Bupa Health Insurer Profile
Bupa has existed for over 60 years and is one of Australia’s leading health funds. They provide health insurance and wellbeing support to over 4.7 million customers in Australia and New Zealand. They are part of the Bupa group which provides health care to more than 22 million people across the world. As part of the Bupa group, their profits are invested back into health care to help their members to live healthier and longer lives.
As well as health insurance, Bupa also offer travel, home, car and life insurance products.
Bupa are more than an insurer though. They also operate Bupa Dental Corp, Bupa Optical, Bupa Aged Care and Bupa Medical Visa Services (to deliver immigration-related health examinations to Australia visa applicants on behalf of the Department of Immigration and Border Protection).
Bupa are committed to helping their members to live healthier, longer and happier lives. To this end, they provide health and wellbeing support and advice.
Bupa Self Management programs are designed for members with certain long term health conditions. They include back pain, osteoarthritis, asthma, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, Coronary Heart Disease and angina, diabetes, depression and osteoporosis.
Other Support Programs include the Parent and Baby Wellbeing program and an Integrated Osteoarthritis Management program.
Members with the relevant level of Extras cover can claim Living Well benefits towards the costs of health programs. To be eligible, members need to have been advised to participate in health-related activities such as gym memberships, Pilates, yoga or nicotine replacement therapy as part of a chronic health program to manage particular conditions.
Bupa also provide 24-hour telephone support for members who encounter problems overseas. This includes advice on basic medical issues, details of nearby medical facilities and medical translation services. Beforehand, they can also offer medical information and health risks and advice on staying healthy while travelling abroad.
Bupa also have Australia’s biggest network of ancillary providers for dental, optical, physiotherapy and chiropractic treatment.
Like most health funds, Bupa offers hospital-only, extras-only and combination cover.
Bupa have agreements with a wide range of private hospitals and day surgeries throughout Australia, along with a commitment to limiting out-of-pocket costs for their members. Being treated at a hospital with an agreement with Bupa usually means that there will be no out-of-pocket costs (unless there are excess or copayments to meet).
Bupa offers several different options for hospital-only cover:
Budget Hospital –Bupa’s lowest level of hospital cover is designed for healthy singles who are not looking for extensive protection. Rehab and cardiac related services are included. Psychiatric, pregnancy, assisted reproductive, renal dialysis, cataract/eye lens, hip/knee replacement and gastric band services are also included on a minimum benefits basis.
Standard Hospital – Bupa’s medium level of hospital cover is broader than Budget Hospital but still restricts services that are likely to be irrelevant for young and healthy individuals. Psychiatric, rehab and pregnancy services are included. Assisted reproductive, renal dialysis, cataract/eye lens and gastric band services are available on a minimum benefits basis.
Top Hospital – Bupa’s most comprehensive level of hospital cover has no exclusions, plus the option for lower premiums in exchange for an excess. It includes psychiatric, rehabilitation, pregnancy, IVF, cardiac services, dialysis, cataract and lens procedures, hip and knee replacements, other joint replacements and obesity services.
Family Essentials – This level of cover is designed for families who are looking for cost effective hospital cover in case of accidents. Emergency ambulance cover is included but there are some restrictions, such as treatments for which Medicare pays no benefit.
Bupa offers several different options for extras-only cover:
Bronze Extras – Aimed at the young and healthy, Bronze Extras includes general dental, optical, physiotherapy, chiro, antenatal and postnatal, natural therapies, living well, pharmacy, Living Well and emergency ambulance. As most basic Extras option, there are relatively low annual limits attached to these services.
Silver Extras – There are more services available compared to Bronze Extras, including major dental, orthodontics, dietary, psychology, podiatry, speech therapy, eye therapy, occupational therapy , home nursing and hearing aids.
Gold Extras – This Extras option is similar to Silver Extras but is more generous in terms of annual limits.
Platinum Extras – As the highest level of Extras cover available, Platinum Extras has the biggest annual limits.
Your Choice Extras – For those wanting more flexibility, Your Choice Extras allows members to choose the four extras services that are most relevant to their needs. Choices can be altered every 12 months to reflect changing situations.
Hospital and extras cover
Bupa have a wide range of hospital and extras packages. These are generally aimed at particular demographics, such as the young and active, young and healthy couples, young singles, growing families, families on a budget and mature singles and couples whose children have left home.
Ambulance cover is included in many of Bupa’s hospital and extras policies but it is also available as a stand-alone option.
There are several ways that members can make claims. For extras, member can claim online and receive funds into their bank account. Claims can also be made by post.
Bupa also offers HICAPS for members. Not familiar with this? It stands for Health Industry Claims and Payments Service. It is electronic and works in real time. Claims are processed there and then at your health care provider, so it is a quick and easy way to claim.
For hospital claims for treatment at Bupa Network hospitals, members may not be sent a bill at all but if they do, they can send it onto to Bupa along with a claim form. For medical claims, it may be billed directly to Bupa if the doctor uses Gap Cover. If they don’t, the claim will need to be taken to Medicare and then Bupa, or members can use a two-way claim form to save time.
Bupa members can benefit from a range of offers from Member Discount Partners. These include health and fitness, entertainment, optical, travel and leisure and rest and relaxation categories.