At Bupa, it’s our purpose that makes us different – helping our members to live longer, healthier, happier lives.
This brochure is a summary of the cover we offer. If you want more information, including what's covered and what's not read this together with our Important Information Guide at bupa.com.au/corporate-info
Unsure of any words? Visit bupa.com.au/glossary
For more information
134 135
bupa.com.au/corporate To log in, get your username and password from your employer or call us on 134 135.
Visit a local Bupa centre
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WHY HAVE PRIVATE HEALTH COVER?
Avoid Lifetime Health Cover loadingAvoid the Federal Government’s Lifetime Health Cover (LHC) loading by taking out hospital cover by 30 June following your 31st birthday. To find out more visit bupa.com.au/lhc
Reduce waiting time Get treated sooner by going to a private hospital.
Claim on most ExtrasEnjoy the benefits of being able to claim for most Extras including dental, physio, optical and chiro.
Save moneyDepending on your income and your age you could save money by taking out hospital cover. Talk to your tax advisor or visit ato.gov.au to find out what this means for you.
Choose your doctor Your choice of specialist and even where you’d like to be treated.
The Australian Government Rebate on private health insuranceThis could make your cover even more affordable. Find out what the Rebate means for you at bupa.com.au/rebate
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SIMPLE AFFORDABLE COVERTO SUIT YOU NOW
COMPETITIVE CORPORATE COVER
OUTSTANDING VALUE
Corporate hospital and extras coverDesigned to suit different needs.
Gap free same day treatmentNo out-of-pocket hospital or medical expenses at Members First day facilities (any excess and/or co-payments related to your level of cover will still apply. Not available in NT).
Members First Provider NetworkOur national network of hospital and extras^ providers can help you to reduce or eliminate out-of-pocket expenses.
^Dental, optical, physio & chiro.
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EASY AND CONVENIENT
MORE THAN HEALTH INSURANCE
MyBupa online portal Manage your cover at a time that suits you.
Accessible health supportYou can access a range of online tools and apps to help manage your health.
Easy to useExtensive range of extras providers offering on-the-spot claiming.
Save money with our Bupa Member ExclusivesGreat offers and discounts for things you will be sure to use like gym memberships, movie tickets and more. Visit bupa.com.au/MemberExclusives
Travel BenefitsWe offer benefits for overseas travel including a 24 hour health advice line and benefits for travel vaccines.
Visit bupa.com.au/other-insurance for information around our other insurance products and discounts for Bupa members.
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FIND THE RIGHT CORPORATE COVER FOR YOU
Create your own package
Choose our Ultimate
packaged cover
Your choice starts here OR
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Choose your hospital cover
Choose Ultimate Corporate Health Cover
PAGE 8 & 9
PAGE 6 & 7
AND
Extras are only available when combined with a level of Corporate hospital cover.
Choose your extras cover
PAGE 12 & 13
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Ultimate Corporate Health Cover includes these hospital features:
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#For most items at all recognised providers covering dental, physio & chiro. Excludes hospital treatments. Fund rules, waiting periods and yearly limits apply. ^At Members First Optical providers only. A lower limit applies at other providers.
ULTIMATE CORPORATE HEALTH COVER
Per person Per membership
Ultimate Corporate Health CoverOur premium option for ultimate peace of mind, with top hospital and extras cover and our dedicated 24/7 advice line.
Top level of hospital cover
Top level of extras cover
100% Amount you get back# (limits apply)
Extras Yearly limits
General Dental Unlimited
Major Dental $1,600
Optical $420^
Physio $1,500
Chiro$1,000 $1,600
Natural therapies $1,000
To see a list of what's covered and what's not covered, see page 10 and 11. There are some situations you won't be covered for and you may have to pay an out-of-pocket cost. For more info, read the Important Information Guide at bupa.com.au/corporate-info
Plus more, see page 10 for the full list
Private hospital cover
Medical cover
Emergency ambulance
You receive: ° 100% back# at any recognised provider
up to the first $500 per person per year for general dental
° 100% back at any recognised provider for major dental and orthodontics up to yearly limits per person
° 100% back# at any recognised provider up to the first $350 per person per year for physio and chiro.
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†On selected optical packages. Conditions apply. Optical benefits are subject to your level of cover. Fund rules, waiting period and annual maximums apply. *When treatment is provided by a Members First physiotherapist or dentist. Fund rules, waiting periods and annual maximums apply. Includes major dental in VIC and SA only. Excludes orthodontics and hospital treatments. **Conditions apply – contact us for details.
Accident benefitIf you are hospitalised due to an accident an additional $2,000 per person, $4,000 per membership can be put towards extras claims once you’ve reached your extras yearly limits.
Gap free opticalYou’ll have access to the ‘no gap’ range of fixed priced packages on glasses and contact lenses at no additional cost† if you visit our Members First optical providers.
No gap for kidsWe’ll cover the cost of your kids’ physio and general dental in most instances until they turn 25.*
Plus:
BONUS ULTIMATE CORPORATE HEALTH COVER FEATURES ° Medical gap bonus – receive $200 when you join and every calendar year thereafter.
This can be used towards a doctor or specialist’s out-of-pocket costs (whilst in hospital) and any unused bonus amounts will accumulate each year
° 100% rebate on Ambulance subscription
° 100% back on laser eye surgery at recognised providers.
Private room offerAt our Members First hospitals, you’ll receive a private room when you book your overnight stay, otherwise receive $50 back per night (when a private room is not available).**
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Corporate Hospital Top
Comprehensive cover, with additional benefits including Family in-hospital benefit and no excess for kids.
Top level of hospital cover
Corporate Hospital Intermediate
Our medium level of hospital cover, includes cover for cardiac, pregnancy and no excess for kids. Minimum benefits apply to some services.
Medium level of hospital cover
COMPREHENSIVE COVER
HOSPITAL COVER AT A GLANCE
$250EXCESS
NILEXCESS
$500EXCESS
$250EXCESS
NILEXCESS
$500EXCESS
Hospital cover helps cover your costs as a private patient in hospital, including treatment and accommodation. Choose from our three excellent options – depending on your needs and budget. There are some situations you won’t be covered for and you may have to pay an out-of-pocket cost. For more info, read the Important Information Guide at bupa.com.au/corporate-info
Plus more, see page 10 for the full list
All covers above include these hospital features:
Private hospital cover
Medical cover
Emergency ambulance
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Corporate Hospital Saver
Budget-friendly hospital cover, with minimum benefits on the things less likely to be needed.
Basic level of hospital cover
BASIC COVER
$250EXCESS
NILEXCESS
$500EXCESS
All our hospital covers include ° Accommodation in a private hospital or
as a private patient in a public hospital*
° Operating theatre, intensive care fees
° Surgically implanted prostheses up to the approved minimum benefits in the Government Prostheses List
° Allied health services including physiotherapy, occupational therapy and dietetics whilst in hospital
° PBS drugs supplied as an inpatient
° Medical Benefit Schedule (MBS) fee or gap cover amount if your doctor participates in this.
Medical coverCover for medical services provided during a hospital stay such as specialists and diagnostic services e.g. pathology and radiology.
Out-of-pocket costs depend on whether doctors and specialists participate in the Bupa Medical Gap Scheme.
There are a range of options that you can consider if you need to go to hospital and we will be there to help you understand these.
Emergency ambulanceEmergency ambulance cover is capped at 1 trip for single memberships, 2 trips for couples/families per year.
Private room offerAt our Members First hospitals, you’ll receive a private room when you book your overnight stay, otherwise receive $50 back per night (when a private room is not available).^
*If you choose to be treated as a private patient in a public hospital and choose a private room, you may have to pay an out-of-pocket charge. ^Conditions apply – contact us for details.
*Effective 1 June 2014. ^Available on Corporate Hospital Top Nil and $250 excess only.
Packages Hospital only Ultimate Corporate
Health Cover
Corporate Hospital
Top
Corporate Hospital
Intermediate
Corporate Hospital Saver
Psychiatric services
Rehabilitation services
Pregnancy (including childbirth)
IVF & assisted reproductive services *
Cardiac services
Renal dialysis
Cataract and eye lens procedures
Hip/knee replacement
All other joint replacements
Gastric banding & obesity related treatment *
Knee Arthroscopy and Meniscectomy Procedures
Appendicitis
Removal of Tonsils and Adenoids
Dental Surgery
Minor Gynaecological Surgery
All other in-patient treatments receiving Medicare BenefitsCosmetic surgery not clinically required
Health subscription refunds^
Family in-hospital benefit
Emergency Ambulance
Excess option NILNIL
$250$500
NIL$250$500
NIL$250$500
No excess for kids
Want to see the extras cover that comes with your package? Go to page 14
COMPARE AND CHOOSE YOUR HOSPITAL COVERFor full details of what's covered and what's not, see the Important Information Guide at bupa.com.au/corporate-info
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Waiting periods The following waiting periods apply:
° palliative care, psychiatric and rehabilitation services – two months
° pre-existing conditions, ailments or illnesses and pregnancy (including childbirth) – 12 months
° laser eye surgery covered under Ultimate Corporate Health cover only – 12 months
° all other treatments included in your cover – two months.
ExcessThe excess is capped at once per person, twice per membership, per calendar year.
Minimum BenefitsFor services in a private hospital which are recognised by Medicare, we will pay minimum shared room benefits and you will have your choice of doctor. These benefits would not be adequate to cover all private hospital costs and are likely to result in large out-of-pocket expenses.
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Members First provider networkWith our Extras covers, you can enjoy the advantages of our extensive network of dental, optical, physiotherapy and chiropractic providers. When you choose to visit a Members First provider, in most instances you will receive higher benefits and have the certainty of knowing how much you’ll get back.
Extras cover is an easy way to help maintain your health. That’s why we have extras including dental, physio and natural therapies that can make all the difference to help keep your health on track.
Extras are only available when combined with a level of Corporate hospital cover.
EXTRAS COVER AT A GLANCE
COMPREHENSIVE COVER
Corporate AdvantageAccess a wide range of services with at least 90% back at our Members First providers.
Extras cover Top level of extras cover
90% Minimum amount you get back
Extras Yearly limits
General dental Unlimited
Major dental $1,100
Optical $300^
Physio$500
combined with other services
Chiro $600 $1,200
Natural therapies $400
Corporate ClassicIncludes a wide range of extra services and generous benefits with at least 80% back at our Members First providers.
Extras coverMedium level of extras cover
80% Minimum amount you get back
Extras Yearly limits
General dental $400
Major dental $500
Optical $240
Physio$400
combined with other services
Chiro $500 $1,000
Natural therapies $600
combined with other services
For most items at our Members First providers covering general dental, physio, chiro and selected optical. Includes major dental in VIC and SA only. Excludes orthodontics and hospital treatments. Fund rules, waiting periods and annual maximums apply. ^At Members First optical providers only. A lower limit applies at other providers.
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BASIC COVER
Corporate Essentials Cover for key extras services with at least 70% back at our Members First providers.
Extras coverBasic level of extras cover
70% Minimum amount you get back
Extras Yearly limits
General dental $400
Major dental
Optical $200
Physio$300
combined limit
Chiro
Natural therapies
†On selected optical packages. Conditions apply. Optical benefits are subject to your level of cover, fund rules, annual maximums and waiting periods. *When treatment is provided by a Members First physiotherapist or dentist. Fund rules, waiting periods and annual maximums apply. Includes major dental in VIC and SA only. Excludes orthodontics and hospital treatments.
Set benefits A pre-defined amount you’ll get back for a service when you get treatment from someone outside the Bupa Members First provider network.
Yearly limits The most you can claim per person in a calendar year, depending on your cover.
Loyalty MaximumsWe increase how much you can claim each year by 20% of the initial amount for some extras services (applies after the first 12 months up to a maximum increase of up to 100%).
Gap free opticalYou’ll have access to the ‘no gap’ range of fixed priced packages on glasses and contact lenses at no additional cost† if you visit our Members First optical providers.
No gap for kidsWe’ll cover the cost of your kids’ physio and general dental in most instances until they turn 25* (available under Corporate Advantage and Corporate Classic Covers).
Per person Per membership
See more details on page 14 and 15
TO FIND OUT MORE ON WHAT YOU CAN CLAIM, VISIT BUPA.COM.AU/BENEFIT-GUIDES
General dental
Natural therapies
Physio ChiroOptical
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Packaged Ultimate
Up to 100% back# (limits apply)
ServicesWaiting periods
General dental
2 months
Unlimited
Gap free general dental for kids*
Major dental
12 months
$1,600
Orthodontics $1,400 Lifetime Limit $3,200
Optical
2 months
$420 $300
No gap optical^
Chiropractic and osteopathy $1,000 $1,600
Physiotherapy $1,500
Gap free physio for kids*
Ante and Post Natal $500
Living Well (see page 16) 6 months $300
Pharmacy**
2 months
$1,500
Natural therapies $1,000 Massage sub-limits: $250 $500
Psychology $1,000
Dietary $1,000
Podiatry (excludes orthotics) $1,000
Speech Therapy $1,000
Eye Therapy $1,000
Occupational Therapy $1,000
Home Nursing $400
Health aids and appliances+ 12 months $1,000
Travel and accommodation 2 months $200 travel, $300 accommodation
Accident Benefit^^ Nil $2000 $4000
Emergency ambulance Nil 1 trip per year (singles)/2 trips per membership (couples and families)
#For most items at all recognised providers covering dental, physio & chiro. Excludes hospital treatments. Fund rules, waiting periods and yearly limits apply. *When treatment is provided by a Members First physiotherapist or dentist. Fund rules, waiting periods and annual maximums apply. Includes major dental in VIC and SA only. Excludes orthodontics and hospital treatments. ^On selected packages at Members First optical providers. Conditions apply. Optical benefits are subject to your level of cover, fund rules, annual maximums and waiting periods.
This table shows yearly limits per person.
CHOOSE YOUR EXTRAS COVER
Per person Members First Non-Members First Per membership Combined Maximum New members
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Choose your own extrasCorporate Advantage Corporate Classic Corporate Essentials
At least 90% Back At least 80% Back At least 70% Back
Unlimited
Year1 2 3
Amount $400$480$560
Year 4 5
6+
Amount $640$720$800
$400
$1,100Year
1 2 3
Amount $0 $500$600
Year 4 5 6
6+
Amount $700$800$900
$1,000
Lifetime Limit for orthodontics $1,600
$400 Combined with general dental
$1,200 Lifetime Limit $2,600
$300 $250 $240 $200
$600 $1,200 $500 $1,000
$300 Year
1 2 3
Amount $500$600$700
Year 4 5
6+
Amount $800$900
$1,000
Year1 2 3
Amount $400$480$560
Year 4 5
6+
Amount $640$720$800
Combined with Physiotherapy Combined with Physiotherapy
$100 $100 $100
$450 $300 $150
$400
$600
Combined with Physiotherapy
$500 $1,000
$500
$350 $350
90% of the cost to yearly limit Sub-limits apply.
Combined with Natural therapies 80% of the cost to yearly limit
Sub-limits apply.
$100 – Travel $150 – Accommodation
$2,000 $4,000
1 trip per year (singles) 2 trips per membership (couples and families)
**Benefits for prescription items that are non-PBS, TGA approved, and not appearing on our exclusions list. +A combined annual maximum applies to this service category. Limits apply. ^^When an accident requires urgent hospital treatment, you can boost annual maximums on extras or pay for your hospital excess. For most items at our Members First providers covering general dental, physio, chiro and selected optical. Includes major dental in VIC and SA only. Excludes orthodontics and hospital treatments. Fund rules, waiting periods and annual maximums apply.
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Living Well
Provides cover for treatments which help you live a healthier lifestyle. These include: gym memberships, yoga, Pilates, nicotine replacement therapy, weight management programs. Gym memberships, yoga and Pilates require your doctor or recognised provider to complete a Living Well form to confirm the program is medically necessary for your health.
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BUPA HEALTH COVER MADE EASYLog in to bupa.com.au/corporate
To log in, get your username and password from your employer or call us on 134 135.
Unsure of any words? Visit: bupa.com.au/glossary
Other important information you should know can be found at: bupa.com.au/corporate-info
To find out more about what the Australian Government Rebate on private health insurance means for you, visit: bupa.com.au/rebate
To get a quote:
134 135
bupa.com.au/corporate
Visit a local Bupa centre
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Bupa PO Box 14639 MELBOURNE VIC 8001
Bupa Australia Pty Ltd ABN 81 000 057 590
Effective 1 April 2014 10283-04-14S
The World of BupaHealth CoverHealth Coaching & ProgramsInternational Health CoverCorporate Health SolutionsOptical Products & ServicesDental ServicesAged CareMedical servicesTravel, Home & Car InsuranceLife Insurance
FOR MORE INFORMATION
134 135
bupa.com.au/corporate
Visit your local Bupa centre