Bupa drops minimum benefits from basic cover options

Posted: 3 March 2018 7:06 am

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The changes to affect 35% of its customer base.

This year Bupa will be dropping minimum benefits (restricted cover) from its basic cover options, something that will impact roughly a third (35%) of its member base. Those with higher cover options won't be affected.

The decision to remove these minimum benefits comes after Bupa discovered there was some confusion with its members regarding the value of restricted cover.

Minimum benefits provide members with only the basic cover, which is roughly equal to what a public hospital would charge a private patient for a shared room. So if a patient chooses to be treated in a private hospital, their policy would only cover a fraction of what the private hospital costs. This has left many customers confused and with hefty out-of-pocket expenses.

It's hoped that by removing cover for these items, not only will there be less confusion over what's covered but that Bupa will be able to better use the money its customers are paying with their premiums.

"To help keep premiums as low as possible, we are changing most services from 'minimum benefits’ (restricted cover) to exclusions and redistributing that money into a lower premium increase and additional benefits such as introducing gap free dental care on a number of common preventative dental services at selected dentists," a Bupa spokesperson said in a statement.

But, which services will be affected? The change won't affect all services for psychiatric, rehabilitation and palliative care, as some products will still cover the minimum benefit. But from 1 July 2018, some procedures will be excluded on all policies including:

  • Hip and knee replacement
  • Cataract and eye lens procedures
  • Pregnancy and birth related services
  • IVF and assisted reproductive services
  • Obesity related procedures and surgeries
  • Abdominoplasty and lipectomy

Anyone impacted by these changes will be contacted by mail or email.

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