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Bupa Health Insurance Review

Written by

Chris Quinn

Written by

Chris Quinn

General Manager

Chris is the General Manager of Health Deal, one of Australia's biggest health insurance comparison services. He has been with Health Deal since the very beginning. Started as

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October 21, 2024

Key Points

  • Bupa is one of Australia’s leading health insurance providers.

  • Offers tailored hospital, extras, and combined cover for singles, couples, families, and seniors.

  • Bupa provides access to a large network of healthcare providers and hospitals.

  • Bupa's hospital cover tiers include Basic, Bronze, Silver, and Gold.

  • Extras cover includes services like optical, dental, and physiotherapy with yearly limits.

  • Bupa members benefit from the Medical Gap Scheme, reducing out-of-pocket costs for treatments.

  • Health Deal offers a simple process for switching to Bupa from other health funds.

  • Bupa holds a strong market share, covering 90.1% of hospital charges in Australia.

  • Government rebates and incentives help reduce the cost of Bupa premiums based on age and income.

Bupa Health Insurance is Australia’s one of the most leading and prominent health insurance fund. It offers a wide variety of health coverage options that are loved by Australians from different stages of life. Bupa has forged its name in the market due to years of delivering quality insurance options and healthcare services. Bupa offers hospital cover, extras cover, and combined cover policies which can be tailor-made to fit the needs of singles, couples, families, and seniors. It has a broad range of practitioners and healthcare providers that ensure that the Bupa members receive the care they deserve and have access to several healthcare services. 

In the Australian health insurance market, there are more than 50 different health funds and Bupa continues to remain a prominent health insurance fund among them. Health Deal is a proud partner of Bupa Health Insurance. With Health Deal’s high-calibre team, you can find a better Health Deal that gives you both value for money and the right level of coverage. You can speak to our experts at 1300 369 399 or fill out the online form here. Get in touch now to speak with an insurance expert for tailored advice and support in making viable health insurance decisions. In this article, we will take you through everything that you need to know about Bupa Health Insurance and what it has to offer. Let us begin. 

About Bupa Australia

Bupa has a very rich background and was established as a part of a global health and care organisation in 1947. Bupa entered the Australian health fund market in 2002 and soon after became the country’s most recognised health insurance provider. Since then, Bupa has catered to around 4 million members and counting. It offers a wider variety of health insurance options that are loved by people from every stage of life. Other than health insurance, Bupa also offers a plethora of insurance for all areas of life. 

Bupa Health Insurance is committed to helping people to live longer, healthier, happier lives and making a better world and it is their mission. The company’s values are directed towards providing care, respect, and passion for improving the health and well-being of its members. Bupa Health Foundation has invested more than $35 million in over 130 partnerships across Australia to deliver on its purpose and support its mission of uniting customers and communities in creating a healthier world. Bupa therefore has one of the largest networks of healthcare providers, partnered hospitals, and practitioners that aim to provide the best possible care to its patients. 

Policy Offerings

Bupa Health Fund provides a comprehensive range of policies that cover a wide variety of healthcare services. Each health fund comes in three major types: hospital-only cover, extras-only cover, or a combined package. Bupa has four main tiers in the hospital, which cover only Basic, Bronze, Silver, and Gold. Each tier covers some specific health care services and each next tier covers the services of the previous tier and its unique services. The extras-only cover includes healthcare services that are not covered in the hospital-only cover like optical and dental services whereas the combined cover includes hospital and extras cover services. 

Bupa’s policies are tailored to fit the needs of its members which is why you can almost always find a policy that is great for you. Remember that an adequate level of coverage for different needs is an important factor when choosing a health fund. Make sure that you do your due research before buying a policy. It is important here to mention that Health Deal does not sell all Bupa policies. 

Hospital Cover Details

Bupa has six different hospital-only cover options. Please note that these cover details are accurate at the time of article release and are subject to change as health funds add and remove policies regularly. Also, note that Health Deal does not sell every single Bupa hospital policy, such as Gold Hospital. Each tier covers a range of medical services. Here we look at each of them in detail:

 

Tier Description Procedures Covered
Basic Accident Only Hospital Minimum coverage that protects against unexpected accidents. – Rehabilitation

– Hospital psychiatric services

– Palliative care

Basic Plus Starter Hospital Affordable coverage for budget-conscious individuals, providing more than the minimum coverage. – Gastrointestinal endoscopy

– Tonsils, adenoids, and grommets

– Joint reconstruction

– Hernia and appendix

– Gynaecology

– Miscarriage and termination of pregnancy

– Dental surgery

– Lung and chest

Bronze Plus Simple Hospital Includes coverage for common treatments. – Gastrointestinal endoscopy

– Brain and nervous system

– Blood

– Chemotherapy, radiotherapy, and immunotherapy for cancer

– Eye (not cataracts)

– Ear, nose, and throat

– Tonsils, adenoids, and grommets

– Bone, joint, and muscle

– Joint reconstruction

Silver Plus Essential Hospital Affordable cover for a wider range of hospital treatments. – Kidney and bladder

– Digestive system

– Hernia and appendix

– Gynaecology

– Miscarriage and termination of pregnancy

– Male reproductive system

– Diabetes management (excluding insulin pumps)

– Pain management

– Breast surgery (medically necessary)

Silver Plus Advanced Hospital Comprehensive cover for a variety of healthcare services (excluding pregnancy, birth, and weight loss surgery). – Skin

– Dental surgery

– Sleep studies

– Podiatric surgery (provided by a registered podiatric surgeon)

– Lung and chest

– Gastrointestinal endoscopy

– Heart and vascular system

– Joint replacements

– Rehabilitation

– Hospital psychiatric services (restricted)

Gold Comprehensive Hospital Premium hospital coverage for total peace of mind. – Palliative care

– Brain and nervous system

– Blood

– Chemotherapy, radiotherapy, and immunotherapy for cancer

– Eye (not cataracts)

– Cataracts

– Ear, nose, and throat

– Implantation of hearing devices

– Joint reconstruction

– Back, neck, and spine

– Kidney and bladder

– Dialysis for chronic kidney failure

– Digestive system

– Hernia and appendix

– Weight loss surgery

– Assisted reproductive system

– Pain management

– Breast surgery (medically necessary)

– Plastic and reconstructive surgery (medically necessary)

As a Bupa member, you can choose to have treatment in a public or private hospital. If you choose a public hospital, Bupa will cover your hospital expenses. If you choose a private hospital for your treatment, you will have a shorter wait times, freedom to choose your doctor and elective surgery times. 

Waiting periods refer to the initial time frames that begin as soon as you take out an Australian private health insurance policy. During this period, you won’t be able to claim or access any benefits covered by the policy. If you require medical services during this time, you’ll need to cover the full cost yourself. The length of these waiting periods can vary depending on the type of condition.

Here are the standard waiting periods for some common health insurance benefits:

  • New Conditions: 2 months
  • Pre-existing Conditions: 12 months
  • Rehabilitation, Psychiatric Care, and Palliative Care: 2 months
  • Pregnancy and Birth-related Services: 12 months
  • IVF and Assisted Reproductive Services: 12 months
  • Weight Loss Surgery: 12 month

Extras Cover Details

Extras cover include services not covered in Hospital-only cover. Bupa offers 12 different types of extras-only covers that cover a range of services. Each cover option is designed to help members live a tension-free life with their health covered. Each option explains the yearly limits on the services and the waiting periods.

The most popular extras-only cover services include optical, dental, and physiotherapy. Each of the services comes with yearly limits, which are limits on how much the health fund will cover you for in a year. For example, if your yearly limit for prescription glasses is $200 then you will only be covered for $200 per year for prescription glasses

Bupa Member Benefits

Bupa offers a wide range of unique benefits to its members, including members’ first services, the Medical Gap Scheme, and extensive “at-home” health programs. Members First is a network of providers that includes thousands of dental providers, physiotherapists, chiropractors, and podiatrists across Australia. Bupa members with Extras Cover can receive additional value and certainty through known out-of-pocket expenses when they visit a Members First provider. Plus they can expect generally higher set benefits, discounts, and at least 60% and up to 100% back on specified services. 

The Bupa Medical Gap Scheme is designed to remove or reduce the costs you pay for your treatment in the hospital. When a doctor has signed up for the Bupa Medical Gap Scheme and agrees to use it for your treatment, the costs you pay are reduced. Your doctor agrees to only charge up to a certain fee. Bupa will then pay a much higher amount than what we normally would, so you pay nothing, or you pay up to $500 out of pocket for medical treatment for that doctor. Remember, you may have to see multiple doctors for one procedure.

Bupa also offers a wide range of At Home services like rehab, dialysis, palliative care, and much more.

Costs and Premiums 

Premiums on policies are the regular payments you pay to maintain the policy coverage. You can choose to pay them weekly, monthly, or yearly, depending on your budget. The amount of your premium will depend on what sort of coverage you have, what services are covered, and what the recurrent cost is. It is important to note that once you stop paying your premium, your coverage will cease. Excess and co-payments are out-of-pocket costs you pay while using a service or making a claim. You can decrease your excess while buying a policy based on your premium and the services covered. 

Digital Services and Account Management

Bupa offers digital services and account management via its mobile app, myBupa, and website and phone services. The myBupa is a very functional app that works great and offers all the services you would otherwise get through the website or on the phone. You can submit your claims through the app and access 24/7 live support. 

Hospital and Provider Networks

Bupa has a large hospital and provider network, so several hospitals and practitioners have partnered with Bupa to offer its members greater access to medical facilities and procedures. These networks exist for hospitals and extra cover.

Customer Support and Service

Bupa has a variety of contact options. You can contact Bupa via:

  • myBupa app
  • Calling service 
  • Email: 
  • Walk in Store 

Their support hours are Monday through Friday, 8 am—8 pm (AEST/AEDT).  You can also refer to scams@bupa.com.au to report any suspicious emails or SMS that impersonate Bupa and stopfraud@bupa.com.au to report any signs of fraudulent activity on accounts or services.

Rebates and Government Incentives

The Australian Government’s rebate can reduce premiums based on the policyholder’s age and income. This also depends on whether the policyholder is single or in a family. Please check out the page, and if you have any questions, please feel free to email us at enquiries@healthdeal.com.au

The Medicare Levy Surcharge is a levy that is paid by an Australian taxpayer who currently earns above a certain income and does not hold private hospital insurance. However, you might be eligible for a Medicare Levy Surcharge Exemption. Whereas Lifetime Health coverage loading is the additional cost for those who take out hospital coverage after the age of 31 years and is different from the medicare levy surcharge. This means that if you have not taken out any private hospital cover after turning 30, and later on you decide to buy one, you will have to pay a 2% LHC loading cost on top of your premium for every year you are aged over 30.

Switching to Bupa

Switching hospital coverage, especially with Health Deal, is super simple. Health Deal will handle the entire switching process for you, so you won’t have to lift a finger. When you sign up for any new insurance policy through Health Deal, they’ll ask you for some information like your Medicare card number, your previous health fund member number and payment details. Once you click submit on your application, the following will occur: 

  1. Health Deal will securely transmit all your information over to your new health fund, Bupa. 
  2. You will receive a welcome email from Health Deal and your new health fund, Bupa. 
  3. Bupa will send a transfer certificate request to your old health fund. This is the document that outlines all the waiting periods you have already served. 
  4. Your old health fund will cancel your ongoing direct debit and will refund you any money you have pre-paid them for the fortnight/month/quarter/year on a pro-rata basis (this takes about 10 working days to receive the refund)
  5. Bupa Health Fund will send you a card in the post, and you’ll receive an onboarding welcome call from someone in their customer service team. 
  6. All your payments will be set during the signup process, so you can just sit back, relax, and enjoy being a new member of Bupa. 

Remember when switching health funds, you will not have to re-serve any wait periods you’ve already served, and any money you’ve pre-paid will be refunded back to you. 

Comparison with Other Providers

To make a careful decision about buying any health cover, we suggest you compare various health fund providers and their products. We encourage you to read their product disclosure statements carefully and refer to their websites for more information. Bupa is a great health fund with various key points that make it a leading player in the market. Its unique selling point includes a robust network of partnered hospital practices and practitioners for its members, great customer service, and a smooth-working mobile app. According to the Private Health Insurance Ombudsman’s State of the Health Funds report, Bupa covers 90.1% of the hospital-related charges in Australia. Bupa also holds the 25.%  Australian private health insurance market share according to the private health insurance market report 2022 – 2023. Purchase Bupa health coverage policies through Health Deal now, or you can use Health Deal’s comparison tool to compare policies from different insurance providers. 

FAQs

What Is Bupa Recognised Provider?

A provider who meets certain requirements set out by Bupa is known as a Bupa Recognised Provider. If you visit a recognised provider, Bupa will pay for the treatment or service if it’s included in your level of coverage. Before you book a treatment or service, it’s a good idea to check with Bupa if your provider is recognised by them or not.

Does Bupa have a Mobile App?

Yes, Bupa has a mobile app called myBupa that you can use to manage your membership. It will help you easily access your health coverage information online, view and update your membership details, view claims history, and even make selected extra claims on your smartphone. It is currently available on Android and iOS.

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Bupa is an excellent and prominent health fund in Australia that offers a wide range of coverage options. You can use the Health Deal Insurance Comparison tool to compare Bupa’s different policies with other health fund policies to choose the one that fits your needs. Here you can compare health insurance plans, costs, and providers. For expert insurance advice,  you can contact Health Deal at enquiries@healthdeal.com.au. You can speak to our experts at 1300 369 399 or fill out the online form here. Get in touch now to speak with an insurance expert for tailored advice and support in making viable health insurance decisions. 

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This guide is for informational purposes only and should not be taken as medical or financial advice. Health Deal is proud to partner with Bupa. While we strive to provide accurate and up-to-date information, health insurance policies and benefits may change. Always check with a financial professional before making any decisions. Health Deal compares selected products from a panel of trusted insurers but does not compare all products in the market. For the most current information, please refer to Bupa’s official website or speak with one of our health insurance experts.

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