Private Health Information Statement - General treatment policy

Extracover

Monthly Premium

$90.90 #

(before any rebate or insurer discount)

Covers two adults & dependants (3 or more people, only 2 of whom are adults)

Available in Northern Territory

Closed to new members

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include an insurer discount. Check with your insurer for details.

This policy covers children and other dependants up to and including the age of 20, students up to and including the age of 31, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

General Treatment Cover

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.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Home nursing covers selected services. Podiatry does not include Orthotics. Where applicable, benefits may be payable under Health Aids & Appliances. Dentures payable once every 3 years. No Annual Limit for Endodontic and oral surgery treatments. Crowns, Bridges & Dentures: $1000 per person. Periodontics: $1000 lifetime limit. Indirect Restorations/Posts/Veneers: $450 per person. Periodic oral examination (012), Scale & Clean (114), Fluoride treatment (121) payable once every 6 months. Pharmacy benefit paid after current PBS patient contribution deducted.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2No annual limit
(no limit on preventative dental)
Periodic oral examination - $11.00
Scale & clean - $28.50
Fluoride treatment - $10.00
Surgical tooth extraction - $58.50
Major dental*12$1,000 per person
(combined limit for major dental & endodontic - Sub-limits apply)
Full crown veneered - $620.00
Endodontic12Filling of one root canal - $120.00
Orthodontic*12$875 per person
$1,650 lifetime limit
Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge
Optical2$200 per personSingle vision lenses & frames - $143.00
Multi-focal lenses & frames - $179.50
Non PBS pharmaceuticals*2$500 per personPer eligible prescription - $50.00
Physiotherapy2$1,250 per person up to $300 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 & other services - Sub-limits apply)
Initial visit - $30.50
Subsequent visit - $23.50
Chiropractic2Initial visit - $35.00
Subsequent visit - $25.00
Podiatry*2Initial visit - $27.00
Subsequent visit - $20.00
Psychology2Initial visit - $48.50
Subsequent visit - $32.00
Hearing aids12$500 per person
2 appliance(s) every 3 years
Hearing aid - $500.00
Blood glucose monitors12$1,000 per person
(combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services - Sub-limits apply)
Per monitor - $106.15
Ante-natal/Post-natal classes2Combined limit - see PhysiotherapyInitial visit - $10.00
Subsequent visit - $10.00
Dietetics/dietary advice2Combined limit - see PhysiotherapyInitial visit - $53.00
Subsequent visit - $26.00
Eye therapy (orthoptics)0Combined limit - see PhysiotherapyInitial visit - $27.00
Subsequent visit - $21.00
Home nursing*2$500 per personInitial visit - $10.00
Subsequent visit - $10.00
Occupational therapy2Combined limit - see PhysiotherapyInitial visit - $52.50
Subsequent visit - $41.00
Orthotics (podiatric orthoses)*12Combined limit - see Blood glucose monitorsOrthotics supply & fit - $75.00
Osteopathy2Combined limit - see PhysiotherapyInitial visit - $33.00
Subsequent visit - $23.50
Speech therapy2Combined limit - see PhysiotherapyInitial visit - $31.00
Subsequent visit - $24.00
Online Doctors Appointments, 100% of charge up to the yearly service limit of 3 per person, benefits payable for Blua Online Doctor Appointments only, benefits are not payable for services included in the Medicare Benefit Schedule (MBS), refer to blua.bupa.com.au for more details. Travel 100% up to $100. Accommodation (per night) $30 up to $150. Where applicable, benefits will be paid under your Hospital cover (cannot claim benefits on both hospital and extras for the same trip). Eligibility criteria apply. 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 $1000 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.

This policy does not include General treatment (Extras) cover for

General treatment legend
AcupunctureRemedial massageOther treatments - check with your insurer

Other features of this general treatment cover

Includes cover for Home/Bush Nursing & School Accidents. Physio has a separate sub-limit of $800 per person. More at myBupa.com.au & in the Important Information Guide at bupa.com.au

Ambulance cover

In Northern Territory this policy provides:

Emergency: with no waiting period, limited to 2 services per year.

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 costs associated with emergency ambulance transport services, including on-the-spot emergency attendances where the service is provided by a Bupa recognised ambulance service capped at one trip for singles and two trips for couples memberships per calendar year. 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.