The Bupa Members First Network is designed to give our health insurance customers access to affordable healthcare by contracting with healthcare providers and ensuring certainty of out-of-pocket expenses. All Bupa health insurance customers can find a registered Members First provider through our Find a provider page as well as through the myBupa app. To learn more about the benefits of the network for your patients visit Bupa Members First Extras Network.
Network benefits for providers
Our Members First network includes thousands of dental practitioners, physiotherapists, chiropractors, and podiatrists across Australia. Providers are at the heart of the network, and Bupa wants to ensure participating providers receive the support needed to promote their practice.
For providers who are part of the network, Bupa may carry out certain activities, including promoting the network to our health insurance customers and listing Members First providers on our Find a provider tool.
Are you an existing Members First provider?
View our forms and downloads for existing Members First providers.
For queries relating to your agreement, please call our Provider Operations Team on 1800 060 239 or email ProvopsNetwork@bupa.com.au
Interested in joining the Bupa Members First Network?
To make an enquiry about joining the network, please submit our expression of interest form.
The Bupa Members First Network gives recognised providers the opportunity to offer their patients (our customers) the certainty of known out-of-pocket expenses for specified services. Recognised providers enter into an agreement with Bupa where they charge Bupa health insurance customers in line with the agreed fee schedule. In most instances, Bupa health insurance customers will receive higher benefits for the specified services listed in the agreed fee schedule (when these services are included in the customer’s policy and eligible extras cover). This gives customers the certainty of knowing how much they’ll get back1.
In addition, fees and claims can be submitted electronically using electronic claiming terminals such as HealthPoint or HICAPS. Bupa health insurance customers simply present their Bupa membership card, and any ‘gap’ (if applicable) can be paid on the spot to the provider. Bupa customers can also make claims via myBupa.
1 For most items at Members First extras providers covering dental, physio, chiro, and podiatry consultations. Yearly limits, waiting periods, benefit claiming restrictions, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers.
If you are a Bupa recognised provider, you may also be eligible to participate in our Bupa Members First Network. Recognised providers are healthcare providers who are in private practice and provide professional services to our health insurance customers in accordance with our Fund Rules. Each provider must also comply with Bupa’s Ancillary Provider Terms and meet the specific criteria for their profession.
To apply to be part of the Bupa Members First Network, you must also be one of the following providers:
- Chiropractor
- Dental Hygienist
- Dental Therapist
- General Dentist
- Oral Health Therapist
- Physiotherapist
- Podiatrist
Provider recognition and acceptance into the Members First network are at Bupa’s absolute discretion.
Yes, as this allows Bupa to ensure certainty of out-of-pocket expenses for Bupa health insurance customers . For example, if a clinic is registered as a Members First Physiotherapy participating clinic, all physiotherapists in the clinic must apply to participate in the Members First Physiotherapy network.
Acceptance onto the network for the clinic and each of the providers within the clinic is at Bupa’s absolute discretion.
Yes, an agreement with a participating provider will only apply to the clinic and clinic location identified in the application. If you work in more than one clinic, you will need to apply for Members First participation at each clinic that you want the Bupa Members First arrangements to apply. Acceptance onto the network at each location is at Bupa’s absolute discretion.
Yes, all Bupa health insurance customers should receive the specified services at the agreed fees. Bupa Members First benefits will be available to all customers with eligible extras cover.1 Bupa membership cards should be used through electronic claiming at all times.
1 For most items at Members First extras providers covering dental, physio, chiro, and podiatry consultations. Yearly limits, waiting periods, benefit claiming restrictions, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers.
Yes, to consistently provide Bupa health insurance customers with certainty on out‑of‑pocket expenses, you agree to charge below or at the agreed fees for services specified in the schedule.
Fees charged in accordance with the maximum chargeable amount must be accepted as the full fee for the service.
No, the agreement has no fixed term. Your participation in these arrangements can be terminated by you or Bupa with 60 days written notice.
No, Bupa health insurance customers are free to go to a recognised provider of their choice. However, the Members First benefits for the specified services are only available to our customers when they attend a Bupa recognised provider participating in these arrangements.1
1 For most items at Members First extras providers covering dental, physio, chiro, and podiatry consultations. Yearly limits, waiting periods, benefit claiming restrictions, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers.