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Bupa health insurance packages

Find out what you get when you bundle Bupa’s hospital and extras cover.

Bupa is one of Australia’s leading healthcare organisations, taking care of the needs of 4.7 million Australians. Its parent company, Bupa Group, delivers healthcare to more than 32 million people in 190 countries.

Bupa offers separate hospital and extras plans, as well as combined packages which deliver both in one policy. We'll look at those here.

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What hospital and extras packages does Bupa offer?

Bupa offers a wide range of packages to suit everyone’s needs, from singles to couples and families. These include:

  • Active Saver
  • Lite Hospital with Budget Extras 60
  • Young Singles Saver
  • Mid Hospital with Budget Extras 60
  • Lite Hospital with Your Choice Extras 60
  • Mid Hospital with Your Choice Extras 60
  • Young Singles Choice
  • Lite Hospital with Top Extras 60
  • Mid Hoospital with Top Extras 60
  • Top Hospital no Pregnancy with Budget Extras 60
  • Top Hospital with Pregnancy with Budget Extras 60
  • Lite Hospital with Top Extras 75
  • Top Hospital no Pregnancy with Your CHoice Extras 60
  • Top Hospital with Pregnancy with Your Choice Extras 60
  • Mid Hospital with Top Extras 75
  • Top Hospital no Pregnancy with Top Extras 60
  • Lite Hospital with Top Extras 90
  • Top Hospital with Pregnancy Top Extras 60
  • Mid Hospital with Top Extras 90
  • Top Hospital no Pregnancy with Top Extras 75
  • Top Hospital with Top Extras 75
  • Top Hospital no Pregnancy with Top Extras 90
  • Top Hospital with Pregnancy with Top Extras 90
  • Ultimate Health Cover

What is unemployment cover?

From the second month of retrenchment or involuntary unemployment, your premiums are covered for up to 12 months at your current level of insurance.

With couples or family health plans, only the main income earner is eligible for unemployment cover benefits. To be eligible, you must meet the following criteria:

  • You have been with the same company for 6 months prior to unemployment.
  • You are not a contractor or self-employed.
  • You have held your health cover for 12 months.
  • You can provide proof of unemployment.

Other cover features

In general, Bupa packages are designed to offer cost-effective hospital plus extras insurance. However, they all provide relatively basic cover, with the exception of Prime Plus and Ultimate Health, which are much more comprehensive but cost a lot more.

It’s important to note that until you reach the Young Singles Choice option, you are not covered for any other Medicare procedures than the ones listed in the table. From Young Singles Choice upwards, you get a significantly higher level of hospital cover.

The only package which offers pregnancy cover is Ultimate Health Cover. If you’re looking for a health fund to cover pregnancy, but don’t feel the need for a comprehensive extras plan, then you may be able to save money by considering separate hospital and extras policies.

In all cases, you receive more back on extras services when you use Members First providers, which are partnered with Bupa. However, the Simple Start plan covers services that are supplied by Members First providers only. If there is no such provider in your area, you should consider a different plan or health fund.

What are the benefits of Bupa?

All the packages enable you to access the Bupa Medical Gap Scheme, or Access Gap Cover, for hospital treatments covered under your plan. This allows you to know ahead of time whether there will be any out-of-pocket expenses, and how much it will be.

Other benefits include:

  • Overseas health advice line: Bupa provides a 24-hour health advice line so you can receive assistance while overseas. You can get answers to simple health questions, medical referrals, translation services, assistance making bookings, and someone to liaise with your family, insurer or another person if necessary.
  • Bupa Plus: A range of health related discounts and bonuses, such as free personal trainer sessions, and significant discounts on a variety of fitness products.
  • No-gap in-hospital pathology and radiology diagnostics: If recognised by Medicare and performed by Bupa-contracted providers, you can have certain diagnostic services with no out-of-pocket expenses when performed in a hospital.

Limitations of Bupa cover

You are only able to claim for treatments provided at a hospital that has an agreement with Bupa, or for services and treatments provided by a registered private practitioner that is recognised by Bupa. With Simple Start cover in particular, your choice of extras providers is limited to Members First practitioners only.

Ambulance cover is included with all Bupa packages, but only for emergencies. This does not include ambulance transport from a hospital to your home, from a hospital to a nursing home or to other non-emergency situations.

Waiting periods also apply, and you cannot make claims during this period.

Hospital waiting periods
  • 12 months for pre-existing conditions, pregnancy and childbirth
  • 2 months for everything else, including psychiatric treatment for pre-existing conditions, palliative care and rehabilitation
Extras waiting periods
  • 12 months for health aids, orthodontics and major dental
  • 6 months for lifestyle benefits, such as the cost of gym memberships
  • 2 months for everything else

How do I make a claim?

In many cases you won’t have to worry about claiming hospital cover, as agreement hospitals can pass on the bill to Bupa directly. You will still need to pay any relevant gap expenses, excess or co-payment to the hospital or practitioner.

To claim extras services there are several options:

  • On the spot. Around 20,000 service providers around Australia accept Bupa membership cards. Simply swipe your membership card, and then pay any difference.
  • Online. Sign in to your myBupa account and enter the details on your receipt, and the reimbursement will be paid automatically to your nominated account. This method is not available for ambulance, health aids, orthodontics, travel/accommodation or pharmacy extras claims.
  • By post. Fill out a claim form, attach your receipt and invoice and then post it to Bupa Reply Paid 990, Adelaide SA 5001. Payments will then be made to you by EFT if you’ve provided your details on the form, or by cheque if you haven’t.
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