Already a member?

What's a pre-existing condition?

Your illness, condition or medical problem is considered to be pre-existing (and no benefits will be payable for the duration of your waiting period) If a medical practitioner appointed by a health fund (not your own doctor) determines you would have had signs or symptoms of a condition that a reasonable doctor could have detected (if you had seen one) during the six months prior to joining or upgrading your cover, or for some other period specified in your product information documents. It is NOT a condition that has been diagnosed by your doctor.

I need to see a doctor for a pre-existing condition

At Bupa we care about your health. If you see a General Practitioner (GP) doctor after your cover commences but before your waiting period for pre-existing conditions ends, even if the condition is actually pre-existing, Bupa will waive (not enforce) your waiting period for that visit and pay the benefit under your cover.

But keep in mind that if you need medical tests or need to go to hospital for treatment during the first 12 months of your membership (or if you've upgraded to a higher level of cover) you are not automatically covered and to find out if benefits will be paid, we first need to check if this relates to a pre-existing condition and if any other waiting periods will apply. Your treating hospital or specialist/doctor should check with Bupa to ensure that you are aware of whether benefits would be paid and whether there are other conditions of your cover that you should be aware of.

To check if you can receive benefits, the GP, referring doctor and possibly the specialist who is going to perform your procedure will need to complete our medical certificate. Once that has been filled in, please send the completed certificate/s back to us at pec@bupa.com.au or the address below:
Bupa
GPO Box 9809
Brisbane QLD 4001 (no postage stamp required)

Within a waiting period, a doctor (appointed by your health fund) will need to make an assessment as to whether your condition is pre-existing. Our appointed doctor will consider your treating doctor's opinion on the signs and symptoms of your condition, but they don't have to agree with them.

Claim online

Claim online or via the Bupa app for most Medical and Extras* services with our step-by-step tool. It's one of the quickest ways to process your claims. Better yet, you generally receive payment in your bank account within five business days.

• 1. Register at myBupa or log into your existing myBupa account online or via the myBupa app.
• 2. In the menu, select `make a claim'. Enter in your service type, confirm that you meet the submission criteria and click `start'.
• 3. Enter in the provider and claim details as it appears on your receipt and:
  • Upload a copy of your invoice or receipt
  • Confirm your Australian bank account details (not an overseas account)
• 4. Review your claim details
• 5. Confirm your contact information
• 6. Accept the terms and conditions
• 7. Click `submit'

Once you've submitted your claim, in most cases, you'll receive an immediate notification of your claim outcome and any eligible benefit payments will be made to your bank account within 24 hours.+

Tap and claim

If you're an Android mobile user you can access your Bupa digital member card for card-less claiming at participating Bupa recognised healthcare providers and get your benefit paid on-the-spot*.
Your digital card can be found in the most up-to-date myBupa App, available in Australian Google Play Store settings only. ±
Tap and claim with iOS to come.
Learn more here