Short Stay Visitors Cover

Benefits included on cover:
	Accommodation for overnight and same-day stays
	Operating theatre, intensive care, ward fees
	Bupa Medical Gap Scheme Available
	Allied services (i.e. Physiotherapy in hospital)
	Public hospital admissions
	Private hospital admissions
	Inpatient medical expenses
	Outpatient medical expenses
	457 visa compliant
Inpatient services included on cover:
	Pregnancy (childbirth)
	Assisted reproductive services (including IVF treatment)
	Cardiac and cardiac related services (eg open heart and bypass surgery and invasive cardiac procedures)
	Cataract & eye lens procedures
	Hip and knee replacement including revisions
	All other joint replacement including revisions (eg shoulder, elbow)
	Sterilisation reversal
	Renal dialysis for chronic renal failure
	Cosmetic surgery that is clinically necessary and where benefits are payable by Medicare
	Cosmetic surgery that is not clinically necessary
	All other inpatient treatments receiving a Medicare benefit
	Cover for pre-existing conditions, ailments or illnesses
	Accidents
	Arthroscopy or Meniscectomy (minor knee surgery)
	Appendicitis
	Removal of tonsils and adenoids
	Dental surgery
	Minor gynaecological surgery (not including laparoscopy surgery)
	Psychiatric
	Rehabilitation
Additional Items:
	Outpatient pharmacy benefits
	100% emergency ambulance services
	Family in-hospital benefit that helps pay for in-hospital partner/family accommodation or meals
	Crutches and wheelchairs benefit
	Cover for extras services
	Repatriation benefits
	Reimbursement on emergency department facility fees at any public or private hospital, if admitted
Excess: $250 excess
Legend:    Glossary
	Covered
	Not covered

This cover is ideal for healthy, young singles or couples visiting Australia on a budget, who are on the following visa types:

• Skilled graduate visa (476)
• Short stay temporary work visa (400)
• Working holiday visa (417)
• Work and holiday visa (462)
• Visiting academic visa (419)
• Visitor visa (600)^~
• Electronic travel authority visa (601)^~
• eVisitor visa (651)^~

^~ Documentation to confirm enrolment in an Australian university, English language centre or other educational institution will be required for this visa subclass.

If your visa subclass is not on this list, you are not eligible for Short Stay Visitors Cover.

Please note: If you are applying for a 457 Long Stay Working Visa, this cover is not suitable as it does not meet the minimum level of insurance required as set out by the Department of Immigration and Border Protection (DIBP). Also not suitable for overseas visitors requiring family cover or visitors over 50 years of age.

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 facility fees at any public or private hospital, if admitted (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.

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 include:

• during a waiting period
• when a service is excluded from your level of cover
• when a service is covered as a minimum benefit and you are admitted to a private hospital, you will not be covered above the minimum benefit
• 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.

Minimum benefits

Some visitors covers have minimum benefits for specific services for the duration of the cover.

A minimum benefit means you will generally receive cover equivalent to shared room minimum benefit payable for an Australian resident. Services paid at minimum benefits will generally not cover all hospital costs and are likely to result in significant out-of-pocket hospital costs in private and public hospitals.

Please check your product summary to determine if minimum benefits apply.

Waiting periods - Hospital

A waiting period is the time between the latter of your arrival in Australia or the start date of your membership and when you are covered for a service or treatment. If you receive a service or treatment during a waiting period, 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.

Please note: you commence serving your waiting periods from the date you arrive into Australia, and not the start date.

Psychiatric, rehabilitation and palliative care - 1 year
 

Understanding your ambulance cover

Emergency ambulance cover

As part of your cover you receive unlimited emergency only ambulance cover for emergency ambulance air and road transportation and on-the-spot emergency treatment by a Recognised Ambulance Provider.

You’ll receive cover for ambulance transport with an approved ambulance service where medically necessary for admission to hospital or for Emergency Treatment. You’re not covered for non-emergency transportation from a hospital to your home, a nursing home or another hospital. Whether the transportation is deemed an emergency is determined by the paramedic and usually recorded on the account.

If you need to make a claim for emergency ambulance benefits, we will give you a Patient Ambulance Transportation Form to complete.

Transportation means a journey from the place where immediate medical treatment is sought to the casualty department of a receiving hospital.

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 Short Stay Visitors Covers, please refer to the Short Stay Visitors Cover Brochure (PDF) and Visitors Cover Important Information Guide (PDF).