Standard Visitors Cover With Platinum Extras
Inclusive of GST
Features at a glanceHospital Cover
BASIC
Extras Cover
TOP
90% back on extras*
About this coverBack to previous pageImportant changes to this health cover
How we define and cover different treatment types under this cover will change in 2018. It is important that you are aware of these changes. To find out more, read the change overview. This option has some exclusions but includes cover in private hospital for hospital and medical expenses and visits to a doctor or specialist in private practice. Platinum Extras is our premium extras cover. You're covered for a comprehensive range of services and you'll receive a high level of benefits compared with other levels of cover. Plus, we'll recognise you for your loyalty with us each year, by adding a Benefit Bonus to the amount you get back each time you claim. So after your first year on a selected extras cover with us, your benefit bonus will increase by 2% each year up to a maximum of 10% (annual maximums apply). Hospital
Important product changes in 2018Why are we making these changes?We have listened to our customers and we know that Health Insurance is confusing. Our changes are intended to make health insurance easier to understand, and to improve the value and affordability of cover. What are the changes
What is covered?Hospital costsWith private hospital cover, you can choose to be treated as a private patient in either a public or a private hospital. What if I am treated in a Members First or Network Hospital?Depending on your level of cover you are covered as a private patient in most hospitals that Bupa has an agreement with known as Members First and Network hospitals across Australia for any trelaatment which is recognised by Medicare and is not either a minimum benefit or excluded service under your cover. A small number of these hospitals may charge a fixed daily fee, capped at a maximum number of days per stay. The hospital should inform you of this fee when you make a booking. This fee is in addition to any excess you may have as part of your hospital cover. When admitted to hospital, in most cases you will be covered for in-hospital charges when provided as part of your in-hospital treatment including:
^Conditions apply. Contact us for more information. Members First day facilitiesIf you are treated in a Members First day facility, there are no out-of-pocket expenses for medical services (eg your specialist’s fees). (Any co-payment or excess related to your level of cover will still apply). We recommend you call us first before making a booking to confirm that your hospital of choice gives you certainty of full cover. We can also discuss any excess that may be applicable to your level of cover. You can find out if a hospital has an agreement with us by checking bupa.com.au/find-a-provider. What happens if I choose to be a private patient in a public hospital or go to a private hospital that doesn't have an agreement with Bupa?With us, if you elect to be treated as a private patient in a public hospital or are admitted to a non-agreement private hospital, you are covered as set out below for any treatment recognised by Medicare unless it is excluded or restricted under your cover. If you choose to be treated as a private patient in a public hospital you are entitled to choose your doctor, if they are available. Depending on your illness or condition, this may be the same doctor who would have been allocated to you by the hospital as a public patient. In a non-agreement private hospital, you are responsible for the cost of your stay and may be charged directly for your hospital accommodation, doctor's services (including diagnostic tests), surgically implanted prostheses (eg artificial hips) and personal expenses such as TV hire and telephone calls. Some of these hospitals bill Bupa directly for the benefits we pay for your hospital stay under your policy. The amount we will pay towards your accommodation in a non-agreement private hospital is limited to a minimum shared room benefit. For a non-agreement private hospital this will only partially cover the full cost and you will have significant out-of-pocket expenses. If you request a single room in a non-agreement private hospital, and you receive one, you will incur out-of-pocket expenses as the hospital may charge you more for the room than the benefit that Bupa pays. It is important to note that in public hospitals, single rooms are generally allocated to people who medically need them the most. If required we will also cover any prostheses that are surgically implanted in you during your hospital stay up to the minimum benefit listed on the Government's Prostheses List. We will cover you for your in-hospital medical costs incurred during an admission in public or non-agreement hospital in the same way as set out under the heading "Inpatient Medical Costs" below. The hospital and the treating doctor should let you know what you'll be billed for and how much you will be charged, ie they should obtain your Informed Financial Consent before you receive the treatment – if they don't, make sure to ask for full details. Call us to confirm what benefits we'll pay for your public hospital or non-agreement private hospital stay. Inpatient medical costsThese are the fees charged by your doctor, surgeon, anaesthetist or other specialist for any treatment given to you when you are admitted to a hospital as an inpatient. Put simply, we pay 100% of a schedule fee or 100% of the cost of inpatient medical fees. Depending on your level of cover, we cover you for either the Australian Medical Association (AMA) Schedule fee or the Medicare Benefits Schedule (MBS) fee, or the full cost of treatment. The schedule fees mentioned above are the fees determined by the AMA and the Federal Government respectively, as the appropriate fee for a specific service. Please check your product summary to determine the benefits that apply. Outpatient medical costsThis is cover for any treatment you receive from a doctor or specialist in private practice, or as an outpatient (ie where you are not admitted into hospital) anywhere in Australia. Depending on what is set out in your level of cover we cover you for 100% to 150% of the Medicare Benefits Schedule (MBS) fee or 100% of the MBS Scheduled fee for Outpatient costs. The MBS fee is set for each specific service by the Federal Government. Outpatient medical cover is available on most of our visitors covers. Please check your product summary to determine the benefits that apply. Outpatient pharmacy benefitYou can also receive benefits on selected pharmacy items prescribed as an outpatient or by a doctor or specialist. Please check your product summary to determine the benefits that apply. A co-payment of $20 applies. What is not covered?Hospital costsSituations when you are likely not to be covered or may incur significant additional expenses include:
Medical costsYou will not be covered for:
Restricted CoverSome visitors covers have specific services or treatments that are listed as having a 'restricted cover' for the duration of the cover. If a treatment is listed as restricted, we will only pay minimum benefits (an amount set by the Government for Australia residents) for that relevant treatment. This means that if you go to a public or private hospital for these treatments, most of the time, the hospital will charge a lot more than what we will pay, so you are likely to have a large amount to pay yourself. Please check your product summary to determine if restricted cover apply. Waiting periods - HospitalA waiting period is the time when you are not covered for a particular service. It starts on the date that you enter Australia or the date that you start your membership, whichever is the later date. Once you have completed your waiting period, you will receive the benefits listed under your level of cover for that service. Please note: you commence serving your waiting periods from the date you arrive into Australia, and not the start date.
Understanding your ambulance coverYou will receive unlimited emergency ambulance services., Tthat means we will pay 100% of the charges for emergency transportation and on-the spot treatment, by our recognised providers*. You will receive limited non-emergency ambulance services. This means your cover will be limited to three times per person, per calendar year, for non-emergency transportation by our recognised providers . Please refer to your product sheet for more information*. *Short Stay Visitors Cover has emergency only ambulance cover. Recognised Ambulance ProvidersBupa will only pay benefits towards ambulance services when they are provided by any of the following recognised providers:
For more information about our working and non-working visitors covers, please refer to the Visitors Cover Brochure and Visitors Cover Important Information Guide. ExtrasShow all detailsGet more back at Members First providersAt Members First providers, you will get at least 90% back on most items, covering general dental, physio and chiro services. At Non-Members First providers, you will get back a fixed amount depending on the service. These Non-Members First providers may charge higher fees than the fixed amount so you may need to pay to cover the ‘gap’.
What will we pay forOnce you have served any applicable waiting periods you can claim benefits for those services included on your cover and that are not claimable elsewhere (eg from a third party like Medicare). For example, Medicare does not provide benefits for:
Extras cover allows you to claim benefits for extras services as long as:
We recommend you contact us before making a booking to confirm how much you can claim and to check that your chosen provider is registered with us. What we won’t pay forExtras benefits will not be payable:
Waiting periodsA waiting period is the time between when you joined us and when you are covered for a service or treatment. If you receive a service or treatment during this time, you are not eligible to receive a benefit payment from us, regardless of when you submit the claim. Different waiting periods apply for different services. If you’re changing from another Australian health fund to Bupa, you’ll continue to be covered for all benefit entitlements that you had on your old cover, as long as these services are offered on your new cover with us. This is referred to as ‘continuity of cover’. To receive continuity of cover, you’ll need to transfer to us within 60 days of leaving your old fund. If you are an existing member and you change your health cover, you may need to wait before you can access your new benefits. Where your new level of cover is higher than what you previously held, the lower level of benefit applies. Waiting periods apply to services as listed below. Please refer to the full policy details to determine the specific services that are covered under your level of cover, including the associated waiting periods for those services. The following waiting periods apply for extras cover:
Understanding your ambulance coverEmergency Ambulance definition When you or your partner take out our extras cover, you will receive capped cover for recognised emergency ambulance transport and on-the-spot treatment. An emergency is when there is reason to believe that the patient’s life may be in danger or the patient should be attended to without undue delay. Transportation means a journey from the place where immediate medical treatment is sought to the casualty department of a receiving hospital. Emergency ambulance transportation is defined as air or road transportation by a Recognised Ambulance Provider of an unplanned and of a non-routine nature for the purpose of providing immediate medical attention to a person. Whether the transportation is deemed an emergency is determined by the paramedic and usually recorded on the account. Benefits are not payable for:
Ambulance cover We recommend that you take out an ambulance subscription with your recognised State Ambulance Provider if it’s available in your state (VIC, SA, NT and rural postcodes in WA). We will only provide ambulance benefits, in accordance with your level of cover, when you do not hold a subscription with an ambulance provider and a state ambulance scheme does not provide cover. For more extras options visit the Extras Cover page Find more Bupa health insurance by Life Stage: Singles Health Insurance, Couples Health Insurance, Family Health Insurance, Single Parents Health Insurance Health Insurance Comparison, compare health insurance by Life Stage Add Pharmacy SaverEnjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores. With Pharmacy Saver, you'll receive a 20% discount on a variety of health-related products. View details > Pharmacy saverAdd Pharmacy Saver to your extras cover and enjoy savings on your pharmaceutical and health care purchases all year round at National Pharmacies stores available in VIC, NSW & SA.^ Also includes access to the National Pharmacies' website and online shopping facilities including online prescription requests available nationwide. You'll get a 20% discount on a variety of health-related products.* Pharmacy Saver is not available for prescriptions on which the Government does not allow discounts. Visit a National Pharmacies store for more information. * These are products designed to manage or prevent diseases, injuries or a condition, or prescribed in connection with an episode of hospital treatment. ^ Locations subject to change. Weekly
Member ExclusivesEven when you’re in great health, there are still plenty of ways to get everyday value thanks to Bupa Plus. We’ve introduced this program to give you access to an exclusive range of discounts, health tools and information to help you live a healthier, happier life. Visit www.bupaplus.com.au 
Inclusive of GST
Download Product Summary
Contact us134 135
From within Australia
+61 2 9323 9500
From outside of Australia
8am - 6pm AEST Mon to Fri
9am - 1pm AEST Sat
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
