Bupa HI Pty Ltd

HealthSmart 80 $500 Excess - Gold

Name: HealthSmart 80 $500 Excess - Gold
Brand: Bupa HI Pty Ltd
Price: 835.4 AUD

$835.40 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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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: Two adults (and no-one else).

Policy ID: BUP/J11B/NGYF20

Source: Private Health Information Statement (PHIS)

This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with insurer for details.
This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.

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: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Co-payments: Every time you go to hospital you will have to pay:

$50 per day for a shared room for overnight admissions - up to $250 per hospital stay
$50 per day for a private room for overnight admissions - up to $250 per hospital stay
$50 for day surgery (no overnight stay)

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

Comprehensive Hospital cover to help protect you or your family. 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 80% back, up to your yearly limits. See http://www.bupa.com.au/find-a-provider.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture 2

$500 per person up to $300 per service

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

sub-limits apply

Initial visit: $33
Subsequent visit: $26

Ante-natal/Post-natal classes 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

Initial visit: $15.05
Subsequent visit: $15.05

Blood glucose monitors* 12

$1,000 per person

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

sub-limits apply

Per monitor: $150

Chinese medicine 2

$500 per person up to $300 per service

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

sub-limits apply

Initial visit: $18.05
Subsequent visit: $18.05

Chiropractic 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $40
Subsequent visit: $30

Dietetics/dietary advice 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $60
Subsequent visit: $32

Endodontic 12

$2,000 per person up to $800 per service

combined limit for endodontic & major dental

sub-limits apply

Filling of one root canal: $200

Exercise physiology 2

$500 per person up to $300 per service

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

sub-limits apply

Initial visit: $21.05
Subsequent visit: $18.05

Eye therapy (orthoptics) 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $36.75
Subsequent visit: $30.15

General dental* 2

$1,000 per person

Fluoride treatment: $16.5
Scale & clean: $58
Surgical tooth extraction: $92.65
Periodic oral examination: $26.5

Health management / Healthy lifestyle 6

$100 per person up to $200 per policy

Health management: 50% of charge

Hearing aids 12

$1,000 per person

Hearing aid: $1000

Major dental* 12

$2,000 per person up to $800 per service

combined limit for endodontic & major dental

sub-limits apply

Full crown veneered: $800

Non PBS pharmaceuticals* 2

$600 per person

Per eligible prescription: $50

Occupational therapy 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $97
Subsequent visit: $58

Optical 2

$250 per person

Multi-focal lenses & frames: $201
Single vision lenses & frames: $141

Orthodontic 12

$1,250 per person

$2,500 lifetime limit

Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge

Orthotics (podiatric orthoses)* 12

$1,000 per person

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

Orthotics supply & fit: $90.3

Osteopathy 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $42
Subsequent visit: $39

Physiotherapy 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $35.5
Subsequent visit: $28

Podiatry 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $27
Subsequent visit: $25

Psychology 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $75
Subsequent visit: $61.5

Remedial massage 2

$500 per person up to $300 per service

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

sub-limits apply

Initial visit: $33
Subsequent visit: $31

Speech therapy 2

$2,000 per person up to $500 per service

combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services

sub-limits apply

Initial visit: $67
Subsequent visit: $34

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $300 per service}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $26}

Ante-natal/Post-natal classes

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $15.05}

{Subsequent visit: $15.05}

Blood glucose monitors*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services}

{sub-limits apply}

Examples of maximum benefits

{Per monitor: $150}

Chinese medicine

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $300 per service}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $18.05}

{Subsequent visit: $18.05}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $32}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $800 per service}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $200}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $300 per service}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $21.05}

{Subsequent visit: $18.05}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $36.75}

{Subsequent visit: $30.15}

General dental*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Fluoride treatment: $16.5}

{Scale & clean: $58}

{Surgical tooth extraction: $92.65}

{Periodic oral examination: $26.5}

Health management / Healthy lifestyle

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$100 per person up to $200 per policy}

Examples of maximum benefits

{Health management: 50% of charge}

Hearing aids

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Hearing aid: $1000}

Major dental*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $800 per service}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $800}

Non PBS pharmaceuticals*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per eligible prescription: $50}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $97}

{Subsequent visit: $58}

Optical

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $201}

{Single vision lenses & frames: $141}

Orthodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,250 per person}

{$2,500 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge}

Orthotics (podiatric orthoses)*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Orthotics supply & fit: $90.3}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $39}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35.5}

{Subsequent visit: $28}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $27}

{Subsequent visit: $25}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $61.5}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $300 per service}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $31}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person up to $500 per service}

{combined limit for ante-natal/post-natal classes, chiropractic, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy, podiatry, psychology, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $67}

{Subsequent visit: $34}

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. Ante/Post-natal consultations and courses including lactation consultations, with a Bupa recognised provider in private practice. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits may apply. Blood glucose monitors, orthotics, and other health aids are payable under the Health Appliances category up to $1000 per year. Sub-limits and restrictions apply. Blood glucose monitors are payable once per year. 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

Home nursing

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).

HealthSmart 80 $500 Excess - Gold

Policy ID: BUP/J11B/NGYF20

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Bupa HI Pty Ltd

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