member to stay with you in hospital; laser eye surgery and Unemployment Cover (subject to eligibility).

View Extras Cover

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Hospital

tick image Bupa Medical Gap Scheme available
tick image Surgically implanted prostheses
tick image Accidents sustained after joining
tick image Knee arthroscopy or meniscectomy procedures
tick image Appendicitis
tick image Removal of tonsils and adenoids
tick image Dental surgery
tick image Minor gynaecological surgery
tick image Psychiatric services
tick image Rehabilitation services
tick image Pregnancy (childbirth)
tick image Assisted reproductive services (IVF)
tick image Cardiac and cardiac related services
tick image Renal dialysis for chronic renal failure
tick image Cataract and eye lens procedures
tick image Hip and knee replacement (including arthroplasty, revision and resurfacing procedures)
tick image All other joint replacements
tick image Gastric banding and obesity related services (includes any abdominoplasty)
tick image All other inpatient treatments receiving a Medicare benefit

Additional Items:
tick image Emergency ambulance services
tick image Family in-hospital benefit that helps pay for in-hospital partner/family accommodation or meals
tick image Laser eye surgery
tick image Health subscription refunds
tick image Unemployment cover
tick image Excess options
tick image Co-payments
tick image Accident benefit
Legend:
green tick Covered orange cross Not Covered Not Covered

Not Covered/Exclusions

If you require treatment for a specific procedure or service that is excluded under your level of cover you will not receive any benefits towards your hospital and medical costs and you may have significant out-of-pocket costs.

If a service is not covered by Medicare there will be no benefit payable from your hospital cover so you should always check with us to see if you’re covered before receiving treatment. For more information please refer to ‘What is not covered’.

minimum benefits Minimum Benefits Minimum Benefits

Minimum Benefits

For services paid at minimum benefits in a private hospital we will pay minimum shared room benefits, and you will have your choice of doctor. These benefits would not be adequate to cover all hospital costs and are likely to result in large out-of-pocket expenses.

For services paid at minimum benefits in a public hospital, we will pay minimum shared room benefits and you will have your choice of doctor. If these benefits are less than the public hospital charges, you will have out-of-pocket expenses to pay.

Help on definitions Definitions help

Definitions help

Click here to view our online glossary.


Understanding your hospital cover

What is covered?

Hospital costs


With private hospital cover, you can choose to be treated as a private patient in either a public or a private hospital.


What if I am treated in a Members First or Network Hospital?

You will be fully covered, in most instances, as a private patient in most hospitals that Bupa has an agreement with, known as Members First and Network hospitals across Australia for any treatment which is recognised by Medicare and is not either restricted or excluded under your cover.

A small number of these hospitals may charge a fixed daily fee. This fee is capped at a maximum number of days for overnight stays. The hospital should inform you of this fee when you make a booking. This fee is in addition to any excess or co-payment you may have as part of your hospital cover.

At Members First Day Hospitals, you have the added benefit of no medical gaps in addition to being covered for hospital costs, provided the treatment is recognised by Medicare and there are no exclusions on your level of cover.#

# Not available in NT. Any co-payment or excess related to your level of cover will still apply.

When admitted to hospital, in most cases you will be covered for all in-hospital charges when provided as part of your in-hospital treatment including:

  • accommodation for overnight or same-day stays
  • operating theatre, intensive care and labour ward fees
  • supplied pharmaceuticals approved by the Pharmaceutical Benefits Scheme
  • physiotherapy, occupational therapy, speech therapy and other allied health services
  • surgically implanted prostheses up to the approved benefits in the Government’s Prostheses List
  • private room where available.

We recommend you call us first before making a booking to confirm that your chosen hospital gives certainty of full cover. We can also discuss any excess or co-payment that might apply to your level of cover. You can find out if a hospital has an agreement with us by checking the Find a Healthcare Provider section of this website.


Can I choose to be treated as a private patient in a public hospital or at a private hospital that Bupa does not have an agreement with?

If you elect to be treated as a private patient in a public hospital or are admitted to a private hospital that Bupa does not have an agreement with, you are covered as set out below for any treatment recognised by Medicare unless it is excluded or restricted under your cover.

In these circumstances, you are likely to incur out-of-pocket expenses for your hospital costs.


What happens if I choose a private hospital that Bupa doesn’t have an agreement with?

If you are admitted to a private hospital that Bupa does not have an agreement with, we will pay shared room minimum benefits and benefits for prostheses up to the benefit in the Government Prostheses List. This will apply for any treatment recognised by Medicare, unless it is excluded or restricted under your cover. These benefits will only partially cover the full cost and you will have significant out-of-pocket expenses.

It is important to note that you will be responsible for the cost of your stay and may be charged directly for your hospital accommodation, doctor’s services (including any diagnostic tests), surgically implanted prostheses (such as artificial hips) and personal expenses such as TV hire and telephone calls. Some of these hospitals bill Bupa directly for the limited benefits we pay. Please also refer to the Medical Costs section below.


What happens if I choose to be a private patient in a public hospital?

As a private patient in a public hospital you are entitled to choose your doctor, if they are available. Depending on your illness or condition, this may be the same doctor who would have been allocated to you by the hospital as a public patient.

If you elect to be treated as a private patient in a public hospital, we will pay shared room minimum benefits and benefits for prostheses up to the benefit in the Government Prostheses List. This will apply for any treatment recognised by Medicare unless it is excluded or restricted under your cover.

If you choose to stay in a private room for an overnight stay, Bupa will pay a fixed benefit towards the cost of your stay. If this benefit is less than the hospital charge, the hospital should let you know what out-of-pocket expenses you will have to pay.

It is important to note that in public hospitals, private rooms are generally allocated to people who medically need them.

You will also be responsible for personal expenses such as TV hire and telephone calls and any prostheses charges above the benefit in the Government Prostheses List. Please also refer to the Medical Costs section below.

To ensure peace of mind, ask your doctor about their fees and whether they participate in our Medical Gap Scheme for your hospital treatment prior to admission. Remember to also ask your doctor about the fees for other practitioners that may be involved in your hospital treatment, such as the anaesthetist and assistant surgeons.

Medical costs


These are the fees charged by a doctor, surgeon, anaesthetist or other specialist for any treatment given when you are in hospital. You are covered for the cost of these medical treatments up to the Medicare Benefit Schedule (MBS) fee. The MBS fee is the amount set by the Federal Government for each medical service covered by Medicare. You must be eligible for Medicare in order to be covered up to the MBS fee.

How benefit is calculated

If you choose to be treated as a private patient in a hospital (public or private), Medicare will cover you for 75% of the MBS fee for associated medical costs and we will cover the remaining 25%.

Bupa Medical Gap Scheme

The Bupa Medical Gap Scheme is an arrangement Bupa has with some medical specialists/doctors such as an anaesthetist to help minimise the amount you’ll need to pay for your medical costs in hospital.

No Gap

If you see a “No Gap” doctor that uses the Bupa Medical Gap Scheme you won’t have to pay any medical costs as your medical specialist or doctor will bill Bupa directly. Check with them that they will use this for your upcoming admission upfront.

Known Gap

If you see a ‘Known Gap’ doctor that uses the Bupa Medical Gap Scheme with you, you will need to pay up to $500 towards your medical costs.

Without the Gap Scheme

If your doctor is not using the gap scheme, Medicare will pay 75% and Bupa will pay 25% of the MBS fee. Any charge above that will be your gap.

Your choice of network

We are partnered with Genesis Heart Care, a network of cardiologists across VIC, QLD, SA and WA that focus on providing quality, evidence based cardiology services. When you see a cardiologist from Genesis Heart Care you will have certainty of no out-of-pocket expenses for your in-hospital cardiologist treatment. You’ll also be provided with information and advice so you can make informed decisions about your treatment and lifestyle.

What is not covered?

Hospital costs


Situations when you will not be covered include:

  • when you have not been admitted into a hospital and are treated as an outpatient (eg emergency room treatment, outpatient ante-natal consultations with an obstetrician)
  • during a waiting period
  • when a service is excluded from your cover
  • when a service is covered as a minimum benefit and you are admitted to a private hospital, you will not be covered above the minimum benefit
  • for the fixed fee charged by a fixed fee hospital or a hospital that has a fixed fee service
  • for psychiatric and rehabilitation day programs, at a hospital Bupa does not have an agreement with
  • hospital treatment provided by a practitioner not authorised by a hospital to provide that treatment
  • hospital treatment for which Medicare pays no benefit, including: medical costs related to surgical podiatry (including the fees charged by the podiatric surgeon); cosmetic surgery where not clinically necessary; respite care; experimental treatment and/or any treatment/procedure not approved by the Medical Services Advisory Committee (MSAC)
  • personal expenses such as: pay TV, internet access, non-local phone calls, newspapers, boarder fees, meals ordered for your visitors, hairdressing and any other personal expenses charged to you unless included in your cover
  • if you are in hospital for more than 35 days and you have been classified as a ‘nursing home type’ patient. (In this situation you may receive limited benefits and be required to make a personal contribution towards the cost of your care) if you choose to use your own allied health provider rather than the hospital’s practitioner for services that form part of your in-hospital treatment (eg chiropractors, dieticians or psychologists)
  • where compensation, damages or benefits may be claimed by another source (eg workers compensation)
  • for any amount charged by a public or non-agreement hospital which is not covered by us or which is above the benefit that we pay
  • for any treatment or service provided outside Australia
  • for some non-PBS, high cost drugs
  • for pharmacy items not opened at the point of leaving the hospital.

Medical costs


You will not be covered for:

  • medical services for surgical procedures performed by a dentist, surgical podiatrist, or any other practitioner or service that is not eligible for a rebate through Medicare.

Waiting periods


A waiting period is the time between the start date of your membership and when you are covered for a service or treatment. If you receive a service or treatment during a waiting period, you are not eligible to receive a benefit payment from us, regardless of when you submit the claim. Different waiting periods apply for different services.

The following waiting periods apply for hospital cover:

  • palliative care, psychiatric and rehabilitation services – two months
  • pre-existing conditions, ailments or illnesses and pregnancy (including childbirth) – 12 months
  • all other treatments included in your cover – two months.

Inpatient vs outpatient

If you are admitted as a private inpatient, you will be covered for the services listed in your chosen level of hospital cover. If you receive treatment as an outpatient (ie you are not admitted), in most instances you will not be covered by private health insurance. If eligible these services may be claimed from Medicare.

When to contact us

If you have been a Bupa member for less than 12 months on your current hospital cover, it is important to contact us before you are admitted to hospital to find out whether the pre-existing condition waiting period applies to you. We need about five working days to make the pre-existing condition assessment, subject to the timely receipt of information from your treating medical practitioner/s. Make sure you allow for this timeframe when you agree to a hospital admission date. If you proceed with the admission without confirming benefit entitlements and we (the health fund) subsequently determine your condition to be pre-existing, you will be required to pay all hospital charges and medical charges not covered by Medicare.

Planning for a baby

If you are thinking about starting a family we recommend that you contact us to check whether your current level of cover includes pregnancy in advance. This is because a 12-month waiting period applies to pregnancy (including childbirth) and assisted reproductive services.

No waiting periods will apply to the newborn provided they have been added to the appropriate family hospital cover within two months of their birth.

Additional features

  • Family In-Hospital Benefit

    We'll help cover the costs of accommodation and meals for your partner, immediate family member, carer or next of kin should they need to stay in hospital with you. They will be covered for $60 per night for accommodation in hospital and up to $30 a day for hospital meals, capped at $1000 per person, per year. Hospital meals are covered when provided at a hospital cafeteria or patient meal menu.

  • Health subscription refund

    100% refund on a subscription to the Arthritis Foundation, Asthma Foundation and Diabetes Australia.

  • Unemployment Cover

    If you have unemployment cover and you're involuntarily retrenched or made redundant from full-time employment, from the start of your second month of unemployment your health insurance premiums will be covered (at the same level of cover) for up to 12 months while you remain unemployed.

    Unemployment Cover is underwritten by CGU Insurance Limited ABN 27 004 478 371, AFS Licence No: 238291.

    Unemployment cover conditions

    To be eligible for unemployment cover the following conditions apply:

    • If you have a family or couples membership only the main income earner is eligible.

    The main income earner must:

    • Have been employed for at least six months with the same company prior to your involuntary retrenchment or redundancy
    • Not be a contractor or in self-employment
    • Have held your health cover for 12 months before your involuntary retrenchment or redundancy
    • Provide proof of your unemployment to our reasonable requirements, every three months providing you still remain unemployed.
  • Parent and Baby Wellbeing

    You will receive access to a range of valuable services for parents with new babies, including consultation and support, identification of depression and anxiety and follow-up support if needed. These services are provided as part of your hospital cover. It's part of our commitment to ensuring the best possible care for you and your family.

  • Accident Benefit

    If you are hospitalised due to an accident an additional $2,000 can be put towards ancillary claims once you've reached your ancillary Annual Maximum.

  • Gap bonus

    Receive a $200 Gap Bonus when you join, and another $200 at the start of each calendar year per membership, to help pay for any medical gaps charged by your doctor or specialist when admitted to hospital. Plus any unused bonus amounts will accumulate.

  • Travel insurance bonus

    You can receive up to eight days (seven nights) of Economy Bupa Travel Insurance annually. Away longer or would like a higher level of cover? That's fine – use the equivalent discount towards your premium on any Bupa Travel Insurance Policy.^

    ^ Based on cost of Economy travel insurance for under 65 year old at standard rates. Travel insurance is issued by CGU Insurance Limited (CGU) ABN 27 004 478 371 AF SL 238291. Any advice is general advice only and does not take into account your individual circumstances. A Travel Insurance Product Disclosure Statement (PDS) or Product Summary is available here. The PDS should be considered before making any decision in relation to this product. Bupa Australia Pty Ltd ABN 81 000 057 590 is an authorised representative of CGU.

  • You may not have to pay the Medicare Levy Surcharge

    Covers you against paying an additional levy known as the Medicare Levy Surcharge. This levy is tiered according to your level of income and whether you hold an appropriate level of private hospital cover. The income levels and surcharges are: singles earning more than $90,000 (1%), $105,000 (1.25%) and more than $140,000 (1.5%) or couples and families with combined taxable incomes greater than $180,000## (1%), $210,000# (1.25%) and $280,000# (1.5%).
    #Family income thresholds increase by $1,500 for each additional child after the first child. Thresholds are effective 1 July 2014 and are indexed annually.

    You should ask your tax adviser for more information or visit the Australian Taxation Office website.

For more Bupa packages visit the All in One Package page

Find more Bupa health insurance by Life Stage: Singles Health Insurance, Couples Health Insurance, Family Health Insurance

Health Insurance Comparison, compare health insurance by Life Stage.

Extras

Services
See our glossary for help on definitions.

Waiting Periods

Annual Maximums

Per person, per calendar year

tick imageGeneral Dental General Dental

General Dental

General dental treatment includes services such as:

  • Your regular 6 monthly examination, scale and clean and fluoride treatment
  • X-rays
  • Mouthguards
  • Fillings (those done directly in the mouth – like Amalgams and white composite fillings)
  • Simple extractions
  • Surgical extractions (such as removal of impacted wisdom teeth)

Please refer to the full policy details to determine what is covered.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

Unlimited

tick imageMajor Dental Major

Major Dental

Major dental treatment includes services such as:

  • Periodontal treatment (treatment of gum disease)
  • Complex oral surgery
  • Root Canal Therapy (Root Treatment)
  • Fillings (those that have to be made outside the mouth eg in a laboratory or by a special machine)
  • Crowns and bridges
  • Implants
  • Dentures (false teeth)

Please refer to the full policy details to determine what is covered. Waiting periods may apply.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

12 months

$1,600

tick imageOrthodontics Major

Orthodontics

Orthodontic treatment includes the use of devices like “braces” to change the position of teeth and the jaws.

Please refer to the full policy details to determine what is covered. Waiting periods may apply. Some levels of cover only include orthodontics if treatment is required as a result of an accident after joining.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

12 months

$1,000

Lifetime limit: $3,200

tick imageOptical Optical

Optical

Optical services are provided on prescription from an optometrist and include:

  • Frames
  • Prescription Lenses
  • Contact Lenses
  • Certain lens coatings

 

Please refer to the full policy details to determine what is covered.

Benefits are only payable for services provided by optometrists and optical dispensers in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing treatment.

2 months

$420 Members First

$300 Non-Members First

tick imagePhysiotherapy Physiotherapy

Physiotherapy

Physiotherapy involves the treatment and rehabilitation of people with movement disorders and other physical disabilities.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by physiotherapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,500

We also cover the cost of your kids’ physiotherapy services until they turn 25. This means you’ll benefit from no out-of-pocket costs for most of your kids’ physiotherapy services.

tick imageChiropractic and Osteopathy Chiropractic and Osteopathy

Chiropractic and Osteopathy

Chiropractic deals with the relationship between the spine and pelvis and the nervous system (which controls how they function). The bones of the spine are manipulated, based on the premise that disease is caused by interference with nerve function.

Osteopathy deals with the structure of the body and the way it functions. It uses massage and stretching techniques to improve the function where needed.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by chiropractors and osteopaths who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000 per person

$1,600 per membership

tick imageAntenatal and Postnatal Antenatal and Postnatal

Antenatal and Postnatal

Antenatal and postnatal services include:

  • Antenatal Sessions or Courses
  • Attendances following the birth related to feeding difficulties

Benefits can only be claimed for sessions and courses provided by registered midwives who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

Benefits are not payable for courses or sessions that are paid for by Medicare Australia.

2 months

$500

tick imageNatural Therapies Natural Therapies

Natural Therapies

Natural therapies may complement or offer alternatives to conventional medical treatment. They include therapies such as Acupuncture, Alexander Technique, Chinese Herbalism, Western Herbalism, Exercise Physiology, Feldenkrais, Naturopathy, Homoeopathy and Iridology.

“Massage” includes benefits payable for Aromatherapy, Bowen Technique, Kinesiology, Reflexology, Shiatsu and Therapeutic massage.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Natural Therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

A sub-limit of $250 per person or $500 per membership per calendar year applies for massage

tick imageLiving Well Living Well

Living Well

Our Living Well benefit helps you reach your goals by covering some of the costs for health–related programs including: gym memberships, yoga, Pilates, nicotine replacement therapy and weight management programs. However, please remember – gym memberships, yoga and Pilates require your doctor or recognised provider to complete a Living Well form to confirm the program is medically necessary.

6 months

$300

tick imagePharmacy Pharmacy

Pharmacy

Your extras pharmacy entitlement covers you for prescription only items that are not supplied under the PBS (Pharmaceutical Benefits Scheme); are TGA (Therapeutic Goods Administration) approved; are prescribed by a registered medical practitioner; supplied by a Bupa recognised, registered pharmacist; and not otherwise excluded by Bupa.

When in hospital, if you are treated with drugs that are not PBS approved, you may not be fully covered and the hospital may charge you for all or part of the cost. You should be advised by the hospital of any charges before treatment.

There are some additional items that are not covered by our pharmacy benefit and these include:

  • Over the counter or non-prescription items
  • Compounded items
  • Weight loss medication (some weight loss medications are covered under the Living Well Programs)
  • Body enhancing medications (eg anabolic steroids).

Pharmacy in-hospital

When you make a claim, we will deduct a pharmacy co-payment and pay the remaining balance up to the set amount under your chosen level of cover.

2 months

$1,500

tick imageDietary Dietary

Dietary

Dietetics is the promotion of health and treatment of disease through diet.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by dietitians who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imagePsychology Psychology

Psychology

Psychology deals with the mind and mental processes, especially in relation to human behaviour.

Psychology services include:

  • Attendances (one on one)
  • Group attendances
  • Couple and Family attendances

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Psychologists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imagePodiatry (excludes orthotics) Podiatry

Podiatry

Podiatry is the prevention, diagnosis, treatment and rehabilitation of conditions of the feet and lower limbs.

Podiatry services include:

  • Attendances
  • Biomechanical analysis

Please note: Benefits for Orthotics if payable, are paid under Health Appliances

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Podiatrists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imageSpeech Therapy Speech Therapy

Speech Therapy

Speech therapy is the assessment and treatment of people who have a communication disability. Communication disabilities are the result of problems with speech, using and understanding language, voice, fluency, hearing, or reading and writing.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by speech therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imageEye Therapy Eye Therapy

Eye Therapy

Eye therapy is a physical therapy for the eyes and brain that develops eye coordination and treats a number of common visual problems eg crossed eyes, lazy eye, and double vision.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by eye therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imageOccupational Therapy Occupational Therapy

Occupational Therapy

Occupational therapy is the training of people with physical injury or illness, psychological or social disability or learning problems with the aim that they can work and live by themselves and lead a relatively normal life, despite their disabilities.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by occupational therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$1,000

tick imageHome Nursing Home Nursing

Home Nursing

Home Nursing describes nursing care following discharge from hospital or instead of being admitted for hospital. Services may include:

  • Catheter Care
  • Stomal therapy
  • Wound management
  • Administration of medication

Benefits are only payable for nursing services by providers who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400

tick imageHealth Aids and Appliances Health aids and appliances

Health aids and appliances

Includes a range of health related items that people suffering with various medical conditions may use to assist them in leading a relatively normal life.

Health appliances include:

  • Asthma pumps
  • Blood glucose monitors
  • INR Blood testing devices (eg Coaguchek)
  • Compression garments
  • Surgical stockings
  • CPAP and BPAP devices
  • TENS machines
  • Hearing Aids
  • Braces and Splints

 

Please refer to the full policy details or call us to determine what is covered. Benefits payable are subject to eligibility.

Benefits are not claimable when a prescribed treatment is not custom made (eg orthotics, braces and splints, surgical shoes). Health appliances must be purchased from a Fund-recognised provider. Call us if you would like any additional information on other criteria that applies to claiming health aids and appliances.

12 months

No overall Maximum.
Limits per item apply.

Defined Appliances include TENS Machines, blood pressure monitors, insoles, orthopaedic and corrective footware, pressure garments, braces, artificial limbs. Limits apply per item. CPAP Devices subject to eligibility.

To receive benefits for health aids and appliances you'll need to visit a recognised provider. You will also need to meet the eligibility criteria, provide proof of purchase and a clinical referral where required.

Benefits are not claimable when a prescribed treatment is not custom made (eg orthotics, surgical shoes). Call us if you would like any additional information on other criteria that applies to claiming health aids and appliances.

A benefit is also payable for the hire, repair and maintenance of health appliances. Restrictions and sub-limits apply. Benefits are not payable in the first 12 months after purchasing an item, within 12 months following the repair, or on items where hire and repair is deemed inappropriate.

Contact us for a full list of health aids and appliances that may be payable and for details of the limits that apply per item.

tick imageTravel and Accommodation Travel and accommodation

Travel and accommodation

Benefits may be payable for travel and overnight (non-hospital) accommodation expenses associated with essential medical or hospital treatment if you are unable to access this treatment where you live.

The total return distance travelled for treatment must be at least 300 kilometres. The overnight (non-hospital) accommodation benefits are payable for the patient and for an attendant.

Please refer to the full policy details to determine what is covered.

2 months

$200 for travel expenses and up to $300 for accommodation expenses per year.

What's covered?

With extras cover, you can claim benefits for those services listed on your cover and that are not claimable elsewhere (eg from a third party like Medicare).

For example, Medicare does not provide benefits for:

  • most dental examinations and treatment
  • most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services
  • acupuncture (unless part of a doctor’s consultation) or other natural therapies
  • glasses and contact lenses
  • most health aids and appliances
  • home nursing.

Extras cover allows you to claim benefits for extras services as long as:

  • the treatment is given by a private practice provider who is recognised and registered with us for benefit purposes
  • they meet the criteria set out in our policies and Fund Rules.

We recommend you contact us before making a booking to confirm how much you can claim and to check that your chosen provider is registered with us.

What's not covered?

Extras benefits will not be payable:

  • during a waiting period
  • where a third party, including Medicare, a Government body, or an insurance company provided a benefit (except for hearing aids and breast prosthesis items)
  • for different services within the same service type from the same provider on the same day. For example, if you went to see an acupuncturist and then received a massage from the same provider on the same day, you cannot claim for both services
  • when a prescribed treatment is not fully custom made (eg orthotics, surgical shoes)
  • when a provider is not recognised by us for benefit purposes
  • for any treatment or service rendered outside Australia
  • when you have reached the maximums on your product including annual, lifetime or service limits for the service you are claiming.

Waiting periods

A waiting period is the time between when you joined us and when you are covered for a service or treatment. If you receive a service or treatment during this time, you are not eligible to receive a benefit payment from us, regardless of when you submit the claim. Different waiting periods apply for different services.

If you’re changing from another Australian health fund to Bupa, you’ll continue to be covered for all benefit entitlements that you had on your old cover, as long as these services are offered on your new cover with us. This is referred to as ‘continuity of cover’. To receive continuity of cover, you’ll need to transfer to us within 60 days of leaving your old fund.

If you are an existing member and you change your health cover, you may need to wait before you can access your new benefits. Where your new level of cover is higher than what you previously held, the lower level of benefit applies.

Waiting periods apply to services as listed below. Please refer to the full policy details to determine the specific services that are covered under your level of cover, including the associated waiting periods for those services.

The following waiting periods apply for extras cover:

  • initial waiting period and health subscription refunds – two months
  • hire, repair and maintenance of health aids and appliances; and Living Well Programs – six months
  • major dental, root fillings, orthodontics, selected health aids and appliances – 12 months
  • laser eye correction surgery – 12 months.

Add Pharmacy Saver

Enjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores. With Pharmacy Saver, you'll receive a 20% discount on a variety of health-related products. View details >

Pharmacy saver

Add Pharmacy Saver to your extras cover and enjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores. You'll get a 20% discount on a variety of health-related products.* Pharmacy Saver is not available for prescriptions on which the Government does not allow discounts. Visit a National Pharmacies store for more information.

* These are products designed to manage or prevent diseases, injuries or a condition, or prescribed in connection with an episode of hospital treatment

Weekly

Member Exclusives

Member exclusives include a range of discounts and deals from specially selected partners to help you enjoy some health and wellness perks at an affordable price. Whether you're interested in fitness and sports or rest, relaxation and travel, you can choose what suits your needs from our range of partner discounts. Full terms and conditions of all offers are available in the Member Exclusives section of myBupa.

 

Payment

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30-DAY COOLING OFF PERIOD

We're confident you'll be happy with your cover, however if you decide to cancel, we'll refund any premiums you have paid within the first 30 days of your membership commencing provided you haven't made a claim. 

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Government Rebate
?

The Government offers all Australian residents who are entitled to Medicare benefits an income-tested rebate on their private health insurance.

The government now income tests the rebate on private health insurance. One way you can save up-front is to claim the rebate as a reduction on your premium, would you like to do that now?

For individuals earning $90000 ($180000 for families*) or under
*This increases by $1,500 per child after the first child