Private Health Information Statement - Hospital policy

Gold Hospital $250 Excess

Monthly Premium

$605.90 #

(before any rebate, loading or discount)

Covers 2 adults (and no-one else)

Available in NSW & ACT

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.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy does not provide accident cover.

This policy includes cover for

Hospital Cover Legend
Assisted reproductive servicesEye (not cataracts)Miscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hospital psychiatric servicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
CataractsImplantation of hearing devicesPregnancy and birth
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestWeight loss surgery
Ear, nose and throatMale 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.

The following payments may also apply for hospital admissions

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.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Hospital Accommodation

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.

Gap Cover

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.

Other features of this hospital cover

Comprehensive Hospital cover & benefits to help with in-hospital meals & accommodation for a loved one to join you. For more details on the product contact Bupa.

Ambulance cover

In NSW & ACT 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.

Other features of this ambulance cover

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.

For further information about this policy see

http://www.bupa.com.au/health-insurance/cover/ambulance

Disclaimer

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.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

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.

Not Covered

These categories are not covered by this policy.