Bupa Private Health Insurance Review

Overview

Bupa Australia is one of Australia’s leading health insurance providers, offering a range of hospital and extras plans with varying levels of coverage and rebates.

Bupa has a large network of Members First medical, dental and other providers where members can claim a rebate of up to 100%.

Bupa also offers members a loyalty program -- Bupa Plus.

With Bupa’s wide range of health insurance products, you can save on a range of entertainment, health, and fitness services as well as enter member-only competitions.

Bupa is on our panel of health funds, so click below to filter hundreds of health insurance options and policies in minutes. Read on to learn more about BUPA’s main health insurance policy options.

Hospital cover

The right hospital cover could help you get the treatment you need in the case of medical emergencies. It can also help you save on out of pocket expenses in the long term, as hospital room and specialist fees can often add up.

It’s important to consider when you may need treatment, where you may want them and what particular services are in line with your budget. 

You could avoid paying the Medicare Levy Surcharge if you earn over $90,000 individually or $180,000 as a couple.

Bupa offers six main policies, including three budget insurance policies, through to a Gold plan that covers pregnancy and birthing.

There's also several mid-level Silver Plus plans.

All Bupa hospital cover options come with ambulance cover and access to the Bupa Plus loyalty program. Find out more about Bupa hospital and extras cover below.

Basic Accident Only Hospital

Bupa's no-frills budget cover for accidents is typically taken out by people earning over $90,000 individually or $180,000 as a couple to avoid paying the Medicare Levy Surcharge. 

It also includes a feature called Accident Inclusion, where you may be eligible to claim for a private hospital stay in the event of an accident for otherwise excluded or restricted services.

Key inclusions:

• Rehabilitation, psychiatric services, and palliative care in public hospitals

• Capped emergency ambulance cover

• Lung and chest cover

Basic Plus Starter Hospital

Bupa’s Basic Plus Starter Hospital includes many treatments that typically come with a higher level of cover. It’s targeted towards younger Australians who want a budget friendly policy. 

Key inclusions:

• Dental surgery

• Joint reconstructions

• Gynaecology

Bronze Plus Simple Hospital

A more comprehensive budget plan that covers accidents and a wide range of common hospital services for a wide range of ages. Comes with the option to choose your excess.

Key inclusions:

• Male reproductive system

• Ear, nose and throat

• Chemotherapy, radiotherapy and immunotherapy

Silver Plus Essential Hospital

A medium level of cover for people who want a high excess to keep costs down. There's no excess for kids when they're admitted to hospital, making this a policy suitable for families, although pregnancy and IVF is excluded.

Key inclusions:

• Back, neck and spine

• Heart and vascular system

• Miscarriage and termination of pregnancy

Silver Plus Advanced Hospital

This is a higher level of cover that includes a broad range of procedures. It covers cataracts, hearing devices, and joint replacements, but not pregnancy or IVF, so this policy may be suitable for seniors.

Key inclusions:

• Joint replacements

• Implantation of hearing devices

• Cataracts

Gold Complete Hospital

Top level hospital cover is Bupa's most expensive policy and includes all Medicare recognised services, including pregnancy, weight loss, and psychiatric services.

Key inclusions:

• Pregnancy and birth

• Assisted reproductive services

• Weight-loss surgery

Ambulance Cover

Emergency ambulance cover is included on all hospital policies after a one-day waiting period.

Want to compare hospital cover? Get below to get started.

Extras cover

BUPA Health Insurance extras reset on January 1 every year.

Whether you’re looking for dental, optical or chiro services, extras cover could reduce your bills for routine treatments, with rebates of up to 100%. 

Extras cover is relatively simple, but it's important to understand your potential gap fees, what you can claim back, and the agreements your health fund has with your local practitioners. 

Compare Club’s experts can help you work out what you need, and recommend you extras cover in line with your budget. 

BUPA has a broad range of extras covers available.

Freedom 50 extras

A low cost basic extras product that doesn’t include optical. You can claim 50% back at Bupa recognised providers. The policy also allows you to be flexible with your annual limits across covered services, meaning you can put them all towards dental or osteo. 

Key inclusions:

• General dental

• Physiotherapy

• Chiropractic & osteo

Starter Extras

Budget option that allows you to claim 60% back at Member First Providers and receive up to 100% back for 6 monthly dental checkups per year when combined with hospital cover.

Key inclusions:

General dental

Remedial massage

Optical

Freedom 60 Extras

Similar to Starter Extras but you can choose a Bupa recognised provider and get up to 60% back on included extras. Also includes a flexi-limit where you can choose which services to use up your extras limits on.

Key inclusions:

• Physiotherapy

• Optical

• General dental

Value Extras

A much broader extras package that allows you to claim up to 60% from your choice of Members First providers, across dental, physio, chiro, optical, orthodontics, and more.

Key inclusions:

• Major dental & endodontic

• Optical

• Digital mental health

FLEXtras

A highly flexible extras package where you can choose a selected number of services, different annual limits and how much you want to get back at any recognised provider.

Key inclusions:

• Can choose between 4 or 6 different services

• Option of standard or higher annual limits

• Choose from a range of services, including major dental, optical, orthodontic, mental health, oral health,antenatal (midwife) and more.

Lifestyle Extras

A more expensive but more comprehensive extras package that includes 12 services, including general and major dental..

Key inclusions:

• Podiatry

• Home nursing

• Non PBS Pharmaceuticals

Super Extras

A mid range package that offers 100% back for 6 monthly dental check-ups per year at Platinum First providers when combined with Hospital cover. Offers 60% back at Members First providers.

Key inclusions:

• Mental health (including psychology)

• Acupuncture

• Occupational therapy

Super Extras Active

This cover is designed for active families, singles, and couples who want access to orthodontics. Can get 60% back at Members First providers and 100% back on six monthly dental check-ups Platinum First providers when combined with hospital cover.

Key inclusions:

• Orthodontics

• Ante-natal (midwife)

• Speech therapy

Top Extras

This package offers a high level of coverage, 70% back at Members First providers and has a wide range of services. Annual limits are higher than most of Bupa’s other extras packages.

Key inclusions:

• Hearing Aids

• Orthodontics

• Blood Glucose Monitors

Top Extras Boost

Bupa's most expensive extras package provides the highest level of cover with 80% back at Members First providers. This is the highest level of cover with high annual limits.

Key inclusions:

Unlimited preventative dental

$1,100 annual limit on major dental

$1,150 annual limit on on physio, chiro, osteo

Want to compare extras cover? Get started below.

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait. But keep an eye out for special deals with waiting periods reduced or waived. Compare Club’s experts can help advise you if there are any deals available on your chosen policies from our panel.

Hospital waiting periods:

• 12 months for pre-existing conditions, pregnancy and birth.

• 2 months for hospital psychiatric services, rehabilitation and palliative care as well as all other services included in your cover.

Extra waiting periods:

• 3 years for laser eye surgery.

• 12 months for major dental services, endodontics, orthodontics, health appliances and health aids.

• 2 months for all other services, including general dental, chiro, osteo and all other services involving a health professional.

• One day for emergency ambulance services.

Member benefits

As well as a wide range of hospital and extra covers, Bupa gives members access to Bupa Plus, a loyalty program with discounts and offers from over 40 partners.

How to claim:

Claim on the spot through the HICAPS payment system at your provider, or contact Bupa through the myBupa online hub.

You can also send your claim form by post.

Hospital agreements

Bupa has agreements with most hospitals and surgery clinics across Australia. When comparing health insurance providers, it’s worthwhile to check if they have agreements with your local hospitals and clinics.

Compare Club’s specialists can check this for you.

Customer service

Bupa received 23.5% of complaints in 2022, and has a market share of 24.8%^.

FAQs

1. Is Bupa a not-for-profit fund?

No, Bupa is a for-profit fund. 

2. Who can apply? Are there restrictions?

You’ll need to be an Australian resident with a Medicare card and over 17.

3. Is it easy to switch to Bupa?

Yes, it’s easy to switch your health insurance and you can do this at any time. They’re on our panel, so click here to get started.

4. Do I need to re-serve waiting periods?

You typically won’t have to serve new waiting periods if you’re switching to an equivalent or lower level of colour. However, you may need to serve waiting periods from your previous health fund if your new policy is a higher level of cover.

5. Can I change my level of cover?

Yes, you can.

You can change to an equivalent, lower or higher level of cover. However, note that you may need to serve waiting periods for the extra benefits if you’re switching to a higher level of cover.

6. Do I get the government rebate?

The Australian Government provides eligible Australians with a rebate of up to 32.812% for every dollar of private health insurance premiums (depending on your age and income)

Learn what you’re entitled to and read our rebate guide.

7. Do I have to pay the Lifetime Health Cover loading?

You may need to pay 2% loading for each year you don’t have hospital cover if you’re over 31. Find out more here.

8. Up to what age are children covered?

Bupa will cover adult children up to the age of 31 if the family policy holder takes out Extended Family Cover, which is an additional premium you can pay to keep your adult children on your cover.

If they're studying full time, dependents can be covered as a student under a family policy with Extended Family Cover up to the age of 31.

You may be able to add your adult children back onto your current policy, but this depends on your current level of cover.

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions. ^Private Health Ombudsman, Bupa, accessed 22nd June 2022. Compare Club compares selected products from a panel of trusted insurers. We do not compare all products in the market.