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Some people choose to take out hospital cover alone, others consider only extras, while many take out combined hospital with extras policies.
Are there waiting periods?
If you’re getting health insurance for the first time, or you’re changing to a higher level of cover, then you will likely serve a waiting period before you can claim.
You do not need to serve extra waiting periods if you’re switching to a policy that has the same or lower level of cover.
What will my out-of-pocket costs be?
An out-of-pocket cost is the amount that is not covered by Medicare or your private health fund. The cost will depend on several factors, such as:
- how much the doctor or hospital fees are
- where you have treatment (such as in or outside hospital)
- whether the treatment is covered by Medicare
- what services are included, excluded, and restricted, on your level of cover
- any excess that applies
Talk to your doctor, hospital, and health fund before you have your treatment so you know what your out-of-pocket costs may be.
Claiming on extras services
You can get cover for non-hospital treatments, like dental, optical, physio, and natural therapies like remedial massage and acupuncture.
Think about what services you would use, such as general dental check-ups, or more costly services like orthodontic treatment, to determine what level of extras cover might suit you. The amount you can claim back on extras services will depend on your level of cover.
^ Yearly service limits apply.
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Learn more about switching to Bupa
There are other comparison sites but they may not have every fund or type of policy on there for you to compare.
The Australian Government introduced a tier system for private health insurance funds to help make it easier for people to pick an appropriate level of hospital cover. Now that all hospital cover tiers include a minimum and standardised coverage of clinical categories, consumers can make comparisons between different funds.
Although the tiers guarantee a minimum level of cover, some insurers like Bupa, provide more than the government requirement. These plans are labelled with plus, e.g. Bronze Plus Simple Hospital. Read more about health insurance tiers.
You do not need to re-serve waiting periods you have already served if:
- you've switched to Bupa on an equivalent or lower level of cover and;
- it's within 60 days of your previous fund’s end cover date.
Any new services or higher benefits on your new level of cover will have a waiting period of up to 12 months. During this waiting period, we'll pay benefits that are equivalent to your previous level of cover.
1 For services provided through Medical Gap Schemes, Bupa covered 90.1% of hospital related charges vs 90% covered covered by Medibank Group from 2022 to 2023. All statistics shown are as outlined in the Private Health Insurance Ombudsman State of the Health Funds Report 2023 which summarises the average coverage of each insurer's policies across Australia.
2 Bupa returned 80.9% of contributions it received back to members as benefits, vs 79% of contributions returned to NIB members as benefits from 2022 to 2023. All statistics shown are as outlined in the Private Health Insurance Ombudsman State of the Health Funds Report 2023, which summarises the average coverage of each insurer's policies across Australia.
3 Bupa's market share was 24.9%, and HCF's was 12.5% as at 30 June 2023. All statistics shown are as outlined in the Private Health Insurance Ombudsman State of the Health Funds Report 2023, which summarises the average coverage of each insurer's policies across Australia.
~ When switching to Bupa on an equivalent or lower level of cover within 60 days of cover end date with old health fund, provided you already served your waiting period and pending receipt of their clearance certificate. We will apply continuity once we receive it.