Review of Bupa Private Health Insurance in Australia 2019
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If you have private health insurance with Bupa and recently received an email about changes to their hospital policies, you might be wondering if they can still help you achieve a healthier, happier life.
Alternatively, maybe you're considering getting coverage from Bupa seeing as they own 26.9% of the Australian health insurance market.
Whatever your reason for wanting to review Bupa health insurance, this article will help guide you in finding the answers you're looking for.
Bupa health insurance review 2019
Bupa offers a variety of cover options for you choose from; Hospital only policies, Bupa Extras or Combined packages. They also have ambulance-only policy options available for those not covered for ambulance services by their state government.
Hospital only coverage
Bupa Hospital insurance helps cover the costs incurred while being treated in a hospital. You have the option of adjusting your premium by choosing your excess amount; zero, $250 or $500 excess. Generally, the higher your choice of co-payment, the lower your monthly premium.
Before we list the different Hospital policies available, let’s first delve into the recent Bupa hospital policy changes.
From 1 July 2018, Bupa will no longer pay minimum benefits (restricted cover) for certain services listed in their Basic and Mid-level hospital policies, including:
- Hip and knee replacement
- Cataract and eye lens procedures
- Renal dialysis for chronic renal failure
- Pregnancy and birth related services
- IVF and assisted reproductive services
- Obesity-related procedures and surgeries
- Abdominoplasty and lipectomy
- Cardiac and cardiac-related services
- All other services receiving Medicare benefits
Important: Bupa will also no longer pay the medical gap benefit when receiving treatment as a private patient in a public hospital or when going to a hospital that's not in their network of contracted hospitals.
If you have a Bupa Hospital policy, please login to your myBupa account to see whether you’re affected by these changes. You might want to compare their offering to some of the other major health insurance companies in Australia to make sure you’re still receiving value for money.
Bupa’s most comprehensive hospital policy generally includes coverage for all the above-listed services, for example, hip and knee replacement, IVF and cataract surgery.
Top Hospital no pregnancy
Offers complete coverage, similar to the above policy, but excludes pregnancy, IVF, obesity-related surgery and hospital treatments for which Medicare does not pay a benefit, for example, cosmetic surgery. However, it does include their free, independent opinion service from Best Doctors and the Ultimate Advice Line.
This is Bupa’s medium level hospital option and is usually a good fit for young and healthy individuals. While this policy does provide coverage for cardiac and pregnancy services, it excludes cataract surgery, hip and knee replacement, assisted reproductive services and dialysis.
An affordable policy option covering accommodation, accidents and restricted coverage for psychiatric services. However, this policy does not cover spinal fusion and any breast procedures, except where required post breast cancer.
Hospital waiting periods
The amount of time you’ll have to wait, after starting your policy, before claiming a benefit:
- Emergency ambulance treatment: None
- Accidents: None
- Palliative care, rehabilitation and psychiatric care: 2 months
- Pre-existing medical conditions: 12 months
- Pregnancy and birth-related services: 12 months
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|Bronze Extras |
Up to 60% back
|The most affordable extras option, which includes emergency ambulance services and covers general dental, Bupa optical, physiotherapy, chiro, antenatal and postnatal services up to your yearly limits.|
|Your Choice Extras |
Up to 60% back
|You can choose to be covered for any 4 of their listed services: General dental, major dental, endodontic, orthodontic, optical, non-PBS pharmaceuticals, physiotherapy, chiro, or podiatry.|
|Silver Extras |
Up to 60% - 66% back
|Includes most general treatment services up to your yearly limit with non-PBS pharmaceuticals, hearing aids and blood glucose monitors having sub-limits.|
|Gold Extras |
Up to 75% - 82.5%
|This is Bupa's top Extras cover option that covers all ancillary services with restrictions on PBS pharmaceuticals, hearing aids and blood glucose monitors.|
|Platinum Extras |
Up to 90% back
|Bupa’s most feature-packed extras with up to 100% back on Members First* dental, physio, chiro and selected optical consultations, up to your yearly limit.|
*Members First is Bupa’s network of providers, which includes thousands of dentists, physiotherapists, chiropractors, podiatrists, and Bupa optical outlets across Australia.
Extras waiting periods
Remember, this is the period of time that needs to pass before you can claim your new policy or upgraded cover:
- Emergency ambulance services: None.
- General dental: 2 months
- Major dental, endodontic and orthodontic: 12 months
- Optical: 2 months
- Physio, chiro and podiatry: 2 months
- Purchase of health aids and appliances: 12 months
- Hire and repair of health aids and tools: 6 months
- Health management programs: 6 months
Hospital and Extras Packages
If you prefer to combine your Hospital cover with Extras, then you can choose one of Bupa’s many packages.
A low-cost combination package that’s generally a good fit for young and healthy individuals. This package includes cover for accidents and emergency ambulance services with a yearly combined limit of $1,000 on general dental, physiotherapy and chiro.
Simple Start (single or couple)
An affordable Hospital and Extras policy that covers a limited number of hospital services and restricted cover on rehabilitation, psychiatrist services and palliative care, with general dental, optical, physio and chiro covered at Member First providers
Young Singles Saver or Young Couples Saver
This package is affordable and offers Basic Hospital cover with 60% back on Members First dental, physio, chiro, podiatry and selected optical.
Young Singles Choice or Young Couples Choice
Designed for young and healthy singles or couples, depending on the package you’ve selected. It includes cover listed in the Budget Hospital policy and provides 60% back on Extras from Members First Providers, including psychology services.
This affordable package cares for your family’s well-being while keeping premiums low. Hospital cover includes hospital treatment and accommodation, but excludes most other services, although psychiatric services are provided to a limited extent. You can claim up to 60% back on a long list of Extras available from Members First Providers, including general and major dental, orthodontics, Bupa optical, physio and chiro.
Hospital coverage includes services like pregnancy and IVF, plus there’s no excess for kids. You'll receive 60% for Members First selected products which include orthodontics.
This package is typically better suited to families with older kids as it does not cover pregnancy and birth-related services but does include cardiac and hip and knee replacements. Get up to 60% back on Members First Providers for most general treatment services.
An affordable, medium-level package option usually ideal for more mature singles and couples who aren’t planning to have kids but might need health aids and appliances in future. You'll receive up to 70% back on extras services at Bupa's Members First network providers.
Ultimate Health Cover
This package is Bupa's ‘all-in-one' deal, which combines Top Hospital and Platinum Extras.
Bupa’s Ambulance-only cover options
Bupa offers Emergency Only Ambulance cover and Premium Ambulance cover:
Emergency Only Ambulance
Gives you unlimited ambulance transport in emergencies, like fractured bones or severe chest pain. You’ll also receive on-the-spot emergency treatment Australia-wide.
The same as Emergency Only Ambulance but includes coverage for non-emergency road and air ambulance trips from a recognised provider.
How to claim Bupa health insurance
- When visiting a public hospital or Members First Network, the hospital will send your bill directly to Bupa.
- When visiting a hospital that doesn’t have an agreement with Bupa, pay upfront and submit your claim form to Bupa.
- For a doctor using Bupa’s gap cover scheme, billing will typically go directly to Bupa.
- When going to a doctor that doesn’t use Bupa’s gap cover scheme, you’ll have to take your medical bill to Medicare and Bupa will pay the rest, up to your limit.
- When claiming Extras cover at one of their service providers, swipe your Bupa membership card at their electronic claims’ facility, or
- Login to your myBupa account and submit your claim online, or
- You can post your claim form, and attached invoice and receipt to Bupa and payments will be made through EFT or cheque.
How to join Bupa private health
If you don’t have private health insurance, you can become a Bupa member by visiting their website, requesting a quote and applying for a policy. New customers purchasing a select combined Hospital and Extras policy before 28 February 2019, can get 6 weeks free coverage after your first month's premium.
After joining, you’ll usually receive your Bupa card which contains your membership number and the list of people covered under your policy.
When switching to Bupa from another health fund, you only need to permit them to contact your old insurer, and they'll handle all the paperwork. However, your limits will transfer when changing health funds and you might not be able to claim on new or increased benefits until you've served the required waiting period.
If applying from outside Australia, Bupa health insurance for visitors can generally be obtained by calling their +61-number available on their website. You might have to provide proof of identity, your visa details and your age. When joining from a Bupa overseas branch, you typically only need to provide your Bupa overseas membership details.
Your FAQs answered
Who owns Bupa healthcare?
Bupa health insurance in Australia is owned by the Bupa Group called Bupa Global, an international health and care company that started in the UK in 1947.
What did Bupa use to be called?
Bupa was initially called the British United Provident Association, established in 1947 when four large and 13 smaller associations and contributory hospital schemes came together to create a private company.
The four large associations included the Central Provident Association, the British Provident Association, the Oxford and District Provident Association, and the Birmingham Extended Benefit Scheme.
How to cancel Bupa health insurance
Download and complete their cancellation form available on their website and mail it to their Brisbane, Queensland office. Alternatively, call them directly but ensure you receive written confirmation that your policy has been cancelled.
Does Bupa cover gym membership?
Yes, generally as a Bupa member you can access the Bupa Plus program and get discounts on a variety of gyms, including 15% off the monthly membership fee from EFM Health Clubs , 10% off Fitness First new 3 and 12 month contract memberships and a 15% discount on Goodlife Health Clubs when on an Active 12 month membership.
What is Bupa dental?
Bupa owned dental clinics are spread-out all-over Australia, with more than 140 clinics country-wide. These Members First Network dental clinics offer a wide range of services at affordable prices with gap-free treatment for selected kids services.
When does Bupa private health insurance reset?
Your maximum benefit amount usually resets on the 1st of January every year. Unclaimed benefit limits do not roll over to the next year.
How do you suspend health insurance coverage?
You can generally suspend your membership for a minimum of 2 months, up to 2 years, when travelling outside of Australia. During this time, you won't have to pay premiums, and you won't be covered for any services or treatments.
To be eligible for such a suspension, you must have had cover in place for at least 12 months, be up to date with payments, notify Bupa private health insurance of your intention to suspend and contact them 30 days before arriving back in Australia.
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