Bupa’s OSHC provides cover for hospital and medical treatment.
Hospital expenses covered
In most cases, we’ll pay for the following services when you’re in hospital, including:
Accommodation for overnight or same-day hospital stays
Operating theatre, intensive care and labour ward fees
Medication provided during your in-hospital treatment under the Pharmaceutical Benefits Scheme (PBS)
Physiotherapy, occupational therapy and dietetics and other allied health services provided in hospital
Surgically implanted prostheses up to the approved minimum benefits in the Government Prostheses List that is used as part of your surgery
Private room where available
Medical expenses covered
Each doctor or specialist that treats you will charge a fee for the service they provide. This also includes most tests you may be sent to have by your doctor including pathology and radiology services.
There is a set fee for each service, called the Medicare Benefits Schedule (MBS) fee. If your doctor charges you 100% of the MBS fee then you will be fully covered for treatment in hospital and out of hospital. If your doctor charges more than 100% of the MBS fee, you'll pay the amount above the MBS fee.^
If you're prescribed pharmacy items by a doctor, specialist or when you have visited hospital and not been admitted, you can claim back $50 per approved prescription item, up to $300 (single) or $600 (couple/family) per year.
You’ll have to pay the Pharmaceutical Benefits Schedule co-payment fee. Australian residents pay the same fee.
Emergency Ambulance Services
You can claim for emergency ambulance transportation and on-the-spot treatment by our recognised providers anywhere in Australia.
Procedures not approved by the Medical Services Advisory Committee
Procedures not recognised by Medicare
Cosmetic surgery (that is not clinically necessary and where benefits are not payable by Medicare)
Assisted reproductive services
Extras services such as a dental check-up, physio, podiatry consultations and chiro. Add OSHC Extras to include these services
Waiting periods apply
You need to be a member for a certain amount of time before claiming money back on services. This is called a waiting period.
If you have your condition before joining Bupa, this is known as a pre-existing condition and we may not be able to cover you. Or you may need to wait until you have completed your waiting period.
2 months* = Pre-existing conditions, ailments or illnesses of a psychiatric nature
12 months = Pregnancy and birth
12 months = All other pre-existing conditions, ailments or illnesses for hospital and outpatient medical services
Waiting periods don’t apply when:
Treatment is required as a result of an accident after joining Bupa
Your compliant OSHC cover does not cover Extras services
To get cover for extra services like dental, physio and chiro, add Bupa OSHC Extras.
How to order a Bupa OSHC membership card
Once you know your Australian address, you can update your address in myBupa
You’ll also need to order your OSHC membership card in three easy steps:
- Login to myBupa
- Go to ‘Cover’ in the menu of the Home Page
- Select ‘Order a membership card’
Please remember that this is just a snapshot of your cover. For full details on what we will and won’t help you pay for under your Bupa OSHC membership, please read your full cover description located in the box below.
* the standard 2 months waiting period for pre-existing conditions of a psychiatric nature is not enforced by Bupa until further notice.
Yearly limits, waiting periods, fund and policy rules apply.