Because Life Happens....Life is full of unexpected surprises. Some good. Some bad. But either way, it’s good to know that Bupa has your back. When it comes to health cover, we’ve

Health Insurance2020

Because Life Happens.

Life is full of unexpected surprises. Some good. Some bad. But either way, it’s good to know that Bupa has your back.

When it comes to health cover, we’ve got something for everyone.

Because life happens, and when it does you can rely on Bupa to help you through it.

Because you can’t predict the future. (But you can prepare for it.)

Health support programs to help find a healthier you.From rehab, TeleHealth, chemotherapy and palliative care delivered at home, to phone-based health coaching and mental health support, our programs are designed to help support you and your family’s health and wellbeing.

It’s all part of our commitment to helping you live a longer, healthier, happier, life.

What is the Bupa Members First Extras Network?We’re all for more benefits.

We’ve brought together thousands of registered healthcare providers across Australia to give Bupa Extras members access to a range of great benefits.

At every Members First Extras Provider, you’ll pay less for most services included, such as most dental, optical, physio, chiro and podiatry consultations1. It’s just one of the benefits of being a Bupa member.

Find a Members First providerOur Find a Provider tool is a quick and easy way to find your nearest healthcare providers on our network. It includes things like hospitals and Bupa Health Insurance stores too – so you’re never far away from great value.

bupa.com.au/find-a-provider

Pay nothing for kidsLittle kids (and big kids) can come with big bills.

That’s why when you combine selected Extras cover and a Hospital cover, on a family policy, most kids’ dental and physio visits, chiro, podiatry consultations and selected glasses are gap free at Members First providers2. Yearly limits apply. Plus, you won’t pay an excess for kids (included on your membership) up to the age of 25 if they need to go to hospital. A hospital excess for Kids will apply to Basic Plus Starter Hospital and Basic Accident Only Hospital only.

Members First PlatinumWhen you combine Hospital and Extras3 that include general dental, you pay nothing for your regular dental check-up and more at Members First Platinum dentists, up to yearly limits.

You’ll get all the benefits of Members First, including more money back for most other dental services. Yearly limits apply.

bupa.com.au/members-first-platinum

Gap free opticalLooking for a new you? Need new prescription glasses or contacts? Our Members First providers and our optical partner, Specsavers, offer you access to a range of ‘no gap’ packages on glasses and contact lenses.

Easy access at myBupaUse and view your membership details online or via our myBupa app. Access your cover details, make claims and update your membership 24/7 using any device with just a few clicks.

– Get real-time notifications when your claim is processed

– Check your remaining limits after your extras claim

Download to your smartphone today.

Make claiming easy4

Tap and claim at Bupa recognised providers by downloading your Bupa membership card to your phone or wearable.4

Follow the steps at bupa.com.au/digitalcard.

With offers from over 40 partners, Bupa Plus is our way of saying thanks to everyone who chooses Bupa as their health insurer.

• endota spa – 25% off endota products purchased online

• RedBalloon – $30 off any RedBalloon experience when you spend $129 or more

• New Balance – 20% off selected full priced New Balance products purchased online

• Movie vouchers – up to 25% off the box office price when you buy Event Cinemas, Birch Carroll & Coyle, Greater Union & Village Cinemas movie vouchers online

To redeem these offers and more, visit myBupa.com.au/offers. Terms and conditions apply.

1. For most items at Members First Extras providers covering dental, physio, chiro, podiatry consultations and selected optical. Yearly limits, waiting periods, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. 2. Waiting periods, fund and policy rules apply. Child dependants only. Excludes orthodontics, orthotics and hospital treatment. Available on Gold Ultimate Health Cover, Top Extras 60, Top Extras 75 and Top Extras 90, when taken with hospital cover on a family membership. 3. Eligible Extras products do not include Your Choice Extras 60 where general dental cover is not selected, Orange 50 and Orange 60. Waiting periods, fund and policy rules apply. 4. Digital cards may be used at HICAPS terminals only and are compatible with Android OS 5.0 and higher.

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https://my.bupa.com.au/offers

Whatever life brings, start here!

Quick overview – head to page 6

Hospital options – see page 10

Extras options – see page 14

Packaged options – see page 18

In good health?Need extra support?

Growing a family?Just for you?On a budget?

or maybe...Don’t know where to start?

4 5

Because we all know health cover can be confusing.

1. This is where hospital treatment that is restricted or an exclusion will be treated as included if a member requires hospital treatment as the result of an accident that occurred in Australia after joining. Treatment must have been sought within 72 hours of the accident and any further treatment for that accident where an admission or readmission is required must be within 180 days of the event. 2. Some non-PBS drugs may not be covered. 3. Waiting periods, fund and policy rules apply. 4. Up to a maximum of 3 years. 5. For most items at our Members First Extras providers covering dental, physio, chiro, podiatry consultations and selected optical packages. Waiting periods,

fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. 6. Applies after the first 12 months up to a maximum increase of 100% on yearly limits over 6 years. 7. On Top Extras 60, Top Extras 75 and Top Extras 90, your percentage back on Extras claims at Members First providers grows by 2% of the original benefit each year, up to a maximum of 10%. The set benefit you get back at other recognised providers also grows by 2% of the original benefit each year, up to a maximum of 10%.

Hospital Cover Product details are available on page 10 and 11

Basic Accident Only Hospital

• Hospital accommodation for accidents requiring urgent medical attention.• Restricted cover shared room (Minimum Benefits) for Hospital

Psychiatric Services, Rehabilitation and Palliative care only.• Accident Inclusion: For accidents sustained after joining, treatment

which is restricted or is an exclusion on your cover, will be payable in the same way as an included service.1

Basic Plus Starter Hospital

• Hospital accommodation for treatments including gastrointestinal endoscopy, tonsils, adenoids and grommets, gynaecology, hernia and appendix, joint reconstructions, miscarriage and termination of pregnancy and dental surgery.

• Accident Inclusion: For accidents sustained after joining, treatment which is restricted or is an exclusion on your cover, will be payable in the same way as an included service.1

Bronze Plus Simple Hospital

• Covers a range of common treatments like chemotherapy, radiotherapy and immunotherapy for cancer2, ear, nose and throat, dental surgery, joint reconstructions, lung and chest and more.


• No excess for kids.

Silver Plus Essential Hospital

• Covers a wide range of hospital treatments including heart and vascular system, back, neck and spine, pain management and plastic and reconstructive surgery (medically necessary).



Silver Plus Advanced Hospital

• Covers a wider range of hospital treatments including cataracts, rehabilitation, joint replacements, insulin pumps and pain management with device.



Gold Complete Hospital

• Premium cover for more peace of mind including pregnancy and birth, assisted reproductive services, hospital psychiatric services, dialysis for chronic kidney failure, weight loss surgery and more.


Extras Cover Product details are available on page 14 and 15

Orange 50 Extras

• Receive at least 50% back for most items at Bupa recognised providers, up to your yearly limits.3

• You’ll have flexibility to use your limits how you want and to reward you for your loyalty to Bupa, these limits also increase over time.4

Budget Extras 60

• Receive up to 60% back for most items at our Members First network of dental, physio, chiro and selected optical providers, up to your yearly limits.5

Orange 60 Extras

• Receive at least 60% back for most items at Bupa recognised providers, up to your yearly limits.3

• You’ll have flexibility to use your limits how you want and to reward you for your loyalty to Bupa, these limits also increase over time.4

Your Choice Extras 60

• Select four services (once every 12 months) that suit you best. Capped emergency ambulance is automatically included in this cover.

• Receive up to 60% back for most items at our Members First network of dental, physio, chiro, podiatry and optical providers, up to your yearly limits.5

• Includes Loyalty Maximums which increases how much you can claim each year by 20% of the initial amount for most Extras services.6

Top Extras 60

• Receive 60% back (increasing to 66% with loyalty benefits that increase each year) for most items at our Members First network of dental, physio, chiro, podiatry and optical providers, up to your yearly limits.5

• Includes benefit bonus.7

Top Extras 75

• Receive 75% back (increasing to 82.5% with loyalty benefits that increase each year) for most items at our Members First network of dental, physio, chiro, podiatry and optical providers, up to your yearly limits.5


Top Extras 90

• Receive 90% back (increasing to 100% with loyalty benefits that increase each year) for most items at our Members First network of dental, physio, chiro, podiatry and optical providers, up to your yearly limits.5


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That’s why we’ve laid everything out so you can choose a Hospital Cover option and an Extras option for a combination that works for you. Or, you can simply choose one if you prefer.

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Hospital Cover

When life happens, it’s good to know you’re covered.

From routine surgery to complex healthcare and everything in between, we can help with a range of hospital covers that suit your needs. And to stay on budget, you can even choose your excess, so your budget doesn’t trip you up.

Basic Accident Only Hospital Basic Plus Starter Hospital Bronze Plus Simple Hospital Silver Plus Essential Hospital Silver Plus Advanced Hospital Gold Complete Hospital

Our six options make it easy to choose:

Because dogs and

skateboards don’t mix.

98

Bronze Plus Simple

Hospital

Silver Plus Essential Hospital

Silver Plus Advanced Hospital

Gold Complete Hospital

$250/$500/$750 $500/$750 Excess

R R P PR R R PR P P PP P P PP P P PP P P PP P P PO O P PP P P PO P P PP P P PP P P PP P P PO O P PO P P PP P P PO O O PP P P PP P P PP P P PO O O PO P P PP P P PP P P PP P P PO O O PO O O PP P P PP P P PO O P PP P P PO O P PP P P PO P P PP P P PP P P PP P P PP P P P

P P O OO O P PP P P PP P P PP P P P

Basic Accident Only Hospital

Basic Plus Starter

Hospital

EXCESS OPTIONS > $500/$750

CLINICAL CATEGORIES

Rehabilitation R R

Hospital Psychiatric services R R

Palliative care R R

Brain and nervous system O OBlood O OChemotherapy, radiotherapy and immunotherapy for cancer1 O OEye (not cataracts) O OCataracts O OEar, nose and throat O OImplantation of hearing devices O OTonsils, adenoids and grommets O PBone, joint and muscle O OJoint reconstructions O PJoint replacements O OBack, neck and spine O OKidney and bladder O ODialysis for chronic kidney failure O ODigestive system O OHernia and appendix O PGastrointestinal endoscopy O PWeight loss surgery O OHeart and vascular system O OLung and chest P2 P2

Gynaecology O PMiscarriage and termination of pregnancy O PPregnancy and birth O OAssisted reproductive services O OMale reproductive system O ODiabetes management (excluding insulin pumps) O OInsulin pumps O OPain management O OPain management with device O OBreast surgery (medically necessary) O OPlastic and reconstructive surgery (medically necessary) O OSkin O ODental surgery O PSleep studies O OPodiatric surgery (provided by a registered podiatric surgeon) O OADDITIONAL BENEFITS

Capped Emergency Ambulance P PUncapped Emergency Ambulance O ONo Excess for Kids O OTravel and Accommodation P PAccident Inclusion P P

R Restricted cover applies, see the Important Information Guide at bupa.com.au/info to find out more. O Indicates the service is excluded, whereby no benefits are payable. 1. Some non-PBS drugs may not be covered. 2. In response to COVID-19, we have added Lung and Chest cover to our Basic and Basic Plus policies from 26 March 2020. This means private patient hospital admissions for Lung and Chest conditions, which includes most COVID-19 related treatments, are included on ALL our hospital policies during this time.

Hospital cover options

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Extras Cover

You know what matters to you most.

Whether the kids need orthodontics or you need a good massage, if you’re ready to go natural or need a little support with diet or movement, we’ve got you covered.

Whatever your life stage – early or later, family or flying solo, lifestyle choice or illness management – you can choose from more than 23 categories from your extras cover.

From budget extras to top cover, the choice is yours. Go on, splash out!

Because life can throw

you in the deep end.

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Orange 50 Extras

Budget Extras 60

Orange 60 Extras

Your Choice Extras 60

Top Extras 60

Top Extras 75

Top Extras 90

At least 50% back at Bupa recognised

providers

At least 60% back at Members First providers1

At least 60% back at Bupa recognised

providers





SERVICES WAITING PERIODSGap Free dental, physio, chiro, podiatry consults, and selected

optical packages for kids at Members First providers.2

General dental 2 months

$5006 Year 1 to $700 Year 3+ t

$1,0006 Year 1 to $1,400 Year 3+ l

$350 t $700 l

$7006 Year 1 to $900 Year 3+ t$1,4006 Year 1 to $1,800 Year 3+ l

$7006 Year 1 to $1,400 Year 6+

Unlimited Unlimited Unlimited

Major dental 12 months O O O$5006 Year 2 to $1,000 Year 7+

$1,000 $1,100 $1,200

Orthodontics 12 months O O O$4506 Year 2 to $900 Year 7+ t

Lifetime Limit $1,300

$700 t Lifetime Limit $2,000



Optical 2 months O$210 tË $420 lË$150 tº $300 lº

$150 t $300 l $260 Ë $180 º $290 Ë $200 º $340 Ë $240 º $380 Ë $280 º

Physiotherapy 2 monthsCombined with General dental

$350 t $700 l nNatural therapies

sub-limit $100 t $200 l

Combined with General dental

$4506 Year 1 to $900 Year 6+

$700 $800 $900

Chiropractic and osteopathy 2 months $3506 Year 1 to $700 Year 6+7 $500 t $1,000 l $600 t $1,200 l $700 t $1,400 l

Natural therapies (includes remedial massage, acupuncture and Chinese herbalism) 2 months O

Massage $100 t $200 l

$5006 Year 1 to $1,000 Year 6+

Massage sub-limit $100 t

$400 tMassage sub-limit

$150 t $300 l

$500 tMassage sub-limit $200 t $400 l

$500 tMassage sub-limit $200 t $400 l Exercise Physiology 2 months O O

Antenatal and Postnatal 2 months O O

Combined with physiotherapy n $350 Sub-limit

$350 $400 $450

Health Management 6 months O $50 O $100 $100 $150 $200

Pharmacy (includes travel vaccines)3 2 months O $100 t $200 l O$3006 Year 1 to $600 Year 6+

$500 $600 $750

Dietary 2 months O O O O $400 $500 $750

Mental Health (includes Psychology, Counselling and Online CBT) 2 months O O O O

$400Online CBT sub-limit

$100

$500 Online CBT sub-limit

$100

$750 Online CBT sub-limit

$100

Podiatry (excludes orthotics) 2 months O O O$3506 Year 1 to $700 Year 6+

$400 $500 $750

Speech Therapy 2 months O O O

$4006 Year 1 to $800 n Year 6+

$400 $500 $750

Eye Therapy 2 months O O O $400 $500 $750

Occupational Therapy 2 months O O O $400 $500 $750

Home Nursing 2 months O O O O $350 $350 $400

Health aids and appliances4 12 months O O O O$8008

Sub-limits apply$1,0008

Sub-limits apply$1,2008

Sub-limits apply

Travel and accommodation 2 months O O O O $100 travel/$150 accommodation

Emergency ambulance services5 No waiting period 1 service t 2 services l 1 service t 2 services l

t Per person l Per membership Ë Members First º Non-Members First n Combined Maximum t Per person l Per membership Ë Members First º Non-Members First n Combined Maximum

This table details the services available under each of our Extras cover options. Yearly limits shown are per person, or per membership (where applicable).

1. For most items at our Members First Extras providers covering dental, physio, chiro, podiatry consultations and selected optical. Yearly limits, waiting periods, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. 2. For most items covering dental, physio, chiro, podiatry consultations and selected optical packages. Available on Gold Ultimate Health Cover, Top Extras 60, Top Extras 75 & Top Extras 90 when taken with Hospital cover on a family membership. Waiting periods, fund and policy rules apply. Child dependants only. Excludes orthodontics, orthotics and

hospital treatments. Set benefits apply at other recognised providers. 3. Benefits for prescription items that are non-PBS, TGA approved, and not appearing on our exclusions list. 4. A combined yearly limit applies to this service category. 5. Fund rules apply. 6. This amount increases year on year up to a maximum of six years. For major dental and orthodontics, benefits start after 12 month waiting period served. 7. Membership limits: $500 Year 1 to $1,000 Year 6+. 8. Hire, repair of health aids and appliances available, for which a 6 month waiting period applies.

Extras cover options

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Packaging your cover

Because sometimes you want the best of both worlds.

A little hospital cover. A lot of extras… or something different that’s just right for you. That’s why we offer packages that suit every life stage.

From finding your feet and figuring it out, to footloose and fancy-free – we’ve made it simpler to package the cover that fits your life.

Because one size

never fits all.

16 17

Basic Plus Active Saver

Basic Plus Young

Singles/Couples Saver

Bronze Plus Young

Singles/Couples Choice

Silver Plus Prime

Gold Ultimate Health Cover

EXCESS/ CO-PAYMENT OPTIONS > $100 Co-Payment8

$50 Co-Payment9

$50 Co-Payment9

Nil/$250/ $500/$750 Nil

CLINICAL CATEGORIES

Rehabilitation R R R P PHospital Psychiatric services R R R P PPalliative care R R P P PBrain and nervous system O O P P PBlood O O P P PChemotherapy, radiotherapy and immunotherapy for cancer 10 O O P P P

Eye (not cataracts) O O P P PCataracts O O O P PEar, nose and throat O O P P PImplantation of hearing devices O O P P PTonsils, adenoids and grommets P P P P PBone, joint and muscle O O P P PJoint reconstructions P P P P PJoint replacements O O O P PBack, neck and spine O O O P PKidney and bladder O O P P PDialysis for chronic kidney failure O O O P PDigestive system O O P P PHernia and appendix P P P P PGastrointestinal endoscopy O O P P PWeight loss surgery O O O O PHeart and vascular system O O O P PLung and chest P11 P11 P P PGynaecology P P P P PMiscarriage and termination of pregnancy P P P P PPregnancy and birth O O O O PAssisted reproductive services O O O O PMale reproductive system O O P P PDiabetes management (excluding insulin pumps) O O P P PInsulin pumps O O P P PPain management O O P P PPain management with device O O P P PBreast surgery (medically necessary) O O P P PPlastic and reconstructive surgery (medically necessary) O O P P P

Skin O O P P PDental surgery P P P P PSleep studies O O P P PPodiatric surgery (provided by a registered podiatric surgeon) P P P P P

ADDITIONAL BENEFITS

Unemployment Cover O O O O PTravel Insurance Bonus O P P P PCapped Emergency Ambulance P P P O OUncapped Emergency Ambulance O O O P PNo Excess for Kids O O O O N/A

Travel and Accommodation P P P P PAccident Inclusion 2 P P O O O

Packaged Cover


• You’ll receive 60% back for most Members First dental, physio, chiro and podiatry consultations up to your yearly limits.1


• Overall $1,000 limit for included Extras services (sub-limits apply per service).

Basic Plus Young Singles/Couples Saver


• Accident Inclusion: For accidents sustained after joining, treatment which is restricted or is an exclusion on your cover, will be payable in the same way as an included service. 2

• In the first year you’re with Bupa, you’ll get a Top-up Bonus of $50 as a single and $100 as a couple to use towards out-of-pocket Extras expenses. This amount increases by 20% each year you remain a customer, until it doubles in Year 6.3

Bronze Plus Young Singles/Couples Choice



Silver Plus Prime



• You can receive up to eight days (seven nights) of Essentials travel insurance annually. Alternatively, you can use the equivalent value as a discount on your premium for any Bupa Travel Insurance policy.4, 5


• You’ll receive 100% back for most Members First dental, physio, chiro, podiatry consultations and selected optical up to your yearly limits.6

• 100% back for Laser eye correction surgery at Bupa recognised providers.7

• Ultimate 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.

• Ultimate Advice Line gives you access to information on a range of topics, including 24 hour medical and accident advice and counselling and grief support.

Below are our combined Hospital and Extras packages.

See next page for associated Extras for these packages.

Packaged cover options Packages(Hospital Cover)

R Restricted cover applies, see the Important Information Guide at bupa.com.au/info to find out more. O Indicates the service is excluded, whereby no benefits are payable.

1. For most items at our Members First extras providers covering dental, physio, chiro, podiatry consultations and selected optical. Waiting periods, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. 2. This is where hospital treatment that is restricted or an exclusion will be treated as included if a member requires hospital treatment as the result of an accident that occurred in Australia after joining. Treatment must have been sought within 72 hours of the accident and any further treatment for that accident where an admission or readmission is required must be within 180 days of the event 3. Applies each calendar year, and where benefits are payable for the service. Any unused amount does not roll over into the next year. 4. Based on cost of Essentials travel insurance for under 65’s at standard rates. 5. Travel, Home & Car Insurance products are issued by Insurance Australia Limited (IAL) ABN 11 000 016 722 AFSL 227681. Any advice is general advice only and does not take into account your individual circumstances. The relevant Product Disclosure Statements are available at bupa.com.au and should be considered before making any decision on these products. Bupa HI Pty Ltd ABN 81 000 057 590 is an authorised representative (number 3542669) of IAL. 6. Subject to set limits. 100% back in most instances up to the first $500 then benefits of 90% apply for general dental. 100% for first 10 standard physio & chiro visits, and podiatry consultations per person per calendar year then benefits of at least 90% apply. Waiting periods, fund and policy rules apply. 7. A 3 year waiting period applies to Laser Eye Correction Surgery. 8. Capped at $500 per admission. 9. Capped at $250 per admission. 10. Some non-PBS drugs may not be covered. 11. In response to COVID-19, we have added Lung and Chest cover to our Basic and Basic Plus policies from 26 March 2020. This means private patient hospital admissions for Lung and Chest conditions, which includes most COVID-19 related treatments, are included on ALL our hospital policies during this time.

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Basic Plus Young Singles/Couples Saver

Bronze Plus Young Singles/Couples Choice

Silver Plus Prime


At least 60% back atMembers First providers1,9




Up to 100% back at Members First providers1,2

SERVICES WAITING PERIODS

General dental 2 months $300

$700 nOrthodontics

– Accident only

$850 nOrthodontics

– Accident only

Unlimited Unlimited

Major dental 12 months $300 nOrthodontics and major

dental – Accident only

$1,000 $1,600

Orthodontics 12 months O$1,000 t

Lifetime Limit $3,200

Optical 2 months O$210 Ë$150 º

$210 Ë$150 º

$260 Ë$180 º

$420 Ë$300 º

Physiotherapy 2 months $300

$450 t n Massage sub-limit $100 t

$500 n

$500 n $1,500

Chiropractic and osteopathy 2 months $300$350 t$500 l

$1,000 t$1,600 l

Natural therapies (includes remedial massage, acupuncture and Chinese herbalism)

2 months$300

$500 t Massage sub-limit $100 t

$300 t n Massage sub-limit $100 t

$1,000 Massage sub-limit $250 t $500 lExercise Physiology 2 months

Antenatal and Postnatal 2 months O O O O $500

Health Management 6 months $50 $50 $75 $100 $300

Pharmacy (includes travel vaccines)3 2 months O $75 $200 $350 $1,500

Dietary 2 months $200 $250 $300Combined with

Natural Therapies n$1,000

Mental Health (includes Psychology, Counselling and Online CBT) 2 months$100

Online CBT sub-limit N/A$200

Online CBT sub-limit $100$300

Online CBT sub-limit $100$200

Online CBT sub-limit $100$1,000

Online CBT sub-limit $150

Podiatry (excludes orthotics) 2 months $200 $250 $300 $400 $1,000

Speech Therapy 2 months O O O O $1,000

Eye Therapy 2 months O O O O $1,000

Occupational Therapy 2 months O O OCombined with Physiotherapy n

$1,000

Home Nursing 2 months O O O $200 $400

Health aids and appliances4 12 months O O O$8007

Sub-limits apply85% of cost7

Sub-limits apply

Laser Eye Correction Surgery 36 months O O O O 100% of cost8

Accident Benefit5 No waiting period O O O O$2,000 t $4,000 l

Travel and accommodation 2 months O O O$100 travel,

$150 accommodation$200 travel, $300 accommodation

Emergency ambulance services6 No waiting period 1 service t 2 services l 1 service t 2 services l Uncapped Emergency Ambulance

t Per person l Per membership Ë Members First º Non-Members First n Combined Maximum t Per person l Per membership Ë Members First º Non-Members First n Combined Maximum

1. For most items at our Members First Extras providers covering dental, physio, chiro, podiatry consultations and selected optical. Yearly limits, waiting periods, fund and policy rules apply. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. 2. Up to yearly limits and subject to set limits. 100% back in most instances up to the first $500 then benefits of 90% apply for general dental. 100% for first 10 standard physio & chiro visits, and podiatry consultations per person per calendar year then benefits of at least

90% apply. Waiting periods, fund and policy rules apply. 3. Benefits for prescription items that are non-PBS, TGA approved, and not appearing on our exclusions list. 4. A combined yearly limit applies to this service category. 5. Accident benefit can only be used towards hospital excess or co-payment, or to boost Extras limits if service yearly limits has been reached. 6. Fund rules apply. 7. Hire and repair of health aids and appliances available, for which a 6 month waiting period applies. Sub-limits apply. 8. At Bupa recognised providers. A 3 year waiting period applies to Laser Eye Correction Surgery. 9. Combined yearly limit of $1,000 applies to all Extras services.

Packages(Extras Cover)The services below are the Extras available in our Packaged options, listed on page 18. Yearly limits per person or per membership (where applicable).

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Mental healthMental health is just as important as physical health.

For information and practical support you can trust, let us help.

Online CBT (Cognitive Behavioural Therapy) To better support you, we have an agreement with This Way Up and expanded our Mental Health offering to include Online CBT courses to help manage symptoms of anxiety and depression. Online CBT is designed to mimic a course of CBT treatment you’d typically receive when seeing a clinician face-to-face.

Mind Care Choices Program The program offers treatment and support to eligible customers in Victoria, New South Wales and Queensland with a diagnosed mental health condition, to help them manage their mental health support and care needs.

Search ‘Bupa taking care of your mental health’ for more information.

Community + home care Care when and where you need it.

Access ongoing health and care support services in your own home or community.

Osteoarthritis Healthy Weight for Life Program Targeted weight loss, strength training and pain management program for eligible customers with hip or knee osteoarthritis.

Rehab Choices Program Home rehab, nursing and other support services following a hospital admission, for eligible customers.

Chemotherapy Choices Program Treatment infusions and care at home for cancer and other conditions, for eligible customers.

Palliative Care Choices Specialist palliative care services delivered to you at home or in hospital according to your choice, for eligible customers.

Health coachingWhether you are living with a long-term medical condition, or just want to find a healthier you, our team of Bupa Health Professionals can help you.

Bupa Health Coaching Program Support for eligible customers who want to better manage a long-term health condition, or make lifestyle changes to reduce their risk of developing health issues.

The COACH Program® Telephone coaching for eligible customers following a heart attack, stroke or other cardiovascular event.

The Dietitian Health Coaching Service Personalised nutrition coaching over the phone for customers on selected covers.**

Recovery Support ProgramPhone support from a Bupa health professional to help eligible customers get back on their feet after a hospital admission.

Having a babyIntroducing a small human to your household is a big change.

Choosing to have a baby can make an impact in ways you may not always expect. We’re here to make this transition a little smoother where we can.

Parent and Baby Wellbeing Program Mental health support for new parents and parents-to-be finding the transition to parenthood difficult. Available on eligible products.

mummatters A mobile tool that helps mums and mums-to-be look after their emotional wellbeing.

** Available to members on Gold Ultimate Health Cover and Silver Plus Prime. * Fund, policy, program eligibility and wait period rules apply.

To find out more about the health and wellbeing programs and services that are right for you, call Bupa TeleHealth on 1300 030 238 to speak with a Bupa health professional – or search ‘Bupa Member Health Support Programs’.

Because your health and wellbeing really matter.Your wellbeing is so much more than looking after your health alone. And everyone is different. That’s why we offer a range of health programs to support you* – not only when you are in need but also to help you stay at your best.

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We also provide access to travel, home, car and pet insurance. And if you already have health insurance with us, you’re eligible for discounts of up to 15% off* our general insurance products.

Bupa Pet Insurance products are issued by The Hollard Insurance Company Pty Ltd (ABN 78 090 584 473, AFSL 241436) (Hollard), administered by PetSure (Australia) Pty Ltd (ABN 95 075 949 923, AFSL 420183) (PetSure) and promoted by Bupa HI Pty Ltd (ABN 81 000 057 590, AR No. 354269) an authorised representative of PetSure. Any advice is general advice only and does not take into account your personal circumstances. Consider the relevant Product Disclosure Statement available at bupa.com.au/pet-insurance to see if these products are right for you. Terms, conditions, limits and exclusions apply. Please read the PDS and do not assume that pet insurance and health insurance are similar.

^Additional excess applies. Please refer to the Product Disclosure Statement (PDS) for details. *Bupa health members get a 10% discount on Bupa Home, Car and Pet Insurance, and a 15% discount on Bupa Travel Insurance. Bupa Travel, Home, Landlords, Car and Valuables Insurance is issued by Insurance Australia Limited ABN 11 000 016 722 AFSL 227681, trading as CGU Insurance. Any advice is general advice only and does not take into account your individual circumstances. Consider the Product Disclosure Statement at bupa.com.au to see if these products are right for you. Bupa HI Pty Ltd ABN 81 000 057 590 is an authorised representative of Insurance Australia Limited.

From comprehensive coverage to a more basic level of protection, Bupa has a range of home insurance options – with a 24/7 claims assistance line should the unexpected happen.

bupa.com.au/ home-insurance

Trust your car to Bupa and choose from three levels of cover – Comprehensive Cover, Third Party Fire and Theft or Third-Party Property Damage.

bupa.com.au/ car-insurance

Protect your pet’s health with great value pet insurance. Choose from three levels of cover, providing up to 80% back on eligible vet bills.

Explore the world and feel safe, protected and ready for the unexpected. With an easy online application, we’ll have you covered when you need it.

bupa.com.au/ travel-insurance

Travel Insurance

Car Insurance

Pet Insurance

Home & Contents InsuranceProtect what is important to you.

Landlords Insurance

Because we’re more than just health insurance.

Insure one (or multiple) items that you care about most, including your mobile, laptop, tablet or musical instruments from damage, theft and everyday accidents.

bupa.com.au/ valuables-insurance

Valuables Insurance

Protect your leased or rental property with Bupa Landlords Insurance to cover against vandalism^ and damage, as well as optional loss of rent and theft cover.

bupa.com.au/ landlords-insurance

bupa.com.au/ pet-insurance

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Switching from another insurerHere’s what you need to know:

1. We handle the paperwork.

Just give us permission to get in touch with your old insurer when you apply. We’ll make sure your insurance is cancelled and obtain your ‘clearance certificate’ from your previous fund.*

2. You may not have to re-serve waiting periods.

You won’t have to serve waiting periods again for any treatments you’ve been previously covered for, as long as your clearance certificate shows that the same services are also offered equivalently on your new Bupa cover.

For more information on switching please refer to the important information guide: bupa.com.au/info

Age-based discounting to reduce your hospital premiumIf you’re aged 18-29, you are entitled to receive an age-based discount on your domestic Hospital cover. The discount is calculated at 2% for each year you’re aged under 30, when you first purchase your domestic Hospital cover. The maximum discount is 10% for 18 to 25 year olds.

Continuity of the age-based discountsIf you currently have health insurance with another fund, we’ll verify your level of discount once we’ve received a clearance certificate from your old health insurer – but don’t worry, we’ll manage this process behind the scenes, so there’s no need for you to do a thing.

How does it work?The younger you are when you purchase Hospital cover, the more discount you may be entitled to. Here’s an example of how it might work:

• If you’re a single aged between 18 and 25, you may be entitled to the full 10% discount on your domestic Hospital cover, until you turn 41.

• If you’re a couple aged 25 and 29, you may be eligible to receive the applicable discount for your age. The discount for a couple’s policy will be applied as an average to the total premium. The partner aged 25 may be eligible for a 10% discount on their domestic Hospital cover, while the partner aged 29 may be eligible for a 2% discount, resulting in a 6% average discount each year they hold domestic Hospital cover until they turn 41.

• When a person turns 41 this discount will gradually start to decrease by 2% each year.

Going to hospital1. Hospital waiting periodsWhen you first take out or upgrade health cover there’s a period of time before you can make a claim on your new level of cover. You can’t claim for services that you receive during this period at your new level of cover, even if you wait to submit the claim once the period is over. Different waiting periods apply to different hospital services:

Hospital cover Waiting period

Pre-existing conditions 12 months

Pregnancy and birth (obstetrics)

12 months

Palliative care, rehabilitation and psychiatric treatments

2 months

All other treatments included in your cover

2 months

Emergency ambulance and treatment after accidents

None

Pre-existing conditionsA pre-existing condition is any condition, ailment or illness that you had signs or symptoms of during the six months before you joined or upgraded to a higher level of cover with us. It is not necessary that you or your doctor knew what your condition was or that the condition had not been diagnosed.

If you knew you weren’t well, or had signs of a condition that a doctor would have detected (if you had seen one) during the six months prior to joining or upgrading, then the condition would be classed as pre-existing.

A doctor appointed by us decides whether your condition is pre-existing, not you or your doctor. The appointed doctor must consider your treating doctors’ opinions on the signs and symptoms of your condition, but is not bound to agree with them.

Restricted cover The Australian Government sets an amount to charge for hospital costs, which is called the ‘minimum benefit’. If your policy says you have ‘restricted cover’ for a type of treatment, it means we will only pay the minimum benefit for your hospital costs. In most cases, if you were to stay in a shared room in a public hospital, you’d be covered, but there may be an amount for you to pay. For a private room, at a private hospital, the hospital may charge even more, leaving a significant amount for you to pay.

2. Costs of going to hospitalThe below will help you understand the type of costs you might encounter during your hospital stay (assuming you are covered by your policy for the treatment you’re receiving in hospital and that you have served all relevant waiting periods).

Hospital costs:Charges related to your hospital admission such as the operating theatre, nursing and allied health services including the use of a bed and food. A couple of things to note:

• How you’re covered for hospital costs when you’re admitted as an ‘inpatient’ depends on your choice of hospital.

• If a treatment is listed as having ‘restricted cover’ on your policy information, we pay less toward your hospital costs. This means you’re likely to have more to pay for these services.

Medical costs:The fees charged by a surgeon, physician, anaesthetist, or other medical specialist when they are treating you in hospital.

How fees for medical treatments are set: The Australian Government sets the fees for medical services. However, a doctor can charge more than this.

How medical costs are covered: Medicare and Bupa both pay a portion of this (75% and 25% respectively). However, your specialist may choose to charge more than the set fee. This means you would have a ‘gap’ to pay yourself. The Bupa Medical Gap Scheme is designed to eliminate or minimise the amount you’ll have to pay in cases like this. Go to page 29 for more information.

3. Reducing your out-of-pocket hospital costs

Private hospitals do vary in cost and the facilities they provide. Below are some of the ways you can reduce your out-of-pocket costs, when you are treated as a private patient in a Members First or Network Hospital:

• No Gap Cardiac Services Bupa has partnered with GenesisCare, Australia’s largest group of privately practising cardiologists, to help achieve better health outcomes for patients with heart disease.

As a Bupa member, you’ll have no out-of-pocket expenses for services from a GenesisCare cardiologist when you’re admitted to hospital (not available in NSW, TAS & NT).

• Members First Day Hospitals If you are treated in a Members First Day Hospital, there are no out-of-pocket expenses for medical services (e.g. your surgeon, anaesthetist or other specialist fees). Not available in NT. Any co-payment or excess related to your cover will still apply.

* This can take up to 14 days, in which time you may not be able to make a claim.

Because we all need to read the important information.

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• Medical Diagnostics (Radiology and Pathology) You’ll pay no gap for in-hospital pathology and radiology diagnostic tests where recognised by Medicare and performed by Bupa contracted providers.

For more information visit: www.bupa.com.au/radiology or www.bupa.com.au/pathology

• Private room or money back guarantee (at our Members First private hospitals) Private room or money back guarantee at our Members First hospitals, means that you’ll receive a private room when you book and request one at least 24 hours before the overnight admission. If a private room is not available, you’ll receive $50 back, per night, from the hospital. You’ll also receive a complimentary daily newspaper and complimentary local calls. Applies to overnight admissions only. Excludes ‘nursing home type patients’, emergency care same-day or occasions where a private room is medically inappropriate.

Bupa Medical Gap SchemeThe Bupa Medical Gap Scheme is designed to remove or reduce the costs you pay for your treatment in hospital. Where a doctor chooses to use the Scheme for your treatment, they agree to only charge up to a certain fee. Bupa then pays a much higher amount than we normally would to help cover the extra cost. If a doctor uses the no-gap option, Bupa covers all of the extra charges, so you pay nothing for that doctor’s medical fees. Otherwise, for each doctor choosing to use the Gap Scheme, the most you’ll pay is up to $500 out-of-pocket on medical costs. Each doctor involved in your treatment can choose to use the Bupa Medical Gap Scheme for your admission in a Public Hospital, or a Private Hospital with which Bupa has an agreement.

See bupa.com.au/medicalgapscheme for more.

Your Extras Cover1. Extras Provider NetworkWith Bupa Extras cover, we’ll pay towards the cost of treatment you receive from any Bupa recognised provider. We’ve also built a network of providers. Our Members First network provides you with certainty on how much you will pay – keeping your costs as low as possible on most services.

• Members First Platinum - Pay nothing for your regular dental check-up and more at Members First Platinum dentists, when you combine Hospital and Extras that include general dental. Up to yearly limits.1 This includes bitewing x-rays, and mouthguards, if you need them. Plus, you’ll get all the benefits of Members First on most other dental services.

• Members First Providers - Our national network of extras providers can help you to reduce or eliminate out-of-pocket expenses on most items depending on your level of cover.

• Recognised Providers - If we recognise a provider, we’ll pay:

- A basic, set amount toward the cost of any Extras services covered under your policy. It will usually be a lower amount than we’d pay for services from Members First Platinum, and Members First Providers.

2. Extras waiting periodsWhen you first take out or upgrade your health cover there’s a period of time before you can make a claim on your new level of cover. This is common across the health insurance industry.

You can’t claim for services that you receive during this period at your new level of cover, even if you wait to submit the claim once the period is over.

Extras cover Waiting period

Hire and repair of health aids and appliances

6 months

Health management programs

6 months

Major Dental 12 months

Orthodontics 12 months

Purchase of health aids and appliances

12 months

All other extras services 2 months

3. Claiming on ExtrasGetting around the health insurance system can be tough, so we’ve created ‘myBupa’ – an online hub that makes using your cover easier than ever. With its intuitive design and 24/7 access across laptop, desktop and mobile, it’s the quickest way to make claims and manage your membership. You can:

• Claim online

• Get an estimate online before you get treatment

• Check your remaining limits

• Get your tax statements; and

• Manage your payments and payment information

Government and tax considerations1. Lifetime Health Cover Loading (LHC)Lifetime Health Cover (LHC) is an Australian Government initiative to encourage Australian residents with full access to Medicare to take out Hospital cover earlier in life and to keep it.

If you don’t have Hospital cover before 30 June following your 31st birthday and then decide to take out Hospital cover, you’ll pay an additional 2% on top of your Hospital cover premium every year you delay – up to a maximum of 70%. This extra cost will remain in place until you’ve had appropriate private Hospital cover for 10 continuous years.

To avoid the LHC loading you’ll need to take out Hospital cover by 30 June following your 31st birthday and maintain your cover.

2. Government rebateDepending on your age and income, the Australian Government contributes an amount (known as a ‘rebate’) towards the cost of your private health insurance premium. If you’re eligible, it may reduce the cost of your premiums.

You can choose to receive the rebate as a reduction to your premium to lower your upfront costs, or it can be calculated when you lodge your tax return.

The rebate percentages change yearly from 1 April. The Government announced that, from 1 April 2014 and every year thereafter, the rebate will be linked to the Consumer Price Index (CPI) growth or the industry average health insurance premium increase, whichever is less.

3. Medicare Levy Surcharge (MLS)To have access to Australia’s public health insurance system (Medicare), most Australian residents pay a Medicare Levy of 2% of their taxable income. Non-Australian residents generally don’t pay the Medicare Levy as they don’t access Medicare benefits.

If you’re single and earn over $90,000 per annum, or a couple/family and earn over $180,000 per annum and don’t have appropriate Hospital cover for you and all your dependants over the whole year, you may be charged the additional Medicare Levy Surcharge (MLS) as part of your tax return, in addition to the Medicare Levy.

You could choose to pay the Medicare Levy Surcharge as part of your tax return. For more information please refer to the Important Information Guide.

1Yearly limits, waiting periods, fund and policy rules apply.

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1. Making your moveWhen you join Bupa, an information exchange takes place between us and your previous fund. This exchange tells us your claims history including any waiting periods you may have served, provided to us as a clearance certificate from your fund. This can take up to 14 days, in which time you may not be able to make a claim.

Once we receive this information, we’ll recognise the level of cover you had, carrying over any remaining limits such as optical on your Extras cover. If you want to be covered for something new or to a new amount, a waiting period may apply.

3. Making a claimWhen it’s time to make your first claim, like a trip to the opticians for example, you have three options to pick from:

Online Log onto myBupa and enter the details found on your receipt. We’ll transfer the payment directly to your account.

On-the-spot Where on-the-spot claiming is available, simply swipe your membership card or tap your digital card (where supported) to claim straight away. No forms, and you’ll only pay the remaining balance.

By post Fill out a claim form, attach your invoice and receipt and post it to us. We’ll make the payment by bank transfer or cheque.

And one more thing...

You can also claim for hospital and medical costs. If you go to a hospital that has a network agreement with Bupa, you may not even see a bill.

If you do receive a bill, send it to us with a claim form attached. If you need more information about your new membership visit, bupa.com.au/your-membership or call 134 135.

2. Private Health Insurance RebateYou might be asked to complete an Australian Government Rebate Form and you can do this by logging in to myBupa.com.au or calling 134 135.

This may help to reduce the cost of your health insurance premiums based on your income.

Your premiums could go up if we don’t receive the form within 30 days. Don’t worry though, you can claim the cost back with your tax.

Because not all

change is scary.

We love our members. That’s why we’ve made switching to Bupa so simple.

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Bupa, PO Box 14639, Melbourne VIC 3001 Bupa HI Pty Ltd | ABN 81 000 057 590 | Effective 9 November 2020 11958-11-20

Go to bupa.com.au/fundrules to see our fund rules.

Unsure of any words? Visit: bupa.com.au/glossary

To find out more about what the Australian Government Rebate on private health insurance means for you, visit: bupa.com.au/rebate

Health cover for when life happens.

For more informationCall on 134 135Go to bupa.com.auVisit a Bupa Health Insurance store

Documents

Because Life Happens....Life is full of unexpected surprises. Some good. Some bad. But either way, it’s good to know that Bupa has your back. When it comes to health cover, we’ve