As you move through life's changes, Bupa will make sure your health cover is in good hands. We've been insuring Australians for 75 years, so we believe no one knows Aussies quite like we do. Explore all the ways Bupa can be the right health insurer for you.

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Hospital insurance helps cover the cost of treatments you receive when you're admitted to hospital. It doesn't cover treatments you receive when you haven't been admitted to hospital – for example, x-rays and blood tests.

Hospital insurance helps cover the cost of 'inpatient' services. These are treatments you receive when you're formally admitted to hospital for care – for example, for surgery. The specific hospital procedures and services you're covered for depends on the level of hospital cover you choose.

You can check your out-of-pocket cost with our Out of pocket tool.

Hospital insurance doesn't cover 'outpatient' services. These are treatments you receive when you haven't been formally admitted to hospital – for example, tests and examinations like x-rays and blood tests. We also don't cover emergency department fees. In most cases, Medicare will help cover these services.

Depending on your level of cover, you may also have exclusions and/or restrictions. If a service is excluded, it's not covered at all. Restricted services receive the minimum default benefit, which generally means a large out-of-pocket expense that you'll have to pay.
Extras insurance allows you to claim benefits on extras services, which are medical services that aren't hospital related – for example, dental or physio. What you get back depends on your level of cover and where you go for treatment. Sometimes we don't pay benefits though, like during a waiting period.

Once you've served any applicable waiting periods, you can claim benefits for the services included in your cover and that aren't claimable elsewhere (for example, from a third party like Medicare).

Extras cover allows you to claim benefits for extras services as long as the treatment is given by a private practice provider who is recognised and registered with us for benefit purposes. The treatment must also meet the criteria set out in our policies and fund rules.

Use Find a provider to check whether your current provider has an agreement with Bupa, to find a Members First provider or Optical Partner. Please note, this does not include a full list of providers. If you can't find your provider listed, call us to check if they’re a recognised provider with us.

There are some situations where your health fund can't pay a benefit but a third party like Medicare or compensation will pay a benefit. For example, a visit to a doctor outside of hospital, like a General Practitioner (GP), will never be covered by health insurance no matter what fund you’re with, but it's covered by Medicare for domestic customers.

Benefits also won’t be payable:

  • during a waiting period.
  • if using the same provider on the same day for a different service (for example, seeing an acupuncturist and a massage therapist from the same provider on the same day).
  • when a provider is not recognised by us for benefit purposes.
  • for any treatment or service given outside of Australia.
  • when you have reached the maximums on your product (including annual, lifetime or service limits) for the service you’re claiming.

      • If you're unsure, contact us and we'll be happy to answer any questions you might have.

You can start claiming as soon as you've served your waiting periods.

Different treatments and services have different waiting periods.

  • We apply the following waiting periods to domestic hospital cover:
  • No waiting period for medical treatment needed due to an accident sustained after joining.
  • 12 months for pre-existing conditions, ailments, or illnesses.
  • 12 months for pregnancy and birth.
  • Two months for travel and accommodation.
  • Two months for hospital psychiatric services, palliative care and rehabilitation.
  • Two months for all other treatment included under the hospital product held.

We apply the following waiting periods for extras cover:

  • Six months for health management.
  • Six months for hire and repair of health aids and appliances.
  • 12 months for health aids and appliances.
  • 12 months for major dental and orthodontics.
  • 12 months for foot orthotics.
  • Two months for all other services included under the extras product held

You can check your hospital out-of-pocket cost with our Out of pocket tool.

You can also use Find a provider to check if your chosen extras provider is a Members First or Members First Platinum member with us. If not, call us to check if they're a recognised provider with us.

¤ Depending on your level of cover, for most services at our Members First extras providers covering dental, physiotherapy, chiropractic and podiatry consultations. Bupa has Members First providers for these services. Not available in all areas. Yearly limits, benefit claiming restrictions, waiting periods, fund and policy rules apply.

¢ Choose either four or six extras services. The 50% or 60% claim back is available at any Bupa recognised provider and is subject to yearly limits.