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Bupa HI Pty Ltd

Gold Ultimate Health Cover

$605.65 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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 covers: Only one person.

This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover.
This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.

Policy ID: BUP/J1/NAWX10 Source: Private Health Information Statement (PHIS)

Hospital Cover

Covered

Restricted Cover

Not Covered

This policy includes cover for

Assisted reproductive services

Back, neck and spine

Blood

Bone, joint and muscle

Brain and nervous system

Breast surgery (medically necessary)

Cataracts

Chemotherapy, radiotherapy and immunotherapy for cancer

Dental surgery

Diabetes management (excluding insulin pumps)

Dialysis for chronic kidney failure

Digestive system

Ear, nose and throat

Eye (not cataracts)

Gastrointestinal endoscopy

Gynaecology

Heart and vascular system

Hernia and appendix

Hospital psychiatric services

Implantation of hearing devices

Insulin pumps

Joint reconstructions

Joint replacements

Kidney and bladder

Lung and chest

Male reproductive system

Miscarriage and termination of pregnancy

Pain management

Pain management with device

Palliative care

Plastic and reconstructive surgery (medically necessary)

Podiatric surgery (provided by a registered podiatric surgeon)

Pregnancy and birth

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

Weight 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: No excess

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
12 months for pregnancy and birth (obstetrics)
2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

You get a Gap Bonus to help pay for medical gaps when admitted to hospital. Plus, access to an advice line to help you navigate the health system. 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 100% back, up to your yearly limits. See http://www.bupa.com.au/find-a-provider.

Policy ID: BUP/J1/NAWX10 Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Note, for treatments marked with * : Home nursing covers selected services. 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.

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$1,000 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

Initial visit: $43
Subsequent visit: $34

Ante-natal/Post-natal classes

$500 per policy

Initial visit: $22
Subsequent visit: $22

Blood glucose monitors*

$600 per policy

Per monitor: 85% of charge

Chinese medicine

$1,000 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

Initial visit: $35.2
Subsequent visit: $26.4

Chiropractic*

$1,000 per policy

combined limit for chiropractic & osteopathy

Initial visit: $55.8
Subsequent visit: $38.5

Dietetics/dietary advice

$1,000 per policy

Initial visit: $64
Subsequent visit: $41

Endodontic

$1,600 per policy

combined limit for endodontic & major dental

Filling of one root canal: $280.5

Exercise physiology

$1,000 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

Initial visit: $35.2
Subsequent visit: $26.4

Eye therapy (orthoptics)

$1,000 per policy

Initial visit: $60
Subsequent visit: $40

General dental*

No annual limit

Fluoride treatment: $35
Scale & clean: $83
Surgical tooth extraction: $132
Periodic oral examination: $41

Health management / Healthy lifestyle

$300 per policy

Health management: 50% of charge

Hearing aids*

$850 per policy

Hearing aid: 100% of charge

Home nursing*

$400 per policy

Initial visit: $44
Subsequent visit: $44

Major dental*

$1,600 per policy

combined limit for endodontic & major dental

Full crown veneered: $1408

Non PBS pharmaceuticals*

$1,500 per policy

Per eligible prescription: $75

Occupational therapy

$1,000 per policy

Initial visit: $110.5
Subsequent visit: $78

Optical

$420 per policy

Multi-focal lenses & frames: $385.5
Single vision lenses & frames: $288

Orthodontic*

$1,600 per policy

$3,200 lifetime limit

Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge

Orthotics (podiatric orthoses)*

$1,000 per policy

sub-limits apply

Orthotics supply & fit: $100

Osteopathy

$1,000 per policy

combined limit for chiropractic & osteopathy

Initial visit: $69
Subsequent visit: $47.5

Physiotherapy*

$1,500 per policy

Initial visit: $62.5
Subsequent visit: $52.5

Podiatry

$1,000 per policy

Initial visit: $65
Subsequent visit: $45.1

Psychology

$1,000 per policy

Initial visit: $147.5
Subsequent visit: $131

Remedial massage

$1,000 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

sub-limits apply

Initial visit: $62.5
Subsequent visit: $55

Speech therapy

$1,000 per policy

Initial visit: $112
Subsequent visit: $74

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. Travel 100% up to $200. Accommodation (per night) $40 up to $300. Where applicable, benefits will be paid under your Hospital cover (cannot claim benefits on both hospital and extras for the same trip). Eligibility criteria apply. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits apply for Digital Mental Health. Orthotics, and other health aids, are payable under the Health Appliances category up to $1000 per year. Sub-limits and restrictions apply. 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

Audiology

Vaccinations

Other features of this general treatment cover: When requiring urgent hospital treatment as the result of an accident, the Accident Benefit can boost extras limits (subject to eligibility criteria).

Ambulance cover

In NSW & ACT 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.

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

Insurer Details

Bupa HI Pty Ltd

Gold Ultimate Health Cover

$605.65 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

Call now 134 135 Sponsor link

Bupa HI Pty Ltd

http://www.bupa.com.au

134 135

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/BUP/J1/NAWX10