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Bupa HI Pty Ltd

HealthSmart $250 Excess - Silver Plus

$395.00 / month

(Before Rebate, Discount & Loading)

Available in QLD

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.

Policy ID: BUP/J8A/QGTO10

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • 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
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 $250 per admission. This is limited to a maximum of $250 per person and $250 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 cover for Singles or Couples not planning a family. For more details on the product contact Bupa.

Extras Cover

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.

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

$150 per service up to $450 per policy

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

sub-limits apply

  • Initial visit: $31.5
  • Subsequent visit: $26.25
Ante-natal/Post-natal classes 2

$200 per service up to $350 per policy

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

  • Initial visit: $29.55
  • Subsequent visit: $29.55
Blood glucose monitors* 12

$750 per policy

  • Per monitor: $123.75
Chinese medicine 2

$150 per service up to $450 per policy

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

sub-limits apply

  • Initial visit: $22.5
  • Subsequent visit: $22.5
Chiropractic 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $32
  • Subsequent visit: $23
Dietetics/dietary advice 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $25
Endodontic 12

$800 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: $130
Exercise physiology 2

$150 per service up to $450 per policy

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

sub-limits apply

  • Initial visit: $31.5
  • Subsequent visit: $27
General dental* 2

$300 per policy

  • Fluoride treatment: $12.5
  • Scale & clean: $49
  • Surgical tooth extraction: $73
  • Periodic oral examination: $22
Health management / Healthy lifestyle 6

$100 per policy

  • Health management: 50% of charge
Major dental* 12

$800 per policy

combined limit for endodontic & major dental

  • Full crown veneered: $635
Non PBS pharmaceuticals* 2

$225 per policy

  • Per eligible prescription: 100% of charge
Occupational therapy 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $100.5
  • Subsequent visit: $69.5
Optical 2

$180 per policy

  • Single vision lenses & frames: $171.5
Osteopathy 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $43
  • Subsequent visit: $38.5
Physiotherapy 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $29
Podiatry* 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $30
  • Subsequent visit: $25
Psychology 2

$200 per service up to $350 per policy

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

sub-limits apply

  • Initial visit: $76
  • Subsequent visit: $69.5
Remedial massage 2

$150 per service up to $450 per policy

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

sub-limits apply

  • Initial visit: $29
  • Subsequent visit: $27
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per service up to $450 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $31.5}

{Subsequent visit: $26.25}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

Examples of maximum benefits

{Initial visit: $29.55}

{Subsequent visit: $29.55}

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$750 per policy}

Examples of maximum benefits

{Per monitor: $123.75}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per service up to $450 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $22.5}

{Subsequent visit: $22.5}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $23}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $25}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $130}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per service up to $450 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $31.5}

{Subsequent visit: $27}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Fluoride treatment: $12.5}

{Scale & clean: $49}

{Surgical tooth extraction: $73}

{Periodic oral examination: $22}

Health management / Healthy lifestyle

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$100 per policy}

Examples of maximum benefits

{Health management: 50% of charge}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $635}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$225 per policy}

Examples of maximum benefits

{Per eligible prescription: 100% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $100.5}

{Subsequent visit: $69.5}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$180 per policy}

Examples of maximum benefits

{Single vision lenses & frames: $171.5}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $43}

{Subsequent visit: $38.5}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $29}

Podiatry*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $25}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per service up to $350 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $76}

{Subsequent visit: $69.5}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per service up to $450 per policy}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $29}

{Subsequent visit: $27}

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, and other health aids, are payable under the Health Appliances category up to $750 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
Eye therapy (orthoptics)
Hearing aids
Home nursing
Orthodontic
Orthotics (podiatric orthoses)
Speech therapy
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).

Ambulance cover

Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au). This includes cover whilst interstate.

Other features of this ambulance cover: You are covered for the uncapped costs associated with emergency ambulance transport services (via air or road) 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

HealthSmart $250 Excess - Silver Plus

$395.00 / month

(Before Rebate, Discount & Loading)

Available in QLD

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/J8A/QGTO10

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