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Bupa Health Insurance

Bupa health insurance review

Our verdict: Bupa health insurance is one of Australia’s most popular funds, in part due to its great value policies and good customer service.

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Pros

  • Basic Plus Starter is the cheapest plan on Finder to cover joint reconstruction, lung and chest; and miscarriage and termination of pregnancy.
  • It's popular. Bupa is the second-largest health insurer by market share, just behind Medibank.
  • Flexibility – with Bupa FLEXtras, you can pick the extras you'll actually use.
  • Bupa had proportionally fewer complaints than other funds including Medibank, HCF and nib*.

Cons

  • Bupa is for-profit, which might matter to some people who want to look for a not-for-profit health fund.
  • Gold Complete may not be the best value option for top tier cover. While it's very comprehensive and costs around $189.99 a month, Bupa's Silver Plus Advanced covers most Gold tier treatments from around $156.25 a month.

Bupa health insurance: Our verdict

Bupa health insurance is Australia's second-biggest health fund, has over 4 million members and provides good value Basic, Bronze and Silver policies.

Bupa is good if:

  • You want good value for your money, particularly its Basic, Bronze and Silver Plus policies.
  • You want an insurer with good customer service – Bupa receives proportionally fewer complaints than most other funds.
  • You appreciate some flexibility with your insurance. Bupa FLEXtras lets you choose either 4 or 6 extras that will suit your needs, and you can opt for a standard or higher annual claims limit.

Bupa is not great if:

  • You want a not-for-profit health fund.
  • You want the cheapest Gold policy on the market.

Review by our insurance writer Gary Hunter

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What types of health insurance does Bupa offer?

Hospital icon

Hospital coverage

Bupa hospital cover policies now reflect the new government private health insurance tiers. It offers the following hospital cover options:

  • Basic Accident Only Hospital. This covers you for things like operating theatre, intensive care and ward fees. It also comes with a feature called Accident Inclusion. For accidents sustained after joining, treatment which is restricted or is an exclusion on this cover may be payable in the same way as an included service.
  • Basic Plus Starter Hospital. As well as Accident Inclusion, this one comes with services such as tonsils, adenoids and grommets, joint reconstructions and dental surgery.
  • Bronze Plus Simple Hospital. This covers a handful of important treatments like cancer treatments, dental surgery, brain and nervous system, tonsils and hernia repair.
  • Silver Plus Essential Hospital. This covers you for 29 of the 38 clinical categories, a few more than the minimum requirement for silver, which is 26.
  • Silver Plus Advanced Hospital. This covers you for several gold tier services like, cataracts, joint replacements, and sleep studies.
  • Gold Complete Hospital. This includes all 38 government-approved treatments you'd receive in a hospital including pregnancy, assisted reproductive services and weight loss surgery.

It's important to note that Bupa plans do not cover the following procedures:

  • Surgical podiatry (a restricted benefit is paid)
  • Cosmetic procedures that are not medically necessary
  • Respite care
  • Experimental treatments
  • Certain high-cost non-PBS drugs
  • Any treatment or procedure for which Medicare does not pay a benefit.

In addition, you will not have cover for the following:

  • Outpatient treatments
  • Hospital co-payments and excess
  • Psychiatric and day programs at non-Bupa partner hospitals
  • Treatments provided by unregistered providers
  • Personal in-hospital expenses like pay TV, newspapers and similar
  • Any services or treatments provided outside of Australia
  • Any pharmacy items purchased and not opened before leaving hospital

Extras icon

Extras coverage

Here are each of the extras plans offered by Bupa, with a quick summary of what each includes.

  • Extras Saver. Bupa's most budget-conscious plan offers 50% back on general dental treatment and cover for one emergency ambulance service per year.
  • Freedom 50 Extras. With Freedom 50 Extras, you'll get 50% back at any provider for services including general dental, physio, chiro and osteo, up to your yearly limits. You'll also get a flexi-limit, which allows you to spread your annual limit across a range of services or use the entire limit on one service.
  • Starter Extras. With Starter Extras, you'll get 60% back at Bupa's selected providers for services including general dental, physio, chiro & osteo and remedial massage up to your yearly limits. Plus, if you combine your cover with Bupa's hospital cover, you'll be able to claim in full for 2 dental check-ups each year.
  • Freedom 60 Extras. This extras policy also gives you 60% back at any provider for services like general dental, physio, chiro and osteo, up to your yearly limits. Furthermore, you can claim your 60% back at any recognised service provider.
  • Value Extras. This covers your basic treatments like general dental, optical and a range of therapies like physio and chiro but it also includes treatments you usually find in higher level policies like major dental. This plan also includes digital mental health services and emergency ambulance cover. Bupa reimburses you 60% toward most covered treatments, but these services need to be accessed via Bupa's selected providers.
  • FLEXtras. Bupa has introduced FLEXtras cover which lets you customise your extras and limits so that you're only paying for services you'll use. Bupa FLEXtras can offer up to 60% back on 4 or 6 claim categories (up to any annual limits) with any recognised provider. Worth noting that mental health, psychology and digital mental health services all count as one service. You can swap out a service when your limits reset. Plus, emergency ambulance services are included.
  • Lifestyle Extras. This covers your basic treatments like general dental, optical and a range of therapies like physio and chiro but it also includes treatments you usually find in higher level policies such as non-Pharmaceutical Benefits Scheme (PBS) medicines. It also includes emergency ambulance cover. Bupa reimburses you 60% toward most covered treatments with Bupa's selected providers.
  • Super Extras. This covers your treatments such as both general dental, optical and a range of therapies like physio and chiro but it also includes treatments you usually find in more comprehensive policies such as major dental, exercise physiology and mental health (including psychology) services. It also includes emergency ambulance cover. Bupa reimburses you 60% toward most covered treatments with Bupa's selected providers.
  • Super Extras Active. This wide-ranging cover includes orthodontics, making it a good option for families. It also includes treatments you usually find in higher level policies like antenatal and postnatal treatments, dietary services, exercise physiology and pharmacy. It also includes emergency ambulance cover. Bupa reimburses you up to 60% toward most covered treatments at Bupa chosen providers.
  • Top Extras. This is much the same cover as the Super Extras Active policy, but with a 70% reimbursement rate instead of 60%. It also has higher benefit limits on many treatments.
  • Top Extras Boost. This top-tier plan comes with a 80% reimbursement rate and higher benefit limits on most treatments.

Clipboard icon

Combined coverage

You can combine any of the standalone hospital policies with any of the extras policies to create your own customised packaged cover. Or you can choose one of Bupa's unique packages that combine hospital and extras cover that you can't buy individually. These are:

  • Basic Plus Active Saver. This package is for someone who wants an entry level of both hospital and extras cover. The hospital portion covers a handful of basic treatments like tonsils, adenoids and grommets, joint reconstructions, dental surgery plus restricted cover for hospital psychiatric services, rehab and palliative care. Extras include a variety of basic inclusions such as general dental, physio, chiro and more – all of which have a combined limit of $1,000.
  • Basic Plus Young Singles/Couples Saver. With this package, the hospital portion covers basic treatments like gynaecology, miscarriage and termination of pregnancy, and tonsils, adenoids and grommets. Your extras cover will give you 60% back on most treatments from Bupa's provider network, with cover for general and major dental, optical, podiatry and travel vaccines. Orthodontics is also covered if treatment is required as a result of an accident.
  • Bronze Plus Young Singles/Couples Choice. The hospital portion of this cover includes everything necessary for it to be classed as bronze, plus 9 other benefits like sleep studies, dental surgery, blood and lung and chest cover. Extras offer services suitable for most young singles and couples, with higher benefit limits that those of Young Singles/Couples Saver. Like Young Singles/Couples Saver, orthodontics is covered if treatment is required as a result of an accident.
  • Silver Plus Prime. This gives you top cover that's tailored to life's later years, minus the services you don't need like pregnancy and birth. As well as everything you get with a silver policy, you'll also get insulin pumps, pain management with device, sleep studies, joint replacements and a generous range of extras services.
  • Gold Ultimate Health Cover. The hospital portion of this includes all 38 clinical categories, meaning you're covered for everything medically necessary in a private hospital. It also includes up to 100% back at Members First providers for selected services, and the highest benefit limits on all extras services that Bupa offers.

Ambulance icon

Ambulance coverage

  • Emergency Only Ambulance Cover. Covers you for unlimited emergency ambulance trips including air services and on-the-spot treatment Australia wide, when provided by recognised providers.
  • Premium Ambulance Cover. Covers you for unlimited emergency ambulance trips including air services and on-the-spot treatment Australia wide, when provided by recognised providers. You're also covered for non-emergency ambulance trips including air services when provided by recognised providers and are capped at $5,000 per person per calendar year.

Bupa health insurance complaints

We looked at the 2020 Ombudsman health insurance complaints. Here's how Bupa stacked up:

  • It's customer service is among the best compared to other large brands. With a market share of 25.4%, only 21.5% of total complaints were about Bupa. This is a better complaint ratio than most of Australia's other large funds including Medibank, HCF and nib.*
  • While it has few complaints compared to market share, it's not quite number 1. TUH, HBF and St.Lukes scored slightly better.
This chart shows the weighted volume of complaints received by each health fund, according to the Commonwealth Ombudsman. The lower the number, the better. Bupa is fourth overall in this ranking. The weighting ensures that funds are compared fairly; larger funds serve more customers so can potentially get more complaints.

Bupa frequently asked questions

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18 Responses

  1. Default Gravatar
    JahneMay 9, 2017

    I am a teacher of yoga teachers (Director The Australasian Yoga institute Established 1976) and an accredited Senior Teacher with Yoga Australia. I believe my clients are able to claim rebates from your fund by quoting my membership number etc. How can my Institute become an Accredited Institute with you so that my graduated/registered students can provide rebates for their clients through you, as we do at the moment through registering through Yoga Australia?

    • Avatarfinder Customer Care
      ZubairMay 10, 2017Staff

      Hi Jahne,

      Thank you for your inquiry.

      You have contacted finder.com.au, a comparison and information service and not actually Bupa Health Insurance. You will need to contact Bupa Health Insurance directly about this matter.

      Cheers,
      Zubair

  2. Default Gravatar
    LorraineMarch 29, 2017

    I am. Carer for my grandchildren I am looking for an affordable extras cover for myself I did not expect to be a single parent at my age

    • Avatarfinder Customer Care
      ZubairMarch 30, 2017Staff

      Hi Lorraine,

      Thank you for your question.

      You have contacted finder.com.au, a comparison and information service and not Bupa.

      If you would like to compare policies from Australian health funds including Bupa Health Fund, please enter your details into quote comparison tool.

      Cheers,
      Zubair

  3. Default Gravatar
    JohnFebruary 8, 2017

    will BUPA pay for standard of care items for patients who are receiving innovative therapies in a clinical trial environment

    • Avatarfinder Customer Care
      RichardFebruary 9, 2017Staff

      Hi John,

      Thanks for getting in touch. You will need to contact Bupa directly about this matter as the exact cover would depend on the treatment and your policy.

      Cheers,
      Richard

  4. Default Gravatar
    VesnaJanuary 19, 2017

    Does Bupa hospital cover, cover the cost or help with the cost of aged care ie nursing home or in home care for the elderly
    Thank you

    • Avatarfinder Customer Care
      RichardJanuary 24, 2017Staff

      Hi Vesna,

      Thanks for getting in touch. Depending on your policy, Bupa may provide limited cover for services such as in-home physiotherapy, respite care and nursing care. Restrictions apply, mostly only for orthopedic. You should contact Bupa directly about the specifics of your policy.

      All the best,
      Richard

  5. Default Gravatar
    MaryNovember 21, 2016

    Does BUPA offer extra government rebates for seniors as some health funds do?

    • Avatarfinder Customer Care
      RichardNovember 21, 2016Staff

      Hi Mary,

      Thanks for getting in touch. Bupa does not have any additional government rebates. You may find our seniors health insurance article helpful.

      All the best,
      Richard

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