Update to our members - July 1 2022
Negotiations continue
We are continuing our negotiations with Ramsay Health Care and are hopeful of reaching an agreement soon.
We thank our members for their patience while we continue to negotiate an agreement that helps keeps health insurance affordable for our members, balances the needs of hospitals, and supports the sustainability of the health system.
We continue to work for our members to give them greater choice about their healthcare. We have recently entered into partnerships with other large hospital groups including Cabrini Health in Victoria, and Mater Health in Queensland.
Members remain covered
We want to assure our members that right now, nothing has changed and they remain covered at Ramsay hospitals. If agreement is not reached there are transitional arrangements (see Table 1.0) in place to help minimise impacts to members seeking treatment.
We understand some members might be concerned about the negotiations, especially those in regions where access to a non-Ramsay private hospital is limited. But be assured, our members remain our top priority.
Working for our members
Bupa has agreements with most private hospitals and hospital groups nationally. These agreements provide our members with access to high-quality health care at an affordable price. When we renegotiate an agreement, consideration is given to how price increases will impact on premium adjustments through our annual rate rises. We take great care during negotiations to ensure we balance the needs of the hospital with maintaining affordability for members.
We acknowledge the cost-of-living pressures faced by many of our members and we are working to help keep premiums as low as possible, and we remain committed to maintaining member access to quality healthcare at an affordable price.
Despite our attempts to negotiate a fair agreement for both Ramsay and our customers, Ramsay has notified us that it will terminate our agreement, effective 2 August 2022.
We continue to negotiate with Ramsay and hope that fair and reasonable new terms are agreed. Our priority is to achieve an outcome for our members that protects access to, and the affordability of high-quality healthcare.
What does this mean for you?
If fair and reasonable terms can be agreed before 2 August 2022, Bupa will remain in contract with Ramsay, if so we expect that this will mean nothing will change. However, if there are any changes, we will keep our customers fully informed of any impacts. In the disappointing event new terms can’t be agreed to by 2 August, the following arrangements apply:
Booked into a Ramsay hospital between now until 2 August 2022:
Nothing will change, you can still attend your admission at a Ramsay hospital before this date and have peace of mind that you will not face additional out of pocket expenses.
For all other admissions, the below transitional arrangements apply:
Table 1.0 Transitional arrangements agreed to in the event of an out of contract scenario.
All admissions meeting the below criteria will face no additional-out of pocket costs AND will be entitled to full network hospital benefits.
| TREATMENT TYPE (IRRESPECTIVE OF WHEN BOOKED) |
ADMISSION DATE: |
| Emergency |
On or before 1 November 2022 |
| Rehabilitation and mental health (incl. psychiatry) |
On or before 1 February 2023 |
| Obstetrics and neonatal |
On or before 1 May 2023 |
| Oncology and renal |
On or before 1 August 2023 |
| Other courses of treatment that started before 2 August 2022 |
On or before 1 August 2023 |
| OTHER TREATMENTS (INCLUDING ELECTIVE SURGERY) | |
| Any other admission that occurs from 2 August 2022 and up to and including 1 October 2022 | |
| Any admission that is booked with Ramsay before 2 August 2022 and occurs on or before 1 February 2023 | |
What happens if I choose to proceed with a treatment or admission at a Ramsay facility where the transitional arrangements are not applicable to my admission?
Bupa members can still attend a Ramsay hospital, however they are more likely to experience additional out-of-pocket costs as determined by Ramsay. Bupa customers that fall into this category are strongly advised to contact their treating Ramsay hospital directly to attain Informed Financial Consent in advance of your admission.
In this scenario, Bupa is doing everything possible on our side to minimise impacts to customers, including our current commitment to continue to pay our existing Ramsay hospital rates. These hospital rates are above the rates that Ramsay would otherwise be legally entitled to in an out of contract situation. Despite this, Ramsay may choose to charge an out-of-pocket cost.
If you are unsure whether you fall into one of these categories, we encourage you to call us on 134 135. For more info, see our FAQs below.
We're committed to keeping insurance affordable and ensuring our members have choice, control, and access to their preferred providers.
Bupa works to keep the health of Australians affordable and accessible, which is why we will continue to negotiate and come to an outcome that best supports our members and the health system. We acknowledge that costs are increasing and that it's the responsibility of both hospitals and health insurers to drive efficiencies in the health system.
You and your hospital treatments
We've provided some important information about how this may impact you if we aren't able to come to an agreement with Ramsay ahead of the current contract expiring on 2 August 2022.
My specialist works out of a Ramsay hospital. What should I do?
Many specialists work out of several hospitals, so if you do not wish to attend a Ramsay hospital, you can ask your specialist if there are other options. If so, check if they can do it in a Network hospital. If you need help, please call us on 134 135.
There aren't any other private hospitals in my area. If you don't reach an agreement with Ramsay, how can I use my cover?
Bupa members may still attend Ramsay hospitals if we don't reach an agreement. To help minimise impacts on our members in an out of contract situation, Bupa has, at this time, committed to continuing to pay our current Ramsay hospital rates. These hospital rates are above the rates that Ramsay would otherwise be legally entitled to. Despite this, Ramsay may choose to charge an out-of-pocket cost. Where transitional arrangements have expired (see table 1.0) Bupa strongly advises members to contact your treating Ramsay hospital directly to attain Informed Financial Consent in advance of your admission.
Please ask your specialist if there are any other options for your treatment. If so, check if they can do it in a Network hospital. If you need help, please call us on 134 135.
What do I do in an emergency? My local emergency department is at a Ramsay hospital.
You can access a Ramsay hospital emergency department. If you're admitted in an emergency up to and including 1 November 2022 (see transitional arrangements outlined in Table 1.0), you'll remain covered under the contract that is in place with Bupa and won’t face any additional out of pocket expenses.
If an agreement isn't reached and Bupa falls out of contract with Ramsay on 2 August 2022, once transitional arrangements for Emergency episodes have ceased on 1 November 2022, Bupa intends to continue paying our current rates. However, Ramsay may choose to charge above these rates, which will result in out-of-pocket costs. For any additional information please contact your treating Ramsay hospital to request a cost estimate so that you can provide Informed Financial Consent.
How would going out of contract with Ramsay impact my out-of-pocket costs?
Should fair terms not be agreed to by 2 August 2022, we will do our best to minimise disruption to our members. Our intent is to:
Hospital stay costs:
- Continuing to pay our current contracted rates, rates that are higher than what Ramsay would otherwise be legally entitled to when out of contract
This is a choice Bupa has made to protect our customers as much as possible to help avoid additional out of pocket expenses. Should Ramsay choose to charge additional out-of-pocket cost, this will be a decision in their sole discretion to make. - Agreeing to transitional arrangements to help minimise disruption to members (see table 1.0).
Medical costs:
- Continuing to extend Bupa’s Medical Gap Scheme arrangements with participating doctors treating patients at Ramsay hospitals – Bupa is not required to apply Medical Gap Scheme arrangements in out of contract hospitals. However, Bupa has made the decision to minimise impacts to our customers and continue to extend these arrangements to those doctors. This decision provides further protection for our customers by helping them to avoid or minimise medical out of pocket costs through ‘no gap’ and ‘known gap’ arrangements.
Bupa and Ramsay
We've answered a few questions that you might have about these negotiations.
Who are Ramsay Health Care?
Ramsay Health Care is a private healthcare provider with 71 private hospitals and day surgery units in Australia.
| Albury-Wodonga Private Hospital | Kareena Private Hospital | Ramsay Clinic Macarthur |
| Armidale Private Hospital | Kingsway Day Surgery | Ramsay Clinic New Farm |
| Attadale Rehabilitation Hospital | Lake Macquarie Private Hospital | Ramsay Clinic Northside |
| Ballina Day Surgery | Lawrence Hargrave Private Hospital | Ramsay Clinic Wentworthville |
| Baringa Private Hospital | Linacre Private Hospital | Ramsay Day Clinic Kahlyn |
| Beleura Private Hospital | Masada Private Hospital | Shepparton Private Hospital |
| Berkeley Vale Private Hospital | Mitcham Private Hospital | Short Street Day Surgery |
| Caboolture Private Hospital | Mt Wilga Private Hospital | Southern Highlands Private Hospital |
| Cairns Day Surgery | Murray Valley Private Hospital | St Andrew's - Ipswich Private Hospital |
| Cairns Private Hospital | Nambour Selangor Private Hospital | St George Private Hospital |
| Castlecrag Private Hospital | Noosa Hospital | Strathfield Private Hospital |
| Coolenberg Day Surgery | North Shore Private Hospital | Sunshine Coast University Private Hospital |
| Donvale Rehabilitation Hospital | North West Brisbane Private Hospital | Tamara Private Hospital |
| Dudley Private Hospital | Nowra Private Hospital | The Avenue Private Hospital |
| Figtree Private Hospital | Peel Health Campus | The Border Cancer Hospital |
| Frances Perry House | Peninsula Private Hospital | The Southport Private Hospital |
| Glenferrie Private Hospital | Pindara Day Procedure Centre | Wangaratta Private Hospital |
| Glengarry Private Hospital | Pindara Private Hospital | Warners Bay Private Hospital |
| Greenslopes Private Hospital | Port Macquarie Private Hospital | Warringal Private Hospital |
| Hillcrest - Rockhampton Private Hospital | Ramsay Clinic Adelaide | Waverley Private Hospital |
| Hollywood Private Hospital | Ramsay Clinic Albert Road | Western Sydney Private Oncology & Infusion Centre |
| Hunters Hill Private Hospital | Ramsay Clinic Cairns | Westmead Private Hospital |
| John Flynn Private Hospital | Ramsay Clinic Caloundra | Wollongong Private Hospital |
| Joondalup Health Campus | Ramsay Clinic Cremorne |
These 71 hospitals are a part of the 530 hospitals that Bupa has an agreement within Australia.
What's happening with Bupa's agreement with Ramsay Health Care?
Bupa has agreements with all major private hospital groups and most independent hospital groups nationally. These agreements ensure our customers have access to high-quality health care at an affordable price. When we renegotiate an agreement, price increases have flow-on effects impacting on premium adjustments each year. We take great care during negotiations to ensure we balance the needs of the hospital with maintaining affordability for customers.
We've recently been in negotiations with Ramsay. The increase Ramsay is seeking would result in a sizeable premium increase for customers at a time when cost of living pressures is having a significant impact. Despite our attempt to negotiate a fair agreement for both Ramsay and our customers, Ramsay has indicated they will terminate our agreement, effective 2 August 2022.
We will continue to negotiate with Ramsay and hope that we can come to an outcome that is fair and supports both our customers and the health system.
Ramsay have stated that your agreement has terminated, is this true and why didn’t you tell me?
We're still negotiating with Ramsay and are hopeful of reaching an agreement before 2 August that makes our customers the priority.
If we successfully reach an agreement before 2 August, nothing will change for our customers. We'll keep you updated as our talks progress.
Why am I hearing from Ramsay and not Bupa?
When will you communicate to me directly?
If there are further updates, we will contact impacted members as well as updating this page. We will ensure we provide reasonable notice for impacted members to consider their options.
What happens if Bupa doesn't reach an agreement with Ramsay Health Care?
Bupa has committed to continuing to pay our current Ramsay hospital rates, even if the contract is terminated. These hospital rates are above the rates that Ramsay would otherwise be legally entitled to. Despite this, Ramsay may choose to charge an out-of-pocket cost.
There are also transitional arrangements (see Table 1.0) in place to ensure minimal impact to any members seeking treatment.
Where transitional arrangements have expired Bupa strongly advises members to contact your treating Ramsay hospital directly for a cost estimate so that you can be provided with Informed Financial Consent in advance of your admission.