(before any rebate, loading or discount)
Covers one adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult)
Available in Victoria
Closed to new members
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
This policy covers children, students up to and including the age of 31 and non-students up to and including the age of 31, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person and $500 per policy per year.
Excess payments do not apply to hospital admissions for dependants.
Co-payments: Every time you go to hospital you will have to pay:
Waiting periods:
For accommodation we pay up to $50 per night to a limit of $150 per person per trip. Benefits are payable per return trip. Eligibility criteria apply. Contact Bupa for more information.
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
Get peace of mind for the whole family with comprehensive Hospital cover which includes no excess/co-payment for kids. For more details on the product contact Bupa.
We have agreements with a network of dental practitioners, chiros, physios & podiatrists across Australia called Members First providers. By using them, in most cases you’ll receive up to 70% back, up to your yearly limits. See http://www.bupa.com.au/find-a-provider.
| Note, for items marked with an asterisk *: Podiatry does not include Orthotics. Where applicable, benefits may be payable under Health Aids & Appliances. Dentures payable once every 3 years. Periodic oral examination (012), Scale & Clean (114), Fluoride treatment (121) payable once every 6 months. Pharmacy benefit paid after current PBS patient contribution deducted. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $300 per person up to $600 per policy (no limit on preventative dental) | Periodic oral examination - $27.00 Scale & clean - $53.50 Fluoride treatment - $16.00 Surgical tooth extraction - $83.35 |
| Major dental* | 12 | $800 per person (combined limit for major dental & endodontic) | Full crown veneered - $576.00 |
| Endodontic | 12 | Filling of one root canal - $96.00 | |
| Orthodontic | 12 | $1,000 per person $2,000 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 60% of charge |
| Optical | 2 | $150 per person | Single vision lenses & frames - $150.00 |
| Non PBS pharmaceuticals* | 2 | $525 per person | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $350 per person up to $200 per service (combined limit for physiotherapy, chiropractic, podiatry, psychology, ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy & speech therapy - Sub-limits apply) | Initial visit - $30.50 Subsequent visit - $24.50 |
| Chiropractic | 2 | Initial visit - $34.00 Subsequent visit - $28.80 | |
| Podiatry* | 2 | Initial visit - $27.00 Subsequent visit - $24.00 | |
| Psychology | 2 | Initial visit - $69.50 Subsequent visit - $57.00 | |
| Acupuncture | 2 | $450 per person up to $150 per service (combined limit for acupuncture, remedial massage, chinese medicine & exercise physiology - Sub-limits apply) | Initial visit - $34.60 Subsequent visit - $26.25 |
| Remedial massage | 2 | Initial visit - $29.00 Subsequent visit - $27.00 | |
| Hearing aids | 12 | $600 per person 1 service(s) every 3 years | Hearing aid - $600.00 |
| Blood glucose monitors* | 12 | $750 per person (combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services - Sub-limits apply) | Per monitor - $120.10 |
| Ante-natal/Post-natal classes | 2 | Combined limit - see Physiotherapy | Initial visit - $24.00 Subsequent visit - $24.00 |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $22.50 Subsequent visit - $22.50 |
| Dietetics/dietary advice | 2 | Combined limit - see Physiotherapy | Initial visit - $52.00 Subsequent visit - $27.00 |
| Exercise physiology | 2 | Combined limit - see Acupuncture | Initial visit - $31.50 Subsequent visit - $27.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - $30.25 Subsequent visit - $27.60 |
| Health management / Healthy lifestyle | 6 | $100 per person up to $200 per policy | Health management - 50% of charge |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $85.00 Subsequent visit - $64.50 |
| Orthotics (podiatric orthoses) | 12 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - $90.00 |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $38.50 Subsequent visit - $33.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $57.00 Subsequent visit - $30.00 |
| Ante/Post-natal consultations and courses including lactation consultations, with a Bupa recognised provider in private practice. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits may apply. Blood glucose monitors, orthotics, and other health aids are payable under the Health Appliances category up to $750 per year. Sub-limits and restrictions apply. Blood glucose monitors are payable once per year. To find out about other health appliances included and relevant sub-limits and restrictions, please contact us. | |||
| Other treatments - check with your insurer |
When requiring urgent hospital treatment as the result of an accident, the Accident Benefit can boost extras limits (subject to eligibility criteria).
In Victoria this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
You are covered for the uncapped costs associated with emergency ambulance transport services (via air or road) including on-the-spot emergency attendances where the service is provided by a Bupa recognised ambulance service. The following ambulance services are recognised by Bupa: ACT Ambulance Service, Ambulance Service of NSW, Ambulance Victoria, Queensland Ambulance Service, South Australia Ambulance Service, St John Ambulance NT, St John Ambulance WA, and Ambulance Tasmania. If you are eligible to claim from another source, a benefit won’t be paid by Bupa.
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.