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Gold Visitors Cover With Silver Extras

 
Inclusive of GST

Payment

Excess:

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Excess

An excess is a set amount you agree to pay upfront before your benefit is paid for overnight or same-day admissions at any hospital. If your cover has an excess you will need to pay it once per person per calendar year to a maximum of twice on the entire membership. There is no excess if your child is admitted to hospital.

Extras Paid Back*:

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Extras Paid Back

You can budget how much you'd like to pay for your monthly premium by choosing how much you want to claim back from your visits for most items at Members First providers covering dental, optical, physio and chiro. Annual maximums and waiting periods apply.

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See detailed pricing

Includes:

  • Gold Visitors Cover $0.0
  • Silver Extras $0.0
  • Pharmacy Saver (weekly) $0.45

Features at a glance

Hospital Cover
      TOP
Extras Cover
      MEDIUM
back on extras*
Price is based on cover for: status, age, stateChange
 

About this cover

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Important 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.

Provides top-level private hospital and medical cover that includes cover for visits to a doctor or specialist in private practice. This cover meets the health insurance requirements of any working visa, including the 457, 482 working visa. Plus you have an option to add an excess for hospital admissions to help reduce your premium.

Silver Extras provides you with a very good level of cover for a wide range of services.

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 benefits will increase by 2% each year up to a maximum of 10% (annual maximums apply).

View Extras Cover

Download Product Summary

Hospital

Benefits included on cover:
Accommodation for overnight and same-day stays
Operating theatre, intensive care, ward fees
Bupa Medical Gap Scheme available
Allied services (eg physiotherapy in hospital)
Private hospital admissions
Public hospital admissions
Inpatient medical expenses - 100% of AMA
Outpatient medical expenses - 150% of MBS
457, 482 visa compliant

Inpatient services included on cover:
Pregnancy and birth related services
IVF and assisted reproductive services
Cosmetic Surgery
Bone marrow transplants
Organ transplants
All other inpatient treatments receiving a Medicare benefit

Additional Items:
Outpatient pharmacy benefits*
100% emergency ambulance services
Repatriation benefits
Family in-hospital benefit that helps pay for in-hospital partner/family accommodation or meals
Crutches and wheelchairs benefit
Reimbursement on emergency department facility fees charged at any private or public hospital
including administration fees even if not admitted to hospital

Excess options: Nil, $500
Legend:    Glossary
Covered
Not covered
AMA Fee Australian Medical Association Fee
MBS Fee Medicare Benefit Schedule Fee
* you pay $20, we refund a 90% of balance per script per item up to $600 per person per calendar year.

Important product changes in 2018

Why 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

Changes from 1 July 2018
Impacted treatment type or feature Description
Clinically Necessary Cosmetic Surgery From 1 July 2018, we’re updating our Overseas Visitors Rules to clarify the definition of Cosmetic Surgery so you have a better idea of what is excluded and deemed as Cosmetic Surgery.
Changes from 1 August 2018
Change type Description
Bupa Medical Gap Scheme ?

Our medical gap scheme helps you reduce the medical costs you pay yourself for in-hospital treatment. From 1 Aug, this will only apply in Members First, Network and Fixed Fee Hospitals. Find one of these hospitals or a Medical Gap Scheme provider here.

Where the Medical Gap Scheme applies is changing.

What is covered?

Hospital costs

With 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 fully 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 treatment which is recognised by Medicare and is not either restricted or excluded 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:

  • accommodation for overnight or same-day stays
  • operating theatre, intensive care and labour ward fees
  • reimbursement on emergency department fees charged at any private or public hospital including administration fees if admitted into hospital (or in all circumstances depending on your level of cover).
  • supplied pharmacy items approved by the Pharmaceutical Benefits Scheme (PBS)
  • physiotherapy, occupational therapy, speech therapy and other allied health services
  • a surgically implanted prosthesis up to the Government minimum benefit published in the Government's Prosthesis List
  • private room where available.^

^Conditions apply. Contact us for more information.

Members First day facilities

If 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 costs

These 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 costs

This 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 benefit

You 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.

Repatriation benefit

You will receive cover for repatriation to your country of origin if you become terminally ill or if you suffer a substantial life altering illness/injury up to $100,000. Or for the return of mortal remains up to $10,000. Benefits are only payable once approved by Bupa.

No Repatriation Benefit will be paid if you were:

  • first diagnosed as terminally ill
  • a reasonable person would have first become aware of the terminal illness
  • if you suffered a substantial life altering illness or injury within the six months prior to the date your cover commenced.

Family In-Hospital Benefit

You could receive benefits for accommodation and meal costs if your partner, immediate family member, carer or next of kin is required to stay at hospital with you or a person on your membership. They will be covered for $60 per night for accommodation in hospital and up to $30 a day for hospital meals.

Hospital meals are covered when provided at a hospital cafeteria or patient meal menu. A $1,000 per person, per calendar year annual maximum applies to Family In-Hospital Benefit.

Crutches and wheelchairs benefit

You will receive a benefit for crutches and wheelchairs.

For a benefit to be payable, the hire or purchase must be linked to an inpatient admission resulting in the requirement of the item. We will not pay benefits without evidence of a hospital admission.

If eligible, we will pay 100% of the cost up to a maximum limit of $500 per person per calendar year for any hire or purchase of crutches or wheelchairs.

Excess

On selected covers there may be an excess option which may lower the amount that you pay for your cover. Excesses are only payable on overnight and same-day inpatient hospital admissions in any hospital.

  • The total excess amount is paid each time a person on your membership is admitted into hospital, to a maximum of once per person and twice per membership each calendar year unless otherwise specified.
  • If the total excess amount for an individual is not reached in a single hospital admission, the remaining balance of that excess is payable in any subsequent hospital admission.
  • No excess applies to your dependent children. Please contact us for further details.

What is not covered?

Hospital costs

Situations when you are likely not to be covered or may incur significant additional expenses include:

  • during a waiting period
  • when a service is excluded from your level of cover
  • when specific services or treatments are a restricted cover
  • labour ward fees on Short Stay Visitors Cover
  • when you are treated at a non-agreement hospital you will not be fully covered
  • for the fixed fee charged by a fixed fee hospital or a hospital that has a fixed fee service. This does not apply to Ultimate Corporate Visitors Cover as any fixed fee will be reimbursed
  • depending on your level of cover, if you have not been admitted into a hospital and are treated as an outpatient (eg emergency room treatment, outpatient ante-natal consultations with an obstetrician) you may not be covered
  • for psychiatric and rehabilitation day programs, at a hospital Bupa does not have an agreement with
  • hospital treatment provided by a practitioner not authorised by a hospital to provide that treatment
  • hospital treatment for which Medicare pays no benefit, including: medical costs in relation to surgical podiatry (including the fees charged by the podiatric surgeon); cosmetic surgery where not clinically necessary; respite care; experimental treatment and/or any treatment/procedure not approved by the Medical Services Advisory Committee (MSAC)
  • personal expenses such as: pay TV, non-local phone calls, newspapers, boarder fees, meals ordered for your visitors, hairdressing and any other personal expenses charged to you unless included in your cover
  • if you are in hospital for more than 35 days and you have been classified as a 'nursing home type' patient. In this situation you may receive limited benefits and be required to make a personal contribution towards the cost of your care
  • some hospital-subsititute treatment and operative services that are a continuation of care associated with an early discharge from hospital
  • for pharmacy items not opened at the point of leaving the hospital unless covered on your visitors or extras cover
  • if you choose to use your own allied health provider (eg chiropractors, dieticians or psychologists) rather than the hospital's practitioner for services that form part of your in-hospital treatment
  • where compensation, damages or benefits may be claimed by another source (eg workers compensation)
  • for any amount charged by a public or non-agreement hospital which is not covered by us or which is above the benefit that we pay
  • for any treatment or service rendered outside Australia
  • for any treatments arranged in advance of your arrival in Australia
  • Non-PBS, high cost drugs
  • if you do not hold a valid visa at the time of admission to hospital and for the duration of your hospital stay.

Medical costs

You will not be covered for:

  • medical services for surgical procedures performed by a dentist, surgical podiatrist, or any other practitioner or service that is not eligible for a rebate through Medicare
  • costs for medical examinations, x-rays, inoculation or vaccinations and other treatments required relating to acquiring a visa for entry into Australia or permanent residency visa.

Waiting periods - Hospital

A 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.
 

Pregnancy and birth related services 12 months
Pre-existing conditions relating to psychiatric, rehabilitation and palliative care 2 months
All other pre-existing conditions, ailments, or illnesses 12 months

Understanding your ambulance cover

You will receive unlimited emergency ambulance services. That 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.

Recognised Ambulance Providers

Bupa will only pay benefits towards ambulance services when they are provided by any of the following recognised providers:

  • ACT Ambulance Service
  • Ambulance Service of NSW
  • Ambulance Victoria
  • Queensland Ambulance Service
  • South Australia Ambulance Service
  • St John Ambulance Service NT
  • St John Ambulance Service WA
  • Tasmanian Ambulance Service.

For more information about our working and non-working visitors covers, please refer to the Visitors Cover Brochure and Visitors Cover Important Information Guide.

Extras

Show all details

Get more back at Members First providers

At Members First providers, you will get at least 60% 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’.

Services
See our glossary for help on definitions.

Waiting Periods

Annual Maximums

Per calendar year

green tickGeneral Dental General Dental

General Dental

General dental treatment includes services such as:

  • Your regular 6 monthly examination, scale and clean and fluoride treatment
  • X-rays
  • Mouthguards
  • Fillings (those done directly in the mouth – like Amalgams and white composite fillings)
  • Simple extractions
  • Surgical extractions (such as removal of impacted wisdom teeth)

Please refer to the full policy details to determine what is covered.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

 

Unlimited

When you combine your Extras with Hospital cover, We will cover the cost of your kids' General Dental services until they turn 25. This means you'll benefit from no out of pocket costs on your kids' general dental services at Members First providers. Limits and conditions apply please contact us for details.

green tickMajor Dental Major

Major Dental

Major dental treatment includes services such as:

  • Periodontal treatment (treatment of gum disease)
  • Complex oral surgery
  • Root Canal Therapy (Root Treatment)
  • Fillings (those that have to be made outside the mouth eg in a laboratory or by a special machine)
  • Crowns and bridges
  • Implants
  • Dentures (false teeth)

Please refer to the full policy details to determine what is covered. Waiting periods may apply.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

12 months

$1,000 per person

green tickOrthodontics Major

Orthodontics

Orthodontic treatment includes the use of devices like “braces” to change the position of teeth and the jaws.

Please refer to the full policy details to determine what is covered. Waiting periods may apply. Some levels of cover only include orthodontics if treatment is required as a result of an accident after joining.

Benefits are only payable for services provided by dentists and dental specialists in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

12 months

$700 per person

Lifetime Limit: $2,000

green tickOptical Optical

Optical

Optical services are provided on prescription from an optometrist and include:

  • Frames
  • Prescription Lenses
  • Contact Lenses
  • Certain lens coatings

Please refer to the full policy details to determine what is covered.

Benefits are only payable for services provided by optometrists and optical dispensers in private practice who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing treatment.

2 months

Members First $290

Non-Members First $200

green tickPhysiotherapy Physiotherapy

Physiotherapy

Physiotherapy involves the treatment and rehabilitation of people with movement disorders and other physical disabilities.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by physiotherapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$700 per person

When you combine your Extras with Hospital cover, We will cover the cost of your kids' Physiotherapy services until they turn 25. This means you'll benefit from no out of pocket costs on your kids' physiotherapy services at Members First providers. Limits and conditions apply please contact us for details.

green tickChiropractic and Osteopathy Chiropractic and Osteopathy

Chiropractic and Osteopathy

Chiropractic deals with the relationship between the spine and pelvis and the nervous system (which controls how they function). The bones of the spine are manipulated, based on the premise that disease is caused by interference with nerve function.

Osteopathy deals with the structure of the body and the way it functions. It uses massage and stretching techniques to improve the function where needed.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by chiropractors and osteopaths who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$500 per person

$1,000 per membership

green tickAntenatal and Postnatal Antenatal and Postnatal

Antenatal and Postnatal

Antenatal and postnatal services include:

  • Antenatal Sessions or Courses with a registered midwife
  • A benefit for a lactation consultant to come to your house to help with feeding difficulties.

Services must be provided by a Bupa recognised provider in private practice. Recognition of providers by Bupa is subject to change without notice. Please contact us to find out if your preferred provider is recognised by Bupa. Benefits are not payable for courses or sessions that are paid for by Medicare Australia. Please refer to full policy details to determine what is covered.

2 months

$350 per person

green tickNatural Therapies Natural Therapies

Natural Therapies

Natural therapies may complement or offer alternatives to conventional medical treatment. They include therapies such as Acupuncture, Alexander Technique, Chinese Herbalism, Western Herbalism, Exercise Physiology, Feldenkrais, Naturopathy, Homoeopathy and Iridology.

“Massage” includes benefits payable for Aromatherapy, Bowen Technique, Kinesiology, Reflexology, Shiatsu and Remedial Massage.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Natural Therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

A sub-limit of $150 per person or $300 per membership per calendar year applies for massage

green tickHealth Management Health Management

Health Management

Our Health Management extras service helps you reach your goals by covering some of the costs for health-related programs including: nicotine replacement therapy, weight management programs and health subscriptions to Diabetes Australia and Asthma Foundation.

6 months

$100 per person

green tickPharmacy Pharmacy

Pharmacy

Your extras pharmacy entitlement covers you for prescription only items that are not supplied under the PBS (Pharmaceutical Benefits Scheme); are TGA (Therapeutic Goods Administration) approved; are prescribed by a registered medical practitioner; supplied by a Bupa recognised, registered pharmacist; and not otherwise excluded by Bupa.

When in hospital, if you are treated with drugs that are not PBS approved, you may not be fully covered and the hospital may charge you for all or part of the cost. You should be advised by the hospital of any charges before treatment.

There are some additional items that are not covered by our pharmacy benefit and these include:

  • Over the counter or non-prescription items
  • Compounded items
  • Weight loss medication (some weight loss medications are covered under the Health Management extras service)
  • Body enhancing medications (eg anabolic steroids).

Pharmacy in-hospital

When you make a claim, we will deduct a pharmacy co-payment and pay the remaining balance up to the set amount under your chosen level of cover.

2 months

$500 per person

green tickDietary Dietary

Dietary

Dietetics is the promotion of health and treatment of disease through diet.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by dietitians who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickPsychology Psychology

Psychology

Psychology deals with the mind and mental processes, especially in relation to human behaviour.

Psychology services include:

  • Attendances (one on one)
  • Group attendances
  • Couple and Family attendances

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Psychologists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickPodiatry (excludes orthotics) Podiatry

Podiatry

Podiatry is the prevention, diagnosis, treatment and rehabilitation of conditions of the feet and lower limbs.

Podiatry services include:

  • Attendances
  • Biomechanical analysis

Please note: Benefits for Orthotics if payable, are paid under Health Appliances

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for services provided by Podiatrists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickSpeech Therapy Speech Therapy

Speech Therapy

Speech therapy is the assessment and treatment of people who have a communication disability. Communication disabilities are the result of problems with speech, using and understanding language, voice, fluency, hearing, or reading and writing.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by speech therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickEye Therapy Eye Therapy

Eye Therapy

Eye therapy is a physical therapy for the eyes and brain that develops eye coordination and treats a number of common visual problems eg crossed eyes, lazy eye, and double vision.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by eye therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickOccupational Therapy Occupational Therapy

Occupational Therapy

Occupational therapy is the training of people with physical injury or illness, psychological or social disability or learning problems with the aim that they can work and live by themselves and lead a relatively normal life, despite their disabilities.

Please refer to the full policy details to determine what is covered.

Benefits can only be claimed for consultation and treatment by occupational therapists who are recognised by Bupa and in private practice. Some providers may not be recognised by Bupa, in which case we will not pay benefits for services they provide. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$400 per person

green tickHome Nursing Home Nursing

Home Nursing

Home Nursing describes nursing care following discharge from hospital or instead of being admitted for hospital. Services may include:

  • Catheter Care
  • Stomal therapy
  • Wound management
  • Administration of medication

Benefits are only payable for nursing services by providers who are recognised by Bupa. Recognition of providers by Bupa is subject to change without notice. Please check with us before undergoing a course of treatment.

2 months

$350 per person

green tickHealth Aids and Appliances Health aids and appliances

Health aids and appliances

Includes a range of health related items that people suffering with various medical conditions may use to assist them in leading a relatively normal life.

Health appliances include:

  • Asthma pumps
  • Blood glucose monitors
  • INR Blood testing devices (eg Coaguchek)
  • Compression garments
  • Surgical stockings
  • CPAP and BPAP devices
  • TENS machines
  • Hearing Aids
  • Braces and Splints

Please refer to the full policy details or call us to determine what is covered. Benefits payable are subject to eligibility.

Benefits are not claimable when a prescribed treatment is not custom made (eg orthotics, braces and splints, surgical shoes). Health appliances must be purchased from a Fund-recognised provider. Call us if you would like any additional information on other criteria that applies to claiming health aids and appliances.

12 months

$800 combined annual maximum.
Limits per item apply.

Defined Appliances include TENS Machines, blood pressure monitors, insoles, orthopaedic and corrective footware, pressure garments, braces, artificial limbs. Limits apply per item. CPAP Devices subject to eligibility.

To receive benefits for health aids and appliances you'll need to visit a recognised provider. You will also need to meet the eligibility criteria, provide proof of purchase and a clinical referral where required.

Benefits are not claimable when a prescribed treatment is not custom made (eg. orthotics, surgical shoes). Call us if you would like any additional information on other criteria that applies to claiming health aids and appliances.

A benefit is also payable for the hire, repair and maintenance of health appliances. Restrictions and sub-limits apply. Benefits are not payable in the first 12 months after purchasing an item, within 12 months following the repair, or on items where hire and repair is deemed inappropriate.

Contact us for a full list of health aids and appliances that may be payable and for details of the limits that apply per item.

green tickTravel and Accommodation Travel and accommodation

Travel and accommodation

Benefits may be payable for travel and overnight (non-hospital) accommodation expenses associated with essential medical or hospital treatment if you are unable to access this treatment where you live.

The total return distance travelled for treatment must be at least 200 kilometres. The overnight (non-hospital) accommodation benefits are payable for the patient and for an attendant.

Please refer to the full policy details to determine what is covered.

2 months

$100 for travel expenses up to $150 for accommodation expenses per year

green tickEmergency Ambulance Services Emergency ambulance services

Emergency ambulance services

Cover for ambulance services varies dependent on the provisions of your state of residence. Please refer to the full policy details to determine what is covered.

No waiting period

Singles = 1 service

Couples = 2 services

(per calendar year)

What we will pay for

Once 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:

  • most dental examinations and treatment
  • most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services
  • acupuncture (unless part of a doctor’s consultation) or other natural therapies
  • glasses and contact lenses
  • most health aids and appliances
  • home nursing.

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
  • they meet the criteria set out in our policies and Fund Rules.

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 for

Extras benefits will not be payable:

  • during a waiting period
  • where a third party, including Medicare, a Government body, or an insurance company provided a benefit (except for hearing aids and breast prosthesis items)
  • for different services within the same service type from the same provider on the same day. For example, if you went to see an acupuncturist and then received a massage from the same provider on the same day, you cannot claim for both services
  • when a prescribed treatment is not fully custom made (eg orthotics, surgical shoes)
  • when a provider is not recognised by us for benefit purposes
  • for any treatment or service rendered outside Australia
  • when you have reached the maximums on your product including annual, lifetime or service limits for the service you are claiming.

Waiting periods

A 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:

  • initial waiting period – two months
  • hire, repair and maintenance of health aids and appliances; and Health Management extras service – six months
  • major dental, root fillings, orthodontics, selected health aids and appliances – 12 months.

Understanding your ambulance cover

Emergency 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:

  • transportation from a hospital to your home
  • transportation from a hospital to a nursing home
  • transportation from a hospital to another hospital where the customer has been admitted to the transferring (first) hospital
  • transportation from the person’s home, a nursing home or hospital for ongoing medical treatment, (eg chemotherapy, dialysis).

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 Extra 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 Saver

Enjoy 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 saver

Add 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 Exclusives

Even 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

 
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