Bupa HI Pty Ltd

FamilyFirst $750 Excess - Gold

Name: FamilyFirst $750 Excess - Gold
Brand: Bupa HI Pty Ltd
Price: 659.05 AUD

$659.05 / 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: One adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult).

Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 31) and non-students (21 to 31), as well as persons with a disability who qualify as a child, non-classified* dependant, student and non-student in these age ranges. *Non-classified dependant: A non-classified dependent person will be treated as a Dependent Child for the purpose of cover and benefits. Details of study status are required for dependants from age 21.

Policy ID: BUP/J9C/NFOU1Y

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 $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

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

Get peace of mind for the whole family with comprehensive Hospital cover which includes no excess/co-payment for kids. 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 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

$450 per person up to $150 per service

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

sub-limits apply

Initial visit: $33.75
Subsequent visit: $26.25

Ante-natal/Post-natal classes 2

$350 per person up to $200 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

Initial visit: $15
Subsequent visit: $15

Blood glucose monitors* 12

$750 per person

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

sub-limits apply

Per monitor: $131.25

Chinese medicine 2

$450 per person up to $150 per service

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

sub-limits apply

Initial visit: $22.5
Subsequent visit: $22.5

Chiropractic 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $39
Subsequent visit: $33

Dietetics/dietary advice 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $55
Subsequent visit: $27

Endodontic 12

$800 per person

combined limit for endodontic & major dental

Filling of one root canal: $130

Exercise physiology 2

$450 per person up to $150 per service

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

sub-limits apply

Initial visit: $31.5
Subsequent visit: $27

Eye therapy (orthoptics) 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $36.75
Subsequent visit: $30.1

General dental* 2

$300 per person up to $600 per policy

Fluoride treatment: $16.5
Scale & clean: $58
Surgical tooth extraction: $92.4
Periodic oral examination: $27.5

Health management / Healthy lifestyle 6

$100 per person up to $200 per policy

Health management: 50% of charge

Hearing aids 12

$600 per person

Hearing aid: $600

Major dental* 12

$800 per person

combined limit for endodontic & major dental

Full crown veneered: $635

Non PBS pharmaceuticals* 2

$525 per person

Per eligible prescription: $50

Occupational therapy 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $97
Subsequent visit: $58

Optical 2

$150 per person

Single vision lenses & frames: $140

Orthodontic 12

$1,000 per person

$2,000 lifetime limit

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

Orthotics (podiatric orthoses) 12

$750 per person

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

Orthotics supply & fit: $90

Osteopathy 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $42
Subsequent visit: $39

Physiotherapy 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $33
Subsequent visit: $26

Podiatry* 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $25
Subsequent visit: $23

Psychology 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $69.5
Subsequent visit: $60.5

Remedial massage 2

$450 per person up to $150 per service

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

sub-limits apply

Initial visit: $33
Subsequent visit: $31.5

Speech therapy 2

$350 per person up to $200 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

sub-limits apply

Initial visit: $67
Subsequent visit: $33

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

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

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33.75}

{Subsequent visit: $26.25}

Ante-natal/Post-natal classes

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

Examples of maximum benefits

{Initial visit: $15}

{Subsequent visit: $15}

Blood glucose monitors*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Per monitor: $131.25}

Chinese medicine

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

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

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

{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

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $39}

{Subsequent visit: $33}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $55}

{Subsequent visit: $27}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{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

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

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $31.5}

{Subsequent visit: $27}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $36.75}

{Subsequent visit: $30.1}

General dental*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 per policy}

Examples of maximum benefits

{Fluoride treatment: $16.5}

{Scale & clean: $58}

{Surgical tooth extraction: $92.4}

{Periodic oral examination: $27.5}

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

{$600 per person}

Examples of maximum benefits

{Hearing aid: $600}

Major dental*

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{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

{$525 per person}

Examples of maximum benefits

{Per eligible prescription: $50}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{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

{$150 per person}

Examples of maximum benefits

{Single vision lenses & frames: $140}

Orthodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{$2,000 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

{$750 per person}

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

Examples of maximum benefits

{Orthotics supply & fit: $90}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{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

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $26}

Podiatry*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $23}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $69.5}

{Subsequent visit: $60.5}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

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

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $31.5}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $200 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}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $67}

{Subsequent visit: $33}

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 $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

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).

FamilyFirst $750 Excess - Gold

Policy ID: BUP/J9C/NFOU1Y

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Bupa HI Pty Ltd

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