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Overseas Visitors Cover
myBupa is our member self service portal. It helps you to easily manage your health cover - anywhere and anytime. Through myBupa you can:
Before you seek any treatment it's important for you to understand what you are covered for.
Call us on 134 135 so we can give you the most complete and up-to-date information about your cover.
It is also important for you to check if any waiting periods apply to certain services on your cover. A waiting period is the time when you first join a health fund or change to a higher level of cover during which benefits are not payable for certain medical procedures or services. It starts on the date that you enter Australia or the date that you start your membership, whichever is the later date. If you receive a service or treatment during the waiting period, you may not be eligible to receive a benefit payment from us, regardless of when you submit your claim. This could leave you with significant out-of-pocket costs to pay. So it's always best to contact Bupa and check first.
If you see a doctor, need medical tests or require hospitalisation during the first 12 months of your membership or when you've upgraded to a higher level of cover, we first need to check if this relates to a pre-existing condition and if the pre-existing waiting period applies to you. It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed.
If you knew you weren’t well, or had signs of a condition that a doctor would have detected (if you had seen one) during the six months prior to joining or upgrading, then the condition would be classed as pre-existing.
To determine if you're entitled to receive benefits you and your referring doctor or the specialist who is going to perform your procedure will need to complete our medical certificate. For GP visits only, the 12 month waiting period for pre-existing conditions does not apply.
Once you have filled this in, please send the completed certificate back to us at:
Bupa
GPO Box 9809
Brisbane QLD 4001 (no postage stamp required)
A doctor appointed by us decides whether your condition is pre-existing, not you or your doctor. The appointed doctor must consider your treating doctor’s opinion on the signs and symptoms of your condition, but is not bound to agree with them.
It takes around 5 working days from when we receive this completed medical certificate to assess if the health service or hospital admission relates to a pre-existing condition, and if you are entitled to a benefit for the service or procedure.
Once you have spoken to us and you understand what you are covered for and if any waiting periods apply to you, you can use the Members First provider map below to find a doctor or specialist. Be sure to ask if they use Bupa's Medical Gap Scheme. This way, in most cases, you can ensure that you can reduce or even eliminate any out-of-pocket costs to you.
If you use one of Bupa's Members First or Network Hospitals you might not even see a bill! The bill will be sent directly to us by the hospital so we can take care of it for you.
However, if you don't use a Bupa Members First or Network Hospital and you do receive a bill from the hospital, please send it to us with a claim form from your local Bupa centre or download one from mybupa.com.au
Bupa
GPO Box 9809
Brisbane QLD 4001
How you claim your medical expenses that are incurred while you are a patient in hospital (for example, your specialist/doctors' fee) depends on whether your doctor uses Bupa's Medical Gap Cover Scheme. If they do, they'll bill us directly. We'll take care of the fees.
If your doctor doesn't use Bupa's Medical Gap Cover Scheme, they may send you a bill for their services. You can then take it to Bupa for payment. Please send it to us with a claim form from your local Bupa centre or download one from mybupa.com.au
Bupa
GPO Box 9809
Brisbane QLD 4001
For any medical insurance claims where there is an unpaid amount for any medical services, the cheque will be sent to you but will be made out to the provider/doctor who provided your medical services. You will be required to forward this onto the medical provider to settle the account for the medical services you received.
Your Statement of Benefit will be sent to you at the same time as the cheque.
If you have any out-of-pocket costs, your doctor should have informed you of these costs before your admission. In most cases with Bupa's Medical Gap Cover Scheme there is no gap. Just check with your doctor.
Once you've had your treatment or made a purchase (for example, a new pair of glasses), the next step is to make a claim on your health insurance. It's actually pretty simple.
Your options are:
Electronic claiming is the fastest way to make your medical insurance claims. After your treatment, swipe your membership card and the claim will be processed automatically. There are no forms for you to complete and you'll only pay the balance of the account.
Simply log into myBupa and enter the details found on your receipt via the ‘claim online' section. We'll transfer the payment directly to your bank account (have your BSB and account number ready).*
*Not available for medical insurance claims on ambulance, health aids and appliances, orthodontics, travel and accommodation, pharmacy or medical claims.
Fill out a claim form (attached below), attach your invoice and receipt and post to: Bupa
GPO Box 9809
Brisbane QLD 4001 We'll make the payment by Electronic Funds Transfer (EFT) or cheque.
If you haven't provided your EFT details on the claim form, then a cheque will be sent directly to you.
Where there is an unpaid amount the cheque will be made out to you but you may still need to settle any outstanding amount with your provider. Your statement of benefit will be sent to you in the mail.
