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Bupa HI Pty Ltd

Silver Plus Prime $750 Excess

$216.20 / month

(Before Rebate, Discount & Loading)

Available in NT

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/J21D/DJKJ10 Source: Private Health Information Statement (PHIS)

Hospital Cover

Covered

Restricted Cover

Not Covered

This policy includes cover for

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)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Pregnancy and birth

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: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $750 per policy per year.

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
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

Hospital and Extras for people who no longer need cover for Pregnancy and birth or Assisted reproductive services. 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 70% back, up to your yearly limits. See http://www.bupa.com.au/find-a-provider.

Policy ID: BUP/J21D/DJKJ10 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. 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. 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

$300 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, exercise physiology & remedial massage

Initial visit: $30
Subsequent visit: $22

Blood glucose monitors*

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

sub-limits apply

Per monitor: 70% of charge

Chinese medicine

$300 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, exercise physiology & remedial massage

Initial visit: $24
Subsequent visit: $18

Chiropractic*

$350 per policy

combined limit for chiropractic & osteopathy

Initial visit: $24.8
Subsequent visit: $17.7

Dietetics/dietary advice

$300 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, exercise physiology & remedial massage

Initial visit: $46
Subsequent visit: $23

Endodontic

$1,000 per policy

combined limit for endodontic & major dental

Filling of one root canal: $150

Exercise physiology

$300 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, exercise physiology & remedial massage

Initial visit: $24
Subsequent visit: $18

General dental*

No annual limit

Fluoride treatment: $15
Scale & clean: $51.5
Surgical tooth extraction: $82.1
Periodic oral examination: $24

Health management / Healthy lifestyle

$100 per policy

Health management: 50% of charge

Hearing aids*

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

sub-limits apply

Hearing aid: 70% of charge

Home nursing*

$200 per policy

Initial visit: $35
Subsequent visit: $35

Major dental*

$1,000 per policy

combined limit for endodontic & major dental

Full crown veneered: $790

Non PBS pharmaceuticals*

$350 per policy

Per eligible prescription: $40

Occupational therapy

$500 per policy

combined limit for occupational therapy & physiotherapy

Initial visit: $81.5
Subsequent visit: $54.5

Optical

$180 per policy

Multi-focal lenses & frames: $180
Single vision lenses & frames: $174.5

Orthotics (podiatric orthoses)

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

sub-limits apply

Orthotics supply & fit: 70% of charge

Osteopathy*

$350 per policy

combined limit for chiropractic & osteopathy

Initial visit: $30.5
Subsequent visit: $22

Physiotherapy

$500 per policy

combined limit for occupational therapy & physiotherapy

Initial visit: $36
Subsequent visit: $29.5

Podiatry*

$400 per policy

Initial visit: $35
Subsequent visit: $30

Psychology

$200 per policy

Initial visit: $89
Subsequent visit: $73.5

Remedial massage

$300 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, exercise physiology & remedial massage

sub-limits apply

Initial visit: $36.5
Subsequent visit: $27.5

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. 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, orthotics, and other health aids, are payable under the Health Appliances category up to $800 per year. Sub-limits and restrictions apply. Blood glucose monitors are payable once per year (sub-limit $400). Hearing aids are payable once every 3 years (sub-limit $500). 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

Ante-natal/Post-natal classes

Audiology

Eye therapy (orthoptics)

Orthodontic

Speech therapy

Vaccinations

Other features of this general treatment cover: Enjoy a Top-up Bonus of $50-$100 every year to help pay out-of-pocket extras expenses payable on your cover.

Ambulance cover

In NT 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 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

Silver Plus Prime $750 Excess

$216.20 / month

(Before Rebate, Discount & Loading)

Available in NT

Call now 134 135 Sponsor link

Bupa HI Pty Ltd

http://www.bupa.com.au

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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/J21D/DJKJ10