Private Health Information Statement - Combined policy

Silver Plus Prime $500 Excess

Monthly Premium

$712.30 #

(before any rebate, loading or discount)

Covers 2 adults (and no-one else)

Available in Tasmania

# 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
Back, neck and spineEye (not cataracts)Male reproductive system
BloodGastrointestinal endoscopyMiscarriage and termination of pregnancy
Bone, joint and muscleGynaecologyPain management
Brain and nervous systemHeart and vascular systemPain management with device
Breast surgery (medically necessary)Hernia and appendixPalliative care
CataractsHospital psychiatric servicesPlastic and reconstructive surgery (medically necessary)
Chemotherapy, radiotherapy and immunotherapy for cancerImplantation of hearing devicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Dental surgeryInsulin pumpsRehabilitation
Diabetes management (excluding insulin pumps)Joint reconstructionsSkin
Dialysis for chronic kidney failureJoint replacementsSleep studies
Digestive systemKidney and bladderTonsils, adenoids and grommets
Ear, nose and throatLung and chest

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesPregnancy and birthWeight loss surgery

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 $500 per admission. This is limited to a maximum of $500 per person and $1000 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
  • 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

Hospital and Extras for people who no longer need cover for Pregnancy and birth or Assisted reproductive services. For more details on the product contact Bupa.

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. Step down benefits apply after first 10 total services across Chiropractic and Osteopathy. 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.
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 - $22.50
Scale & clean - $38.00
Fluoride treatment - $20.00
Surgical tooth extraction - $65.00
Major dental*12$1,000 per person
(combined limit for major dental & endodontic)
Full crown veneered - $615.00
Endodontic12Filling of one root canal - $110.00
Optical2$180 per personSingle vision lenses & frames - $174.50
Multi-focal lenses & frames - $180.00
Non PBS pharmaceuticals*2$350 per personPer eligible prescription - $40.00
Physiotherapy2$500 per person
(combined limit for physiotherapy & occupational therapy)
Initial visit - $27.00
Subsequent visit - $20.50
Chiropractic*2$350 per person up to $700 per policy
(combined limit for chiropractic & osteopathy)
Initial visit - $24.00
Subsequent visit - $18.00
Podiatry*2$400 per personInitial visit - $33.00
Subsequent visit - $30.00
Psychology2$200 per personInitial visit - $77.00
Subsequent visit - $71.50
Acupuncture2$300 per person
(combined limit for acupuncture, remedial massage, chinese medicine, dietetics/dietary advice & exercise physiology - Sub-limits apply)
Initial visit - $30.00
Subsequent visit - $22.00
Remedial massage2Initial visit - $36.50
Subsequent visit - $27.50
Hearing aids*12$800 per person
(combined limit for hearing aids, blood glucose monitors, orthotics (podiatric orthoses) & other services - Sub-limits apply)
Hearing aid - 70% of charge
Blood glucose monitors*12Per monitor - 70% of charge
Chinese medicine2Combined limit - see AcupunctureInitial visit - $24.00
Subsequent visit - $18.00
Dietetics/dietary advice2Combined limit - see AcupunctureInitial visit - $46.00
Subsequent visit - $23.00
Exercise physiology2Combined limit - see AcupunctureInitial visit - $24.00
Subsequent visit - $18.00
Health management / Healthy lifestyle6$100 per personHealth management - 50% of charge
Home nursing*2$200 per personInitial visit - $35.00
Subsequent visit - $35.00
Occupational therapy2Combined limit - see PhysiotherapyInitial visit - $49.50
Subsequent visit - $35.50
Orthotics (podiatric orthoses)12Combined limit - see Hearing aidsOrthotics supply & fit - 70% of charge
Osteopathy*2Combined limit - see ChiropracticInitial visit - $29.50
Subsequent visit - $22.00
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. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits apply for Digital Mental Health. Blood glucose monitors, hearing aids, orthotics, and other health aids, are payable under the Health Appliances category up to $800 per year. Sub-limits and restrictions apply. Blood glucose monitors are payable once per year (sub-limit $400). Hearing aids are payable once every 3 years (sub-limit $500). 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
OrthodonticOther treatments - check with your insurer

Other features of this general treatment cover

Enjoy a Top-up Bonus of $50-$100 every year to help pay out-of-pocket extras expenses payable on your cover.

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

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.