(before any rebate, loading or discount)
Covers only one person
Available in South Australia
# 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 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.
| Blood | Gastrointestinal endoscopy | Pain management |
| Bone, joint and muscle | Gynaecology | Pain management with device |
| Brain and nervous system | Hernia and appendix | Palliative care |
| Breast surgery (medically necessary) | Implantation of hearing devices | Plastic and reconstructive surgery (medically necessary) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | Hospital psychiatric services |
| Eye (not cataracts) | Miscarriage and termination of pregnancy | Rehabilitation |
| Assisted reproductive services | Dialysis for chronic kidney failure | Pregnancy and birth |
| Back, neck and spine | Heart and vascular system | Weight loss surgery |
| Cataracts | Joint replacements |
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: No excess
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.
Cover for a limited set of hospital services to help protect you from the unexpected. 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 60% back, up to your yearly limits. See http://www.bupa.com.au/find-a-provider.
| Note, for items marked with an asterisk *: 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. Orthodontic treatment is only covered if resulting from an accident requiring immediate medical attention sustained after joining this cover. 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 | $850 per policy (combined limit for general dental, major dental, endodontic & orthodontic) | Periodic oral examination - $19.00 Scale & clean - $40.50 Fluoride treatment - $15.00 Surgical tooth extraction - $58.00 |
| Major dental* | 12 | Full crown veneered - $425.00 | |
| Endodontic | 12 | Filling of one root canal - $84.00 | |
| Orthodontic* | 0 | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge | |
| Optical | 2 | $150 per policy | Single vision lenses & frames - $145.00 Multi-focal lenses & frames - $150.00 |
| Non PBS pharmaceuticals* | 2 | $200 per policy | Per eligible prescription - $40.00 |
| Physiotherapy | 2 | $500 per policy (combined limit for physiotherapy, chiropractic & osteopathy) | Initial visit - $26.00 Subsequent visit - $18.00 |
| Chiropractic* | 2 | Initial visit - $24.00 Subsequent visit - $16.50 | |
| Podiatry* | 2 | $300 per policy | Initial visit - $23.00 Subsequent visit - $17.00 |
| Psychology | 2 | $300 per policy | Initial visit - $92.50 Subsequent visit - $86.00 |
| Acupuncture | 2 | $500 per policy (combined limit for acupuncture, remedial massage, chinese medicine & exercise physiology - Sub-limits apply) | Initial visit - $22.00 Subsequent visit - $18.00 |
| Remedial massage | 2 | Initial visit - $22.00 Subsequent visit - $20.50 | |
| Chinese medicine | 2 | Initial visit - $17.00 Subsequent visit - $17.00 | |
| Dietetics/dietary advice | 2 | $300 per policy | Initial visit - $37.00 Subsequent visit - $19.00 |
| Exercise physiology | 2 | Combined limit - see Acupuncture | Initial visit - $17.00 Subsequent visit - $17.00 |
| Health management / Healthy lifestyle | 6 | $75 per policy | Health management - 50% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $29.50 Subsequent visit - $20.50 |
| 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 | Other treatments - check with your insurer |
Enjoy a Top-up Bonus of $75-$150 every year to help pay out-of-pocket extras expenses payable on your cover.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
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.