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Top FAQs for switching health funds

Is it easy to switch to Bupa?

It certainly is. Here at Bupa, we believe in making it as easy as possible for our people to switch. Once you decide to have Bupa as your healthcare partner, we can arrange the transfer for you.

With your consent, we can cancel your current policy and request that your current health insurer issues a copy of your clearance certificate (which also outlines any waiting periods that you have already served) to both yourself for your own records and Bupa.

By phone or in a Bupa centre

If you switch to Bupa over the phone or in a retail centre you can give us verbal consent to contact your current health insurer.

Online

If you apply online, you will be sent a clearance certificate request form to sign and send back to us using the prepaid envelope. We'll do the rest.

What does the switching process involve?

Bupa can arrange the transfer for you.

  1. Tell us the name of your current health insurer and your membership number
  2. With your consent, Bupa will contact your current health insurer and arrange for cancellation
  3. Your current health insurer should then send you, and Bupa, a copy of your clearance certificate which outlines all the details of your membership with them.

Do I need to re-serve the waiting periods I've served with my current fund?

If you switch to Bupa on an equivalent level of cover or lower, you will have continuity of cover for all services common to both policies. What that means for you is, that all waiting periods already served, do not need to be re-served.

For Hospital cover.

  • Waiting periods already served will be recognised
  • Bupa will recognise the closest equivalent cover levels
  • Partially served waiting periods will be recognised, but only the partially completed portion
  • If you choose a lower level of cover than you previously held, the lower benefits on your new cover will apply immediately and may include different excess levels or minimum benefits. You may also need to serve waiting periods for services or treatments that weren't covered on your previous cover.

Example: If your current policy covers you in a public hospital as a private patient for pregnancy and you choose to transfer across to Bupa on a policy that covers pregnancy in a private hospital, this is considered an upgrade. While you will still be covered in a public hospital as a private patient with Bupa there will be a 12-month waiting period for the higher private hospital pregnancy cover.

For Extras cover.

  • Waiting periods already served will be recognised
  • We will recognise your cover at the closest equivalent level – if you select cover with higher annual maximums than your existing cover a waiting period may apply to the increased portion
  • Your extras claims during the calendar year at your previous health insurer will be counted towards your annual maximums the calendar year that you switch.

Lifetime-based maximums (eg: orthodontics claims) will transfer with you. For example, say you claimed $850 on orthodontics with your current health insurer and your lifetime maximum is set at $1,300, if you switch to Bupa then the $850 spent on orthodontics will be recognised and you will have $450 of your lifetime maximum remaining. You may however, need to serve waiting periods for services that weren't covered on your previous cover.

Where your new cover is higher than what you had with your old fund, the lower benefit (including different excess levels) will apply for the waiting period relevant for that service.

What happens to the waiting periods that I have already served?

When switching health insurers, a clearance certificate should be provided from your previous insurer. A clearance certificate is a summary of your time with that health insurer. Amongst other things, it lists what waiting periods have been served and if any waiting periods still apply.

If you switch to Bupa on an equivalent level of cover or lower, you will have continuity of cover for all services common to both policies. What that means for you is, that all waiting periods already served, do not need to be re-served. Please note that any continuity of benefits will apply only once we receive the clearance certificate and the details have been recorded against your membership.

For Hospital cover.

  • Waiting periods already served will be recognised
  • Bupa will recognise the closest equivalent cover levels
  • Partially served waiting periods will be recognised, but only the partially completed portion
  • If you choose a lower level of cover than you previously held, the lower benefits on your new cover will apply immediately and may include different excess levels or minimum benefits. You may also need to serve waiting periods for services or treatments that weren't covered on your previous cover.

Example: If your current policy covers you in a public hospital as a private patient for pregnancy and you choose to transfer across to Bupa on a policy that covers pregnancy in a private hospital, this is considered an upgrade. While you will still be covered in a public hospital as a private patient with Bupa there will be a 12-month waiting period for the higher private hospital pregnancy cover.

For Extras cover.

  • Waiting periods already served will be recognised
  • We will recognise your cover at the closest equivalent level – if you select cover with higher annual maximums than your existing cover a waiting period may apply to the increased portion
  • Your extras claims during the calendar year at your previous health insurer will be counted towards your annual maximums the calendar year that you switch.

Lifetime-based maximums (eg: orthodontics claims) will transfer with you. For example, say you claimed $850 on orthodontics with your current health insurer and your lifetime maximum is set at $1,300, if you switch to Bupa then the $850 spent on orthodontics will be recognised and you will have $450 of your lifetime maximum remaining. You may however, need to serve waiting periods for services that weren't covered on your previous cover.

Where your new cover is higher than what you had with your old fund, the lower benefit (including different excess levels) will apply for the waiting period relevant for that service.

How will Bupa know what level of cover I’ve been on?

When switching health insurers, a clearance certificate should be provided from your previous insurer. A clearance certificate is a summary of your time with that health insurer. It lists details such as:

  • Start date of policy
  • People covered on the policy
  • Absent days
  • Waiting periods that have been served
  • Any restrictions that may have applied
  • If any waiting periods still apply

How will Bupa know what waiting periods I have already served?

When switching health insurers, a clearance certificate should be provided from your previous insurer. A clearance certificate is a summary of your time with that health insurer. Among other things, it lists what waiting periods that have been served and if any waiting periods still apply.

What happens if I change my mind and want to cancel?

You have a 30-day cooling off period which means if you cancel your policy within 30 days of commencement, and provided you have not made any claims, any premiums paid will be refunded.

Where can I claim? Can I claim at retail centres?

At Bupa you can claim on the spot at over 40,000 providers nationally who use electronic claiming. Simply swipe your membership card at the time of treatment and we'll automatically process your claim and any benefit will be paid immediately. Then you just pay the balance (if any). It's on-the-spot claiming made easy.

Ways to claim include:

  1. Retail centre
  2. On the spot claiming
  3. Online (for most items at myBupa)
  4. Via phone
  5. Mail

When should I cancel my policy with my previous health insurer?

Bupa can arrange the cancellation of your current policy with your consent – see Is it easy to switch to Bupa? The cancellation of your current policy with your previous health insurer will be effective as of your nominated start date with Bupa.

Do I need to contact my current fund?

Bupa can arrange the transfer for you.

  1. Tell us the name of your current health insurer and your membership number
  2. With your consent, Bupa will contact your current health insurer and arrange for cancellation
  3. Your current health insurer should then send you, and Bupa, a copy of your clearance certificate which outlines all the details of your membership with them.

What do I have to do with my previous fund?

Once you have supplied us with your member number at your previous health insurer and your consent to handle the switch; not a thing. Bupa can arrange the entire transfer for you.

We can cancel your current policy and request that your previous health insurer issues a copy of your clearance certificate to both yourself and Bupa.

You may want to cancel your direct debit with your previous health insurer – read more at 'Will I get a reimbursement as I'm paid past today with my other health insurer?'

Does Bupa insure everyone?

We insure all sorts of people from many walks of life including Australian citizens and overseas visitors who may be studying, working or holidaying.

If you have any other queries about how Bupa can cover you at your life stage,
please call us on 134 135.

When does my policy with Bupa commence? Can I choose a start date?

Your policy with Bupa can be set up immediately or from a future date of your choice.

Will I get a reimbursement as I'm paid past today with my health insurer?

You should. Your previous health insurer should refund you any monies you've paid in advance so you won't find yourself out of pocket paying for two overlapping policies.

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