To become a Bupa recognised provider, gymnasium applicants must meet and continue to satisfy all aspects of the recognition criteria, as follows:

1. Provide the Recognised Gymnasium Services (recognised services).
2. Obtain and maintain a current full membership with a professional association.
3. Have a registered Australian Business Name (ABN).
4. Adhere to the National Fitness Industry Code of Practice.
5. Ensure the recognised services are provided to Bupa health insurance customers by staff (employees, contractors, or other business representatives) who:
1. are registered with a professional association as exercise professionals;
2. hold relevant industry standard qualifications;
3. are qualified to provide the recognised services.
6. Have membership-based services.
7. Comply with the relevant professional association and industry standards, including the National Fitness Industry Code of Practice.
8. Ensure there are adequate monitoring, procedures, and systems in place to ensure the safety and wellbeing of the Gymnasium's members and ensure a timely response in an emergency.
9. Hold and maintain current professional indemnity insurance and public liability insurances for a minimum $5million per claim and $20million aggregate.
10. Comply with Bupa's Provider terms for Gyms and Personal Trainers (PDF)

Please review the details below for more information on recognition and how to apply to register as a Bupa recognised provider.

1. Bupa pays benefits towards gym fees for Recognised Gymnasium Services (recognised services) that the support the treatment, palliation or amelioration of a diagnosed health condition or conditions (under the Health Management category on selected Extras products). Benefits can only be paid for recognised services that are provided at Bupa recognised providers for eligible Bupa health insurance customers (Bupa customers).
2. The recognised services must be required by the Bupa customer to support the treatment, palliation or amelioration of a diagnosed health condition or conditions.
3. Bupa customers must provide a signed authorisation (using the Health Management Gym and PT Medical Form) from their doctor or approved allied health provider (e.g. Exercise Physiologist, Physiotherapist or Chiropractor), confirming their need to undertake exercise.
4. Benefits are payable in accordance with Bupa's eligibility criteria, fund, and policy rules. Additional information is available for Bupa customers if they call Bupa's contact centre on 134 135.
5. Benefits do not apply for trial periods, joining fees, casual attendances or bundled passes at a Gymnasium.
6. Yearly limits, waiting periods, benefit claiming restrictions, fund and policy rules apply.

1. The Gymnasium must provide the Recognised Gymnasium Services (recognised services), namely exercise practices including pre-exercise evaluation, exercise consultations, use of exercise equipment, and exercise services that are designed to address and assist with the management of the Bupa health insurance customer’s desired health outcome (to support the treatment, palliation or amelioration of a diagnosed health condition or conditions). The exercise interventions utilised must be evidence-based and may be delivered in an individualised session (personal training), completion of an exercise program (open gym floor), in a group setting (group personal training) or within a class session.

   Recognised services must be provided at an appropriate premises in accordance with the Provider Terms for Gymnasiums and Personal Trainers (as applicable).

   Recognised services for Gymnasiums exclude:

   1. services provided by other allied health providers, as these services may be claimable under an allied health modality in a Bupa health insurance customer’s Extras policy¹;
   2. services provided out of studios, facilities and businesses whose primary purpose is to provide services that do not attract a Benefit under the Private Health Insurance Act 2007 (such as Pilates or Yoga studios);
   3. services provided by businesses that in Bupa’s reasonable opinion do not directly help to address or improve a diagnosed health condition. Examples include (but are not limited to), Martial Arts Dojos, Self Defence training facilities and Pole Dancing Studios.

   ¹ Yearly limits, waiting periods, benefit claiming restrictions, fund and policy rules apply.

The Gymnasium must be in "private practice" as defined in the Bupa Fund Rules, namely, a business operating on an independent and self-supporting basis either as a sole trader, partnership, corporate or group practice but is not subsidised by another party such as any type of publicly funded facility for the provision of accommodation, facilities or other services or practitioners. The provision of treatment at a public hospital or any other type of publicly funded facility is not treatment provided in private practice.

Gymnasiums must have current membership with a Bupa recognised professional association listed below.

To apply for recognition, please contact your professional association. The following associations meet the requirements set out in Bupa's Accreditation Requirements for Professional Associations.

Industry associations who meet Bupa's Accreditation Requirements for Professional Associations and wish to express interest in being listed above may contact Bupa at provopsancillary@bupa.com.au.

1. Bupa may use its absolute discretion in granting Bupa recognised provider registration. Meeting the criteria above does not guarantee that a Gymnasium is registered as a Bupa recognised provider.
2. Bupa reserves the right to audit Bupa recognised providers to ensure ongoing compliance with the recognition criteria, and on request (giving at least 10 business days' notice) requires reasonable access to the facility or membership/financial records to validate compliance with the recognition criteria and/or to validate claims. Bupa audit requests may be made by letter, email or telephone and audits may be undertaken by Bupa or a Bupa authorised representative.
3. Gymnasiums that, in Bupa's reasonable opinion, do not comply with the recognition criteria (including the Provider Terms for Gyms and Personal Trainers) or who have not provided Bupa access to audit or have not provided requested audit records within 10 business days of the receipt of an audit request may have their registration as a Bupa recognised provider immediately suspended or terminated.
4. Bupa may suspend or terminate a Bupa recognised provider registration in its absolute discretion. Notification of suspension or termination will be provided in most instances to the Bupa recognised professional association, however, Bupa may use its discretion to write to Bupa recognised providers directly. Bupa may also suspend or terminate registration as a Bupa recognised provider where there have been no customer claims processed by Bupa for a period of 2 or more years.
5. Bupa health insurance customers are unable to claim for Benefits while a provider is suspended or terminated, and Bupa may at Bupa's discretion write to Bupa health insurance customers who have claimed for the Gymnasium's services following suspension or termination.
6. If the Gymnasium seeks to be re-registered with Bupa following a suspension or termination, it must contact the relevant professional association.
7. The Gymnasium may choose to cease participating as a Bupa recognised provider at any time by providing 60 days' notice to the relevant professional association.

Bupa will publish any changes to its recognition criteria on its website and will also notify professional associations of any changes to the recognition criteria.