Accident and injury form

To help your claims process, please provide detailed information about the accident or injury using this form. You can then submit an accident benefit claim online using myBupa.

Accident and injury form

Ambulance claims

Ambulance claims can be submitted online using myBupa.

Application to join Bupa

If you'd like to join Bupa, you can join online.

Authority form

This form may be used by Bupa members to grant another person ('The authorised person') authority to access their policy. Authorised persons must be 18+ years of age.

Download: Authority form

Claiming

You can claim online using myBupa. You will need the original account(s) you received from your healthcare provider and the original receipt(s) if you paid your provider.

Claim queries

• Please remember that claims can only be paid within 2 years of the date on which the service was rendered. If you have a question about:
• The status of your claim
• How to fill in a claim form

What documents you need to attach to your claim form

Please contact us using myBupa.

Clearance certificate form

When transferring to Bupa from another Australian registered health fund, a clearance certificate may entitle you to continuity of services common to both funds.

Download: Clearance certificate form

Direct debit

Pay by direct debit from a credit card, cheque or savings account and keep your health insurance payments up-to-date automatically. Simply set up online payments using myBupa for your convenience.

Government rebate form

Complete and return this form or visit the ‘Cover’ section in myBupa to receive the Australian Government Rebate on private health insurance. All the people listed on the policy must be eligible for a current Medicare card.

If you wish to stop receiving the Australian Government Rebate on private health insurance as a reduced premium, please notify us or update your rebate registration details in myBupa.

Download: Government rebate application form

Handling your personal information form

When it comes to your health claims, it's important you're comfortable with how we handle your personal details. The following form must be read and completed by everyone on your membership aged 18+.

Download: Handling your personal information form (PDF, 362KB)

Medical certificate form

Require a hospital admission and have held your current level of hospital cover for less than 12 months? You’ll need two medical certificates to be completed by your doctor and treating specialist, as you may be subject to waiting periods for pre-existing conditions. Complete the Medical Certificate form and submit it along with your claim using myBupa.

Download: A medical certificate form

Membership suspension form

Are you about to go on an overseas holiday? Or have you just returned home? Fill out this form to ensure you're covered when you need to be.

Download: Membership suspension form

Overseas visitors cover membership suspension form

Are you about to go on an overseas holiday? Or have you just returned home? Fill out this form to ensure you're covered when you need to be.

Download: Overseas visitor's cover membership suspension form (PDF, 230KB)

Register a foster or adopted child as a dependant application form

If you want to add a foster or adopted child to your membership, complete this application form to register them as a dependant.

Download: Application form to register a foster or adopted child as a dependant

Student dependant registration form

If you have a dependant between the age of 21 and 25, unmarried and in full-time study, it’s possible for them to remain covered until their 25th birthday. In order to register a dependant, the following form must be completed.

Download: Student dependant registration form

Travel and accommodation expenses

If you have incurred any travel and accommodation expenses that can be claimed under your cover submit your claim using myBupa.

Unemployment benefit cover form / Retrenchment Redundancy notification form

Unemployment benefit covers the payment of health insurance premiums in the event that the main income earner becomes involuntarily unemployed as a result of retrenchment or redundancy from full-time employment. Unemployment cover benefits are available on certain levels of Hospital cover. In order to apply to receive unemployment benefits, please complete and sign a Retrenchment/ Redundancy notification form. A member can still claim unemployment benefits if they undertake part-time or casual work during this period, as this isn’t considered to be full-time. Conditions apply.

Download: Unemployment benefit cover form / Retrenchment / Redundancy notification form