BRINGING YOU CORPORATE BENEFITS - Bupa

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					CORPORATE HEALTH COVER


B R I N G I N G YO U
C O R P O R AT E B E N E F I T S




            A
B
    W E LCO M E
    T O B U PA



    We all want to live longer, healthier,
    happier lives. Bupa has a range of
    health covers designed to help find a
    healthier you.

    It’s about more than just what you can
    claim. Throughout these pages, you’ll
    discover we’re committed to supporting
    you for the long term, no matter where
    life takes you. It’s all about creating a
    healthier Australia, and it starts
    right here.

    The information in this brochure and
    the guides in the back pocket are
    important and should be read carefully
    and kept in a safe place.


    CONTENTS
    Why private health insurance?            2
    The Australian Government Rebate
                                             4
    on private health insurance
    Why Bupa?                                6
    We’ve made choosing simple               11
    Hospital Cover                           13
    Extras Cover                         23
    Ultimate Corporate Health Cover      35
    Member exclusives                    40
    Join us today                        42
    Important information                44




1
 W H Y PRIVAT E H EALTH I NS U R A N C E ?


1 . FO R P E AC E
OF MIND
CHOICE IS A
WO N D E R F U L T H I N G
Private health insurance covers most private hospital
costs. This means you can generally choose your own
doctor and where you are treated without worrying
about treatment costs. And, if you choose to be
treated in a private hospital, you don’t have to worry
about public hospital waiting lists. You can also enjoy
cover for a wide range of extras services including:
dental, optical, physio, chiro and massage, which are
not fully covered by Medicare.




THINKING ABOUT
S TA R T I N G A FA M I LY ?
If so, taking out or upgrading your private health
insurance can ensure you’re covered for important
services like pregnancy and childbirth. Then you can
rest easy and focus on enjoying life knowing that your
health insurance needs are covered.




R E ST E ASY K N OW I N G
YO U ’ R E C OV E R E D
There are a number of good financial and practical
reasons for getting private health insurance. But
when it comes down to it, the peace of mind it gives
you and your loved ones is just as important. It’s a
good idea to review your private health insurance
from time to time to ensure you still have the most
relevant level of cover for you.




                                              2
2 . I T C A N S AV E
YO U M O N E Y
I T PAY S T O J O I N                                                                    0%                   +20%
EARLIER IN LIFE                                                                       LOADING                  LOADING
You could pay more for hospital cover depending on
what age you first take it out. After age 31, the Federal
Government’s Lifetime Health Cover (LHC) Loading
means your premium could increase by 2% a year to a
maximum of 70%. This applies for 10 years straight. To
avoid paying any loading simply take out and maintain
hospital cover by 30 June following your 31st birthday.
For couples, any loadings are shared across both adults
on the membership.


M O N E Y B AC K
I N YO U R P O C K E T
The Australian Government Rebate on private health
insurance makes private health cover more affordable                                   ADAM                   JENNY
for most customers. The rebate is income tested and                                FIRST JOINED             FIRST JOINED
reduced on a tiered basis (see full details on page 4). It is                        AT AGE 30                AT AGE 40
available to all Australians who are eligible for Medicare
and applies to all covers in this brochure. The rebate is
quick and easy to claim – you can choose to get it as a
reduced premium, claim it directly from Medicare or as a
lump sum at tax time.


GET MORE FOR
YO U R M O N E Y                                                                                                     $168K
Did you know the Government’s Medicare Levy                                        $84K
Surcharge kicks in if you don’t have private
hospital cover but earn over $84,000 (for singles)
or $168,000 (for couples)?* This means you may
have to pay extra tax – more than the cost of some
of our hospital covers. You should ask your tax
adviser for more information or visit ato.gov.au


*Note: thresholds are effective 1 July 2012 and are indexed annually. On a family membership this increases by $1,500 per child
after the first child. The family thresholds apply to single parent families, couples including de facto couples. There are specific
rules for calculating adjusted taxable income for Medicare Levy Surcharge and income testing purposes.
For more information go to ato.gov.au


                                                                3
TH E AUSTR ALIAN
G OVER N M ENT R EBATE O N
PRIVATE H E ALTH I N SU R AN C E
The Australian Government Rebate on private health insurance is income tested and the Medicare
Levy Surcharge (MLS) increased for high income earners. When you join Bupa we will make it
easy for you to choose the option that best suits your needs, including nominating a rebate tier.
See the table below for details on the rebate you are entitled to based on your income, along with
the corresponding MLS.


W H AT A M I E N T ITL E D TO A N D H OW M U C H M L S W I L L I
H AV E TO PAY ?

 Australian Government Rebate and Medicare Levy Surcharge income thresholds 2012/2013

 Singles
                                          Up to                  $84,001 –               $97,001 –                More than
 Income
                                         $84,000                 $97,000*                $130,000*                $130,000*
 Rebate Tiers                           Base Tier                    Tier 1                 Tier 2                   Tier 3
 PHI Rebate
  up to 65 years                            30%                    20%                      10%                      0%
  65 – 69 years                             35%                    25%                      15%                      0%
  70 years and over                         40%                    30%                      20%                      0%
 Medicare Levy Surcharge                     0%                        1%                  1.25%                    1.50%


 Couples/Families
                                          Up to                 $168,001 –               $194,001 –               More than
 Income
                                        $168,000                $194,000*                $260,000*                $260,000*
Rebate Tiers                            Base Tier                    Tier 1                 Tier 2                   Tier 3
PHI Rebate
 up to 65 years                            30%                    20%                       10%                      0%
 65 – 69 years                             35%                     25%                      15%                      0%
 70 years and over                         40%                    30%                      20%                       0%
Medicare Levy Surcharge                     0%                        1%                   1.25%                   1.50%




  Indicates changes for higher income earners that take effect from 1 July 2012.

*Note: thresholds are effective 1 July 2012 and are indexed annually. On a family membership this increases by $1,500 per
child after the first child. The family thresholds apply to single parent families, couples including de facto couples. There are
specific rules for calculating adjusted taxable income for Medicare Levy Surcharge and income testing purposes. For more
information go to ato.gov.au


                                                                 4
R EBATE C L A I M I N G O P TI O N S
There are three ways that you can claim the Australian Government Rebate on
private health insurance:

° upfront as a premium reduction
° directly from Medicare
° it can be taken into account when you lodge your next tax return.
If you are concerned about a tax liability you can nominate a rebate tier to apply to your
policy using the relevant section in the application form. If you nominate to receive a rebate
but don't specify a tier we will proceed with nominating you under the base tier (i.e. 30% if
under 65, 35% if 65–69 and 40% if 70 and over).
If at any time after joining your circumstances change and you need to update your rebate
tier, there are a number of ways to do this. Contact us for more details.




 Natalie is 28 years old and earns $68k            Tristan and Geniveve together earn
 per year as an accountant.                        $217k per year.
 Natalie will receive a 30% rebate and             Their rebate will be 10% and their
 won't pay the Medicare Levy Surcharge.            Medicare Levy Surcharge will be 1.25% if
                                                   they don't maintain/hold an appropriate
                                                   level of private hospital cover.




                                               5
W H Y BUPA?




W E WA N T YO U T O
L I V E A LO N G E R ,
H E A LT H I E R ,
HAPPIER LIFE
Bupa is a healthcare leader proudly
looking after the needs of more than
three million Australians. We have
been around for over 60 years and
we’re part of a global group whose
care and expertise now stretches
across 190 countries.

It is our purpose that makes us
different. We exist to help our members
live longer, healthier, happier lives.
Which is why our global family reinvests
its profits to provide better services
for members and to ensure quality
healthcare remains affordable.

We are dedicated to helping find a
healthier you. To find out more:

Call us on 134 135
Visit bupa.com.au/corporate
Drop by your local Bupa centre




                                           6
                                                  WE PUT OUR
                                                  M E M B E R S AT
                                                  THE HEART OF
                                                  EVERYTHING
                                                  WE DO



We know the health system                                    By your side wherever you are
We know the health system can be                             If the unexpected happens during your
confusing. That’s why our friendly team                      stay or while you’re travelling overseas,
are here to help you make sense of it. They                  we’re always here to provide phone-based
can answer important questions like: what                    support and guidance. Our 24-hour advice
you’re currently covered for, what to ask                    line is exclusive to Bupa and provides
your doctor before treatment and how much                    you with helpful information, including:
you’ll get back.
                                                             ° basic advice on simple medical problems
For your convenience                                           provided by doctors and nurses
We give you choice so you can manage                         ° contact details and location of
your cover whenever, wherever. You can                         the nearest medical facilities
contact us by phone or talk to someone face                  ° medical translation services,
to face at one of over 100 retail centres. Or                  including reviewing bills and help
just jump online or use your smart phone to                    booking medical appointments  
access myBupa.
                                                             ° passing telephone messages
                                                               on to your family.
Freedom to choose your provider
We pay the same dollar benefit at all                         And if you’re planning a trip overseas, you
recognised providers.                                        can get pre-departure medical information
                                                             on the countries you are visiting. We’ll advise
If you choose to be treated at a Members                     you on the health risks of that country and
First provider you will also have the added                  give you tips on how to stay healthy while
certainty of receiving between 70–100% of                    you’re travelling.
the cost back for selected services depending
                                                             Just look for the number on the back of your
on your level of your extras cover.                          membership card.
Keeping healthcare affordable
We know that when you’re sick you need
to focus on the most important issue –
your health and recovery. With us you are
fully covered as a private patient in most
Members First and Network hospitals across
Australia. Plus, if you need to be admitted,
in most cases you will be covered for all
in-hospital charges.*

*A small number of Members First and Network hospitals may have a service where a fixed fee applies. An excess may
apply depending on your level of cover.


                                                         7
W H Y BUPA?




FIND A
H E A LT H I E R
YO U
At Bupa, we know that everyone
wants to be healthy, but sometimes
life gets in the way. That’s why we
support you with health programs,
tools and apps, and world-class health
information to help you take your first
step towards a healthier you.

Programs and support
We have developed a range of
programs and guides to support
members with chronic conditions
like asthma, depression or diabetes.
Members can also benefit from other
resources like our specialised parent
and baby wellbeing program.

World-class health information
Visit our website to stay in the know on
health topics that are important to you.
The information is designed by health
professionals and ranges from conditions
and treatments through to exercise
and diet tips. We also recommend
other reputable websites because our
knowledge is your knowledge.

See page 40 for other member exclusives.




                                           8
G E T T I N G TO A
H E A LT H I E R YO U




myBupa                                                                Online Health Assessment
myBupa is a new and improved way to                                   To really take charge of your health, you need
manage your health cover online. It really is                         to know just how healthy you are in the first
your very own little piece of Bupa. Here are                          place. Our new Online Health Assessment is
just a few things you can now do whenever                             very easy to use, and will help you take your
it suits you:                                                         first step towards a healthier you.
° make a claim on most extras                                         What you’ll find out
° change payment details
                                                                      ° Your “real health age”
° make one off payments
                                                                      ° lifestyle risk scores
° order a membership card
                                                                      ° recommended changes you can make to
° find a provider                                                        help improve your health age
° contact us.                                                         ° Bupa programs that may be helpful to you.
Visit bupa.com.au and log into myBupa. It’s                           Take your Online Health Assessment at
very easy and will only take a few minutes.                           bupa.com.au/OHA
You will find new things there all the time.
                                                                      We are regularly developing more new tools
You can now do all this from your mobile by                           and apps so keep checking bupa.com.au/Apps
visiting bupa.com.au on your smartphone or                            and our social media sites for updates:
by downloading the Bupa mobile app from
the iTunes Store* or Google Play.^
                                                                             Twitter.com/BupaAustralia

                                                                             Facebook.com/BupaAustralia

                                                                             Youtube.com/BupaAustralia


*Apple, iPad, iPhone, iPod Touch, and iTunes are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a
service mark of Apple Inc. ^Android and Google Play are trademarks of Google Inc.


                                                                  9
B E N E F I T S AVA I L A B L E O N
C O R P O R AT E H E A LT H C O V E R
Higher benefits
Corporate health cover offers higher benefits on extras when compared to
both Bupa’s similar product offered to retail customers and those of our main
competitors.

Gap free physio and dental for kids*
We’ll cover the cost of your kids’ physio and general dental until they turn
25. That means no out-of-pocket expenses for kids’ dental check-ups, teeth
cleaning, fillings, x-rays and more.* And no out-of-pocket costs for physio in most
instances.* At Bupa, we take care of your kids’ health.

No gap optical packages
You’ll have access to the ‘no gap’ range of fixed-priced packages on glasses
and contact lenses at no additional cost† if you visit our Members First optical
providers including: BLINK Optical, Kevin Paisley Fashion Eyewear, National
Pharmacies Optical, Prevue Eyewear, Stacey and Stacey Optometrists and
selected independent retailers. Also, at Specsavers you can choose from a
range of fixed-priced frames and lens packages with no out–of–pocket costs.†

Freedom to choose your provider
We pay the same dollar benefit at all recognised providers. If you choose to be
treated at a Members First provider you will also have the added certainty of
receiving between 70–100% of the cost back for selected services depending
on your level of your extras cover.

Excess waiver
Available on Corporate Hospital Top, Corporate Hospital Intermediate and
Corporate Hospital Saver Level 2, which means singles and single parents
won’t have to pay the first excess per calendar year and families won’t have to
pay the first two excesses per calendar year.

No excess for kids
There is also no excess payable if your child is admitted to hospital on
Corporate Hospital Top and Corporate Hospital Intermediate.

Accident benefit
If you are involved in an accident and require urgent hospital treatment, the
accident benefit provides up to $2,000 per person, $4,000 per policy which
can be used to pay for:
a) Hospital excess(es) and/or
b) To boost extras cover in the event that limits have been reached.

*Available on Ultimate Corporate Health Cover, Corporate Advantage and Corporate Classic covers when
taken with hospital cover on a family membership, when treatment is provided by a Members First dentist
or physiotherapist. Fund rules, waiting periods and annual maximums apply. Child dependants only. Includes
Major Dental in VIC and SA only. Excludes orthodontics and hospital treatments. †Optical benefits are subject
to your level of cover, annual maximums and waiting periods. Conditions apply.



                                                    10
WE’VE MADE
CHOOSING SIMPLE
We know private health insurance can be confusing so we’re here
to help you find what you’re looking for.
To tailor your own cover simply choose any of our hospital covers
then add one of our extras covers. Alternatively, you can select our
Ultimate Corporate packaged cover which combines hospital and
extras already. You can even choose to have a hospital or extras
cover on its own.
The following pages will help you to understand your options so
you can choose what’s right for you.




 1. CHOOSE                               2. CHOOSE
 YO U R H O S P I TA L                   YO U R E X T R A S
 COV E R                                 COV E R
 This helps pay for treatment            Extras covers you for services
 in hospital and generally gives         that Medicare often doesn’t


                                   +
 you the peace of mind of                cover such as: dental, optical,
 choosing your doctor as well            physio, chiro, massage and
 as when and where you are               much more. See page 23.
 treated. See page 13.




                                   OR

 3 . U LT I M AT E C O R P O R AT E
 H E A LT H C O V E R
 Ultimate Corporate Health Cover gives you our very
 best level of hospital cover combined with our top
 extras cover in one premium package. See page 35.




                                   11
     N O E XC E S S
     FOR KIDS
     There is no excess payable
     for dependant children on
     your membership.*
     *No excess offer applies to Corporate
     Hospital Top and Corporate Hospital
     Intermediate cover. See the Important
     Information section at the back of this
     brochure for more details.




12
                           HOSPITAL COVER
1.
C H O O S E YO U R
H O S P I TA L C O V E R




13
 HOSPITAL COVER



HOW MUCH
COV E R D O
YO U N E E D ?

We want to help you choose the most
relevant level of cover for you. So
we have laid out our hospital covers
for you to explore and make the
best decision.

To see our detailed comparison table,
including services covered, go to page 21.




   BAS IC

C O R P O R AT E                               C O R P O R AT E H O S P I TA L
H O S P I TA L S AV E R                        I N T E R M E D I AT E
This option covers you for most                This level of hospital cover gives
services while restricting some                you cover for services including
treatments that you’re unlikely                pregnancy, which is restricted on
to need for now. Together with                 Corporate Hospital Saver. You also
excess options, this helps keep your           get a choice of excess options to
premium down. Note that pregnancy              help lower the cost of your cover.
related services (including childbirth)
are restricted.                                See page 17.

See page 16.


LEVEL 1   LEVEL 2   LEVEL 3                    LEVEL 1   LEVEL 2   LEVEL 3
NIL       250 $500
          $
                                               NIL       250 $500
                                                         $
EXCESS    EXCESS    EXCESS                     EXCESS    EXCESS    EXCESS




                                          14
                                                         HOSPITAL COVER
               + +
         A L L C O V E R S S U I TA B L E F O R
    S I N G L E S , C O U P L E S A N D FA M I L I E S




                         COM P R E H E N S I V E

C O R P O R AT E
H O S P I TA L T O P
If you want the true peace of mind
that comes with our top hospital
cover, this may be a good option
for you. There are no exclusions and
you get a choice of excesses to help
lower the cost of your premium.

See page 18.




LEVEL 1   LEVEL 2   LEVEL 3
NIL       250 $500
          $
EXCESS    EXCESS    EXCESS




     15
 HOSPITAL COVER


C O R P O R AT E H O S P I TA L S AV E R
An ideal option if you’re young and active – this basic cover gives you a
‘safety net’ for many hospital treatments while keeping it very affordable.

 WH AT ’ S COVERED?

You’re covered for all hospital treatments                        ° schedule fees charged by a doctor,
recognised by Medicare, except the services                         surgeon, anaesthetist or other specialist
that pay minimum benefits listed below.                              for your inpatient medical treatment, plus
Examples of what you are covered for include:                       additional coverage if your doctor uses
                                                                    the Bupa Medical Gap Scheme
° hospital accommodation – overnight and
  same-day                                                        ° pathology and radiology diagnostic
                                                                    tests performed in hospital by Bupa
° theatre and intensive care fees                                   contracted providers.
° surgically implanted prostheses                                 Waiting periods apply see page 20.
  up to the approved benefits in the
  Government’s Prostheses List

 WH AT ’ S N OT FULLY COV ER ED?

The following services only receive public                        There are some services that are not fully
hospital shared room benefits                                      covered or not covered at all by any of our
(minimum benefits):                                                hospital covers, such as cosmetic surgery
° hip and knee joint replacement                                  that is not clinically required. See page 20
  (including arthroplasty, revision and                           for details.
  resurfacing procedures)
° cataract and eye lens procedures
° pregnancy related services (including
  childbirth) and assisted reproductive services
° psychiatric services.

Look after your health and get more value with:                                                LEVEL 1    LEVEL 2    LEVEL 3

° a choice of excesses to lower the cost of your cover                                          NIL       $
                                                                                                           250 $500
                                                                                               EXCESS     EXCESS     EXCESS
° Excess Waiver Feature for adults on Corporate Saver Level 2
  (see page 20 for details)
° our Members First and Network hospital agreements which help to eliminate or reduce
  your out-of-pocket expenses*
° a single room or $50 back when you book your overnight admission at Members First hospitals
  (conditions apply – contact us for details)*
° no out-of-pocket hospital expenses and no gaps on your doctors’ fees at our Members
  First day facilities*^
° limited emergency and on-the-spot ambulance services included in your cover.~
See pages 20–21 and the Important Information section at the back of this brochure to find
out more about your hospital cover.
*To see if your chosen facility has an arrangement with us, view our current Bupa Hospital Listing on our website or call us.
^Available in NSW, QLD, SA, VIC and WA. ~Limits apply.

                                                             16
                                                                                                                                HOSPITAL COVER
C O R P O R AT E H O S P I TA L
I N T E R M E D I AT E
This medium-level option gives you coverage for pregnancy and childbirth,
as well as cardiac related services.

 WH AT ’ S COVERED?

You’re covered for all hospital treatments                        ° schedule fees charged by a doctor,
recognised by Medicare, except the services                         surgeon, anaesthetist or other specialist
that pay minimum benefits listed below.                              for your inpatient medical treatment, plus
Examples of what you are covered for include:                       additional coverage if your doctor uses
                                                                    the Bupa Medical Gap Scheme
° hospital accommodation – overnight
  and same-day                                                    ° pathology and radiology diagnostic tests
                                                                    performed in hospital by Bupa
° theatre and intensive care fees                                   contracted providers.
° surgically implanted prostheses
  up to the approved benefits in the                               Waiting periods apply see page 20.
  Government’s Prostheses List

 WH AT ’ S N OT FULLY COV ER ED?

The following services only receive public                        There are some services that are not fully
hospital shared room benefits                                      covered or not covered at all by any of our
(minimum benefits):                                                hospital covers, such as cosmetic surgery
                                                                  that is not clinically required. See page 20
° hip and knee joint replacement
  (including arthroplasty, revision and                           for details.
  resurfacing procedures)
° cataract and eye lens procedures.


Look after your health and get more value with:                                                LEVEL 1   LEVEL 2     LEVEL 3

° a choice of excesses to lower the cost of your cover                                         NIL       $
                                                                                                          250 $500
                                                                                               EXCESS     EXCESS     EXCESS
° no excess if your child is admitted to hospital
° Excess Waiver Feature for adults on Corporate Intermediate Level 2 (see page 20 for details)
° our Members First and Network hospital agreements which help to eliminate or reduce
  your out-of-pocket expenses*
° a single room or $50 back when you book your overnight admission at Members First
  hospitals (conditions apply – contact us for details)*
° no out-of-pocket hospital expenses and no gaps on your doctors’ fees at our Members
  First day facilities*^
° limited emergency and on-the-spot ambulance services included in your cover.~
See pages 20–21 and the Important Information section at the back of this brochure to find
out more about your hospital cover.
*To see if your chosen facility has an arrangement with us, view our current Bupa Hospital Listing on our website or call us.
^Available in NSW, QLD, SA, VIC and WA. ~Limits apply.


                                                             17
 HOSPITAL COVER


C O R P O R AT E H O S P I TA L T O P
Our highest level of corporate hospital cover with no exclusions and a range of
additional benefits.

 WH AT ’ S COVERED?

You’re covered for all hospital treatments                        ° schedule fees charged by a doctor,
recognised by Medicare.                                             surgeon, anaesthetist or other specialist
Examples of what you are covered for include:                       for your inpatient medical treatment, plus
                                                                    additional coverage if your doctor uses
° hospital accommodation – overnight and                            the Bupa Medical Gap Scheme
  same-day
                                                                  ° pathology and radiology diagnostic
° theatre and intensive care fees                                   tests performed in hospital by Bupa
° surgically implanted prostheses                                   contracted providers.
  up to the approved benefits in the
                                                                  Waiting periods apply see page 20.
  Government’s Prostheses List

 E XC LU SION S (services not covered)

No exclusions specific to this cover.                              There are some services that are not fully
                                                                  covered or not covered at all by any of our
                                                                  hospital covers, such as cosmetic surgery
                                                                  that is not clinically required. See page 20
                                                                  for details.

Look after your health and get more value with:                                                LEVEL 1   LEVEL 2    LEVEL 3

° a choice of excesses to lower the cost of your cover                                         NIL       $
                                                                                                          250 $500
                                                                                               EXCESS     EXCESS     EXCESS
° no excess if your child is admitted to hospital
° Excess Waiver Feature for adults on Corporate Top Level 2 (see page 20 for details)
° our Bupa Members First and Network hospital agreements which help to eliminate or reduce
  your out-of-pocket expenses*
° a single room or $50 back when you book your overnight admission at Members First
  hospitals (conditions apply – contact us for details)*
° no out-of-pocket hospital expenses and no gaps on your doctors’ fees at our Members
  First day facilities*^
° limited emergency and on-the-spot ambulance services included in your cover~
° Special Benefits – provisions for a family member to stay with you in hospital
° baby books (available for expectant parents)
° health subscription refunds (e.g. Asthma Foundation membership fees) – not available on
  Corporate Hospital Top Level Three.
See pages 20–21 and the Important Information section at the back of this brochure to find
out more about your hospital cover.

* To see if your chosen facility has an arrangement with us, view our current Bupa Hospital Listing on our website or call us.
^Available in NSW, QLD, SA, VIC and WA. ~Limits apply.


                                                             18
                                               HOSPITAL COVER
     PARENT AND
     BABY WELLBEING
     PROGRAM
     Members with newborn
     babies, who may be
     feeling overwhelmed or
     struggling to cope, can
     access confidential support
     and advice through this
     specialised program. ˆ

     ˆAvailable to members who have hospital
     or packaged cover.




19
 HOSPITAL COVER


H O S P I TA L
COV E R

What’s covered
Hospital cover helps pay for treatments that            There is no waiting period for treatment you
are recognised by Medicare when you are                 require as a result of an accident sustained
admitted to hospital. When a treatment is               after joining us. There are also no waiting
included in your hospital cover we will help            periods for newborn babies provided you
pay for things like: your room, theatre fees,           are on a family hospital cover and the baby
surgically implanted prostheses and fees                is added to your membership no later than
charged by your doctor/s when they treat                two months after their birth.
you in hospital.
                                                        Excess
What’s not covered
                                                        An excess is a set amount you agree to
There are situations where you are likely not to        pay upfront before your benefit is paid
be covered under any of our hospital covers.            for overnight or same-day admissions at
The following are not covered by us at all              any hospital. The excess is paid when you
(nil hospital, prosthesis or medical benefits):          are admitted into hospital, and is capped
procedures not recognised by Medicare;                  at $500 for singles and $1,000 for single
procedures not approved by the Medical                  parents and families per calendar year.
Services Advisory Committee; experimental
treatment; respite care; cosmetic surgery that          The Excess Waiver feature, available on
is not clinically required. Surgical podiatry           Corporate Hospital Top, Corporate Hospital
receives minimum benefits (if a prosthesis is            Intermediate and Corporate Hospital Saver
surgically implanted during a procedure, the            Level 2, means singles and single parents
cost of this will be covered).                          won’t have to pay the first excess per calendar
                                                        year and families won’t have to pay the first
Waiting periods                                         two excesses per calendar year. There is also
A waiting period is the time between when               no excess payable if your child is admitted
you joined us and when you are covered                  to hospital on Corporate Hospital Top and
for a service or treatment. If you receive a            Corporate Hospital Intermediate.
service or treatment during this time, you
                                                        Bupa Medical Gap Scheme
are not eligible to receive a benefit payment
from us, regardless of when you submit the              This is a direct billing arrangement between
claim. The following waiting periods apply to           Bupa and your doctor/s that either eliminates
hospital cover:                                         or reduces out-of-pocket expenses for
                                                        in-hospital doctors’ fees (the ‘gap’). See
° pre-existing conditions, ailments or                  page 43 for more information.
  illnesses and pregnancy related services
  (including childbirth) – 12 months
                                                         You should also see the Important
° all other treatments covered by your                   Information section at the back of this
  product – two months.                                  brochure for more details.


                                                   20
                                                                                                                           HOSPITAL COVER
                                                      C O R P O R AT E       C O R P O R AT E       C O R P O R AT E
                                                       H O S P I TA L          H O S P I TA L        H O S P I TA L
                                                          S AV E R         I N T E R M E D I AT E         TO P
Services                                               See page 16             See page 17            See page 18
For Inpatient Services included on cover:
Accommodation for Overnight and
Same-day Stays
Operating Theatre, Intensive Care,
Ward Fees
Bupa Medical Gap Scheme available
Surgically Implanted Prothesis
Inpatient Services included on cover:
Accidents After Joining
Knee Arthroscopy and
Meniscectomy Procedures
Appendicitis
Removal of Tonsils and Adenoids
Dental Surgery
Minor Gynaecological Surgery
Psychiatric Services
Rehabilitation Services
Pregnancy Related Services
(including childbirth) and Assisted
Reproductive Services
Cardiac and Cardiac Related Services
(e.g. open heart and bypass surgery)
Renal Dialysis for Chronic Renal Failure
Cataract and Eye Lens Procedures
Hip/Knee Replacement
(including arthroplasty, revisions and
resurfacing procedures)
All Other Joint Replacements
All other Inpatient Treatments Receiving a
Medicare benefit
Additional Items:
Baby Books (contact us for details)
Emergency Ambulance Services^
Health Subscription Refunds^^
Special Benefits
(contact us for details)
Excesses
Excess Options*                                       Nil, $250, $500        Nil, $250, $500        Nil, $250, $500
No Excess for Kids
Excess Waiver*



 See the Important Information section for more details about Minimum Benefits. Indicates the service is not included.
^Limits apply – see the Important Information section for details. ^^Health Subscription Refunds applies to Corporate
Hospital Top, Levels 1 and 2 only (i.e. nil and $250 excess). *Excess Waiver Feature applies to the $250 excess level on
Corporate Hospital Top, Corporate Hospital Intermediate and Corporate Hospital Saver Level 2 cover only.


                                                           21
     F R E E D O M TO
     C H O O S E YO U R
     P ROV I D E R
     Depending on your extras
     cover, at Members First
     providers you will receive
     between 70–100% of the cost
     back for selected services. If
     you choose to visit a provider
     outside of our network, you
     will still receive the same dollar
     benefit amount back as at our
     Members First providers.




22
                     EXTRAS COVER
2.
C H O O S E YO U R
E X T R AS COV E R




23
 EX T RAS COV ER



HOW MUCH
COV E R D O
YO U N E E D ?

We want to help you choose the most
relevant level of cover for you. So we
have laid out our extras covers side by
side to help you to compare.

To see our detailed comparison table,
including services covered and annual
maximums for each level of cover, go to
pages 31–33.




  BAS IC

C O R P O R AT E                               C O R P O R AT E
ESSENTIALS                                     CLASSIC
Enjoy access to a wide range of                If you want generous benefits and a
services with at least 70% back at             high level of cover, this option may
Members First providers. Plus, you’ll          suit you. It gives you access to a
receive the same dollar benefit                 wide range of services that Medicare
amount at all other providers.                 doesn’t cover with at least 80% back
                                               at Members First providers. And
See page 26.                                   you’ll receive the same dollar benefit
                                               amount at all other providers.

                                               See page 28.




                                          24
                                                         EXTRAS COVER
             + +
         A L L C O V E R S S U I TA B L E F O R
    S I N G L E S , C O U P L E S A N D FA M I L I E S




                        COM P R E H E N S I V E

C O R P O R AT E
A D VA N TA G E
Get peace of mind knowing that
you’re covered to our highest level of
extras cover. The real advantage here
is access to a wide range of services
that Medicare doesn’t cover with
at least 90% back at Members First
providers. And the same dollar benefit
amount at all other providers.

See page 29.




    25
 EX T RAS COV ER


C O R P O R AT E
ESSENTIALS

A basic level of extras cover with good benefits and coverage for the
services that may be relevant to your needs.

                  AT L E A S T 7 0 % B A C K AT M E M B E R S F I R S T P R O V I D E R S
                                          ANNUAL M AXI M UM S                                              WA I TI N G
 S E RVICES                               Per Person Per Calendar Year                                     P E R I O DS
General Dental                            $350                                                                2 months
Major Dental                              Combined with general dental                                       12 months
Optical                                   $200 – No Gap optical packages – see p30                            2 months
Physiotherapy, Chiropractic,                                                                                  2 months
                                 $150 Combined
Osteopathy and Natural Therapies
Living Well (see p40)                     $100                                                                6 months
Pharmacy (see p32)                        $150                                                                2 months
                                          1 service per calendar year (singles)
Emergency Ambulance ~                                                                                             None
                                          2 services per calendar year (families)


Freedom to choose your provider
We pay the same dollar benefit at all recognised providers. If you choose to be treated at a
Members First provider you will also have the added certainty of receiving between 70–100%
of the cost back for selected services depending on your level of your extras cover.


See pages 31–33, the Important Information section and the Corporate Benefits Guide in the
back of this brochure to find out more about your extras cover.




 For most items at our Members First providers covering dental, physio and chiro services. Includes major dental in VIC
and SA only. ~Limits apply.


                                                          26
                                                  EXTRAS COVER


GET A PAIR ON US
Find out how you can get
a pair of spectacles or a
supply of contact lenses
completely covered by us.†
†Conditions apply. Please refer to the
Corporate Benefits Guide for more details.




                                             27
 EX T RAS COV ER


C O R P O R AT E
CLASSIC

Cover for a wide range of services with high benefits and annual maximums.
                  AT L E A S T 8 0 % B A C K AT M E M B E R S F I R S T P R O V I D E R S
                                      ANNUAL M AXI M UM S                                                   WA ITIN G
 S E RV IC E S
                                      Per Person Per Calendar Year                                          PER IODS
                                      Year 1 $400 – Year 6+ $800
General Dental                                                                                               2 months
                                      No Gap for kids – see p30
Major Dental                          Year 1 $400 – Year 6+ $800                                            12 months
Orthodontics                          $1,600 Lifetime Limit                                                 12 months
Optical                               $225 – No Gap optical packages – see p30                               2 months
Chiropractic and Osteopathy           $500 per person $1,000 per membership                                  2 months
Physiotherapy                         Year 1 $350 – Year 6 $700                                              2 months
Antenatal and Postnatal               No Gap physio for kids – see p30                                       2 months
Living Well (see p40)                 $100                                                                   6 months
Pharmacy (see p32)                    $300                                                                   2 months
Natural Therapies
(see p32 for a full list)
Dietary
Psychology
                                      $600                                                                   2 months
Podiatry (excludes orthotics)
Speech Therapy
Eye Therapy
Occupational Therapy
Health Aids and Appliances            Combined with Natural Therapies and other
                                                                                                            12 months
(see p32 for the full list)           services annual maximum (sub-limits apply)
Hire, Repair and Maintenance          $100 sub-limit within Natural Therapies
                                                                                                             6 months
of Health Aids and Appliances         and other services annual maximum
Home Nursing                          $350                                                                   2 months
Accident Benefit                       $2,000 per person $4,000 per membership                                     None
Travel and Accommodation              $100 – Travel $150 – Accommodation                                     2 months
                                      1 service per calendar year (singles)
Emergency Ambulance ~                                                                                             None
                                      2 services per calendar year (families)

See pages 31–33, the Important Information section and the Corporate Benefits Guide to find out
more about your extras cover.
  Loyalty maximums                                             Freedom to choose your provider
We increase how much you can claim each                        We pay the same dollar benefit at all
year by 20% of the initial amount for most                     recognised providers. If you choose to be
extras services (applies after the first 12                     treated at a Members First provider you will
months up to a maximum increase of 100%).                      also have the added certainty of receiving
                                                               between 70–100% of the cost back for
                                                               selected services depending on your level
                                                               of your extras cover.
 For most items at our Members First providers covering dental, physio and chiro services. Includes major dental in VIC
and SA only. ~Limits apply.


                                                          28
C O R P O R AT E
A DVA N TAG E

Cover for a wide range of services with higher benefits and annual maximums.
                  AT L E A S T 9 0 % B A C K AT M E M B E R S F I R S T P R O V I D E R S
                                     ANNUAL M AXI M UM S                                                    WA ITIN G
SE RV IC E S
                                     Per Person Per Calendar Year                                           PER IODS
General Dental                       Unlimited – No Gap for kids – see p30                                   2 months
Major Dental                         $800                                                                   12 months
Orthodontics                         $1,200 per person $2,400 Lifetime Limit                                12 months
Optical                              $250 – No Gap optical packages – see p30                                2 months
Chiropractic and Osteopathy          $600 per person $1,200 per membership                                   2 months
Physiotherapy                        Year 1 $400 – Year 6 $800                                               2 months
Antenatal and Postnatal              No Gap physio for kids – see p30                                        2 months
Natural Therapies
                                     $400                                                                    2 months
(see p30 for a full list)
Living Well (see p40)                $100                                                                    6 months
Pharmacy (see p32)                   $450                                                                    2 months
Psychology                           $500 per person $1,000 per membership                                   2 months
Dietary
Podiatry (excludes orthotics)
Speech Therapy                       $500                                                                    2 months
Eye Therapy
Occupational Therapy
Home Nursing                         $350                                                                    2 months
Health Aids and Appliances
                                     $850                                                                   12 months
(see p32 for a full list)
Hire, Repair and Maintenance         $100 sub-limit within Health Aids and Appliances
                                                                                                             6 months
of Health Aids and Appliances        annual maximum
Accident Benefit                      $2,000 per person $4,000 per membership                                     None
Travel and Accommodation             Travel – $100 Accommodation – $150                                      2 months
                                     1 service per calendar year for singles
Emergency Ambulance ~                                                                                            None
                                     2 services per calendar year for families

See pages 31–33, the Important Information section and the Corporate Benefits Guide to find out
more about your extras cover.
   Loyalty maximums                                           Freedom to choose your provider
We increase how much you can claim each                       We pay the same dollar benefit at all
year by 20% of the initial amount for most                    recognised providers. If you choose to be
extras services (applies after the first 12                    treated at a Members First provider you will
                                                              also have the added certainty of receiving
months up to a maximum increase of 100%).
                                                              between 70–100% of the cost back for
                                                              selected services depending on your level
                                                              of your extras cover.
 For most items at our Members First providers covering dental, physio and chiro services. Includes major dental in VIC
and SA only. ~Limits apply.


                                                          29
                                                                                                                EXTRAS COVER
Save with our Members First network               Are all extras services covered?
Our extensive Members First provider              There are instances when extras benefits
network offers nation-wide access to              are not payable including:
general dental, optical, physiotherapy and
chiropractic services. If you have extras         ° for different services within the same
cover with us, you will have the certainty of       service type from the same provider on the
knowing how much you’ll get back in most            same day. For example, if you went to see an
instances when you visit these providers.           acupuncturist and then received a massage
Visit our website to find a Members First            from the same provider on the same day,
provider near you. Also, keep an eye out for        you cannot claim for both services
the following logo at your providers:
                                                  ° when a provider is not recognised by us
                                                    for benefit purposes
                                                  ° when a third party provides a benefit
                                                    (e.g. when you hold a state
                                                    ambulance subscription).

                                                  Gap free physio and dental for kids*
                                                  We‘ll cover the cost of your kids’ physio
Set benefits
                                                  and general dental until they turn 25. That
If you visit a non-Members First provider         means no out-of-pocket expenses for kids’
you will receive a set amount back known          dental check-ups, teeth cleaning, fillings,
as a set benefit. This benefit amount is            x-rays and more.* And no out-of-pocket
the same as what you would receive at a           costs for physio in most instances.* At
Members First provider.
                                                  Bupa, your kids’ health is taken care of.
For a services where we do not have a             *Available on Ultimate Corporate Health Cover,
Members First Network, you will receive a set     Corporate Advantage and Corporate Classic covers
benefit as well. See the Corporate Benefits        when taken with hospital cover on a family membership,
                                                  when treatment is provided by a Members First dentist
Guide in the back of this brochure or call us     or physiotherapist. Fund rules, waiting periods and
if you want to know how much you will get         annual maximums apply. Child dependants only. Includes
                                                  Major Dental in VIC and SA only. Excludes orthodontics
back before you visit your extras provider.       and hospital treatments.

Annual maximums and service limits
There are limits to the amount you can             See pages 31–33 and the Important
claim back and/or the number of times you          Information section at the back of this
can claim on most services.                        brochure to find out more.



 MEMBERS FIRST OPTICAL                            OT H E R O P T I C A L B E N E F I T S
 Our Members First optical providers              At Specsavers you can choose from a
 include BLINK Optical, Kevin Paisley             range of fixed-priced frames and lens
 Fashion Eyewear, National Pharmacies             packages with no out–of–pocket costs.†
 Optical, Prevue Eyewear, Stacey and Stacey
                                                  †Optical benefits are subject to your level of cover, annual
 Optometrists and selected independent            maximums and waiting periods. Conditions apply. #Not in
 retailers. You’ll have access to the ‘no gap’    conjunction with any other offers.
 range of fixed-priced packages on glasses
 and contact lenses at no additional cost†
 and up to $100 off all fashion frames if you
 visit one of these providers.#


                                                 30
 EX T RAS COV ER

H OW M U C H C A N YO U C L A I M U P TO ?


                                      C O R P O R AT E             C O R P O R AT E             C O R P O R AT E
                                      ESSENTIALS                     CLASSIC                    A D VA N TA G E
                                            70% back*                     80% back*                   90% back*
                                       Annual Maximums              Annual Maximums               Annual Maximums
                   Waiting                Per Person                   Per Person                    Per Person
 Services          Periods             Per Calendar Year            Per Calendar Year             Per Calendar Year
 General
 Dental                                                             Year        Amount
                                                                      1            $400
                                                                      2            $480
                     2 months                                         3            $560                 Unlimited
                                                                     4             $640
                                                                      5            $720
                                                                     6+            $800
                                             $350
                                           Combined
 Major
                                            annual
 Dental
                                           maximum                  Year        Amount
                                                                      1             $0
                                                                      2            $400
                     12 months                                                                           $800
                                                                      3            $480
                                                                     4             $560
                                                                      5            $640
                                                                     6             $720
                                                                     6+            $800
 Orthodontics                                                      $1,600 Lifetime Limit
                                                                      for orthodontics           $1,200 per person
                     12 months
                                                                                                $2,400 Lifetime Limit

 Optical
                     2 months                 $200                          $225                          $250

 Chiropractic
 and                                                                  $500 per person             $600 per person
                     2 months
 Osteopathy                                                       $1,000 per membership       $1,200 per membership

 Physiotherapy                               $150
                                           Combined                 Year        Amount            Year       Amount
                                            annual                    1            $350             1            $400
                                           maximum                    2            $420             2            $480
                     2 months                                         3            $490             3            $560
 Antenatal
                                                                     4             $560            4             $640
 and
                                                                      5            $630             5            $720
 postnatal
                                                                     6+            $700            6+            $800




*For most items at our Members First providers covering dental, physio and chiro services. Includes major dental and
orthodontics in VIC and SA only. Annual maximums and waiting periods apply. Loyalty Maximums (see page 29) other dollar
amounts relate to annual maximums. New members.


                                                             31
                                                                                      C O R P O R AT E E S S E N T I A L S
                                                                                                       Set Benefits
                                                                                                  Annual Maximums
Services                                                       Waiting Periods
                                                                                             Per Person Per Calendar Year
 Living Well (see p40)                                              6 months                               $100
 Pharmacy^^                                                         2 months                               $150

 Natural Therapies
 Includes: acupuncture, Alexander Technique,
 Chinese herbalism, exercise physiology, Feldenkrais,
 homeopathy, iridology, naturopathy, Western                                                Combined with Physiotherapy
 herbalism and massage.                                             2 months
                                                                                                 annual maximum
 Massage includes: aromatherapy, Bowen
 Technique, kinesiology, reflexology, shiatsu,
 and remedial massage.
 Psychology                                                         2 months
 Dietary                                                            2 months
 Podiatry (excludes orthotics)                                      2 months
 Speech Therapy                                                     2 months
 Eye Therapy                                                        2 months
 Occupational Therapy                                               2 months
 Home Nursing                                                       2 months
 Health Aids and Appliances+

 Sub-Limits
  Asthma Pumps
  Blood Glucose Monitors or INR Blood
  Testing Devices (Coagucheck)
  Defined Appliances (includes orthotics)^
  Surgical Stockings
                                                                   12 months
  CPAP Devices#
  Hearing Aids
  TENS Machine
  Blood Pressure Monitors
  Hire, Repair and Maintenance of Health Aids
  and Appliances

 Travel and Accommodation                                           2 months

 Accident Benefit~                                              No waiting period
                                                                                              1 service per year (singles)
 Emergency Ambulance Services~                                 No waiting period
                                                                                             2 services per year (families)




^^Benefits for prescription items that are non-PBS, TGA approved, and not appearing on our exclusions list. +A combined annual
maximum applies to this service category. ^Defined Appliances includes orthotics, orthopaedic and corrective footwear, pressure
garments, braces and artificial limbs. Limits apply per item.


                                                            32
                                                                                                                                        EXTRAS COVER
        C O R P O R AT E C L A S S I C                                     C O R P O R AT E A D VA N TA G E
                       Set Benefits                                                           Set Benefits
                  Annual Maximums                                                       Annual Maximums
             Per Person Per Calendar Year                                          Per Person Per Calendar Year
                           $100                                                                  $100
                           $300                                                                  $450




                                                                                                 $400




          Combined annual maximum $600
                                                                            $500 per person, $1,000 per membership




                                                                                                 $500




                           $350                                                                  $350

          Combined with Natural Therapies
                                                                                                 $850
         annual maximum (sub-limits apply)

                  1 claim every 3 years                                           1 claim every 3 years up to $300

                     1 claim per year                                                1 claim per year up to $500

                     $500 per year                                                          $500 per year
                      $100 per year                                                         $100 per year
                  1 claim every 2 years                                           1 claim every 2 years up to $750
                  1 claim every 3 years                                           1 claim every 3 years up to $850
                      $175 per year                                                          $175 per year
                      $175 per year                                                          $175 per year
$100 per calendar year combined annual maximum with                 $100 per calendar year combined annual maximum with
                  Natural Therapies                                               Health Aids and Appliances
                    $100 – Travel                                                        $100 – Travel
               $150 – Accommodation                                                $150 – Accommodation
     $2000 per person $4000 per membership                                 $2000 per person $4000 per membership
              1 service per year (singles)                                          1 service per year (singles)
             2 services per year (families)                                        2 services per year (families)




     #Subject to eligibility. Call us for details. ~When an accident requires urgent hospital treatment, can boost annual maximums on
     extras or pay for your hospital excess. Limits apply – see the Important Information section for more details.


                                                                    33
     GAP BONUS
     Receive a $200 Gap
     Bonus when you join, and
     another $200 at the start
     of each calendar year per
     membership, to help pay for
     any medical gaps charged
     by your doctor or specialist
     when admitted to hospital.
     Plus, any unused bonus
     amounts will accumulate.



34
                            ULTIMATE CORPORATE HEALTH COVER
3.
C H O O S E U LT I M AT E
C O R P O R AT E
H E A LT H C O V E R




35
 U LTIM AT E CO R P OR ATE H EALT H COV E R



U LT I M AT E
C O R P O R AT E
H E A LT H C O V E R

Ultimate Corporate Health Cover gives you our very best level of hospital
cover with no excess or co-payment to pay combined with our top extras
cover. With a range of additional benefits, some unique to this cover, you can
relax knowing that this premium package gives you genuine peace of mind.


H O S P I TA L
WH AT ’ S COVERED?                              EXC LUS I O N S (services not covered)

You're covered for all hospital treatments      No exclusions specific to this cover.
recognised by Medicare.
                                                There are some services that are not fully
Examples of what we pay benefits for include:    covered or not covered at all by any of our
                                                hospital covers, such as cosmetic surgery
° hospital accommodation – overnight and
  same-day                                      that is not clinically required. See page 20
                                                for details.
° theatre and intensive care fees
° surgically implanted prostheses
  up to the approved benefits in the
  Government’s Prostheses List
° schedule fees charged by a doctor,
  surgeon, anaesthetist or other specialist
  for your inpatient medical treatment, plus
  additional coverage if your doctor uses
  the Bupa Medical Gap Scheme
° pathology and radiology diagnostic
  tests performed in hospital by Bupa               You should also see the Important
  contracted providers.                             Information section at the back of this
Waiting periods apply.                              brochure for more details.




                                               36
                                                                                                                      ULTIMATE CORPORATE HEALTH COVER
EXTRAS
                    U P T O 1 0 0 % B A C K AT M E M B E R S F I R S T P R O V I D E R S

                                                           A N N UA L M A X I M U M S                  WA I TI N G
 S E RVICES                                                Per Person Per Calendar Year                P E R I O DS
General Dental                                             Unlimited (No Gap for kids see p39)            2 months
Major Dental                                               Year 1 $800 – Year 6+ $1,600                  12 months
Orthodontics                                               $1,400 per person
                                                                                                         12 months
                                                           $3,200 Lifetime Limit
Optical                                                    $420 or $300
                                                                                                          2 months
                                                           (No Gap optical packages see p39)
Physiotherapy                                              Year 1 $750 – Year 6+ $1,500
                                                                                                          2 months
                                                           (No Gap for kids see p39)
Chiropractic and Osteopathy                                Year 1 $500 – Year 6+ $1,000 (per person)
                                                                                                          2 months
                                                           Year 1 $800 – $1,600 (per family)
Antenatal and Postnatal                                    $500                                           2 months
Natural Therapies
Includes: acupuncture, Alexander Technique, Chinese
herbalism, exercise physiology, Feldenkrais, homeopathy,   Year 1 $500 – Year 6+ $1,000
iridology, naturopathy and Western herbalism.              Includes sub-limits for massage:               2 months
                                                           $250 per person, $500 per membership
Massage includes: aromatherapy, Bowen Technique,
kinesiology, reflexology, shiatsu, and remedial massage.
Living Well (see p40)                                      $100                                           6 months
Pharmacy^^                                                 Year 1 $750 – Year 6+ $1,500                   2 months
Dietary                                                    Year 1 $500 – Year 6+ $1,000                   2 months
Psychology                                                 Year 1 $500 – Year 6+ $1,000                   2 months
Podiatry (excludes orthotics)                              Year 1 $500 – Year 6+ $1,000                   2 months
Speech Therapy                                             Year 1 $500 – Year 6+ $1,000                   2 months
Eye Therapy                                                Year 1 $500 – Year 6+ $1,000                   2 months
Occupational Therapy                                       Year 1 $500 – Year 6+ $1,000                   2 months
Home Nursing                                               $400                                           2 months
Health Aids and Appliances                                 $1,000                                        12 months
Hire Repair and Maintenance of Health Aids                 $100 combined limit with
                                                                                                          6 months
and Appliances                                             Health Aids and Appliances
Travel and Accommodation                                   $200 – Travel, $300 – Accommodation            2 months
Emergency Ambulance Services~                              1 service per year (singles)
                                                                                                              None
                                                           2 services per year (families)
   = Members First       = non-Members First



See pages 20 and 36, the Important Information section and the Corporate Benefits Guide
in the back of this brochure to find out more about your hospital and extras cover.




 For most items at our Members First providers covering dental, physio and chiro services. Includes major dental in
VIC and SA only. Loyalty Maximums (see page 38). ^^Benefits for prescription items that are non-PBS, TGA approved,
and not appearing on our exclusions list. ~Limits apply.


                                                            37
 U LT IMAT E CO R P OR ATE H EALT H COV E R



F O R U LT I M AT E
P E AC E O F M I N D
A N D VA L U E

Receive 100% back for:                                            Can also enjoy:
° general dental at any recognised provider up                    ° a single room or $50 back when you book
  to the first $500 per person per year                              your overnight admission at our Members
                                                                    First hospitals (conditions apply – contact
° major dental at any recognised provider
  up to your annual maximums                                        us for details) *

° all orthodontics at any recognised                              ° Special Benefits – to help pay for meals
  provider until your annual maximum and                            and accommodation for a relative or carer
  lifetime limit has been reached                                   who stays with you in hospital

° physio and chiro at any recognised                              ° health subscription refunds (e.g. Asthma
  provider up to the first $350 per person                           Foundation membership fees)
  per year                                                        ° a bowel cancer screening kit benefit
° a range of fixed-priced packages on                              ° baby books plus a ‘parent and baby’
  spectacles and contact lenses from our                            wellbeing program (available for
  Members First providers                                           expectant parents).
° your hospital costs (in most instances) at our                   Loyalty Maximums
  Members First, Network and public hospitals
                                                                  We increase how much you can claim each
° your hospital expenses and doctors' fees                        year by 20% of the initial amount for most
  at our Members First day facilities*^                           extras services (applies after the first 12
° a subscription with your state ambulance                        months up to a maximum increase of 100%).
  provider (where available), and limited                         See page 37 for more details.
  emergency and on-the-spot ambulance
  services included in your cover.~

See the Important Information section and the Corporate Benefits Guide in the back of this
brochure for more information.




*To see if your chosen facility has an arrangement with us, view our current Bupa Hospital Listing on our website or call us.
^Available in NSW, QLD, SA and VIC. ~Limits apply to ambulance cover included in your cover.


                                                             38
                                                                                              ULTIMATE CORPORATE HEALTH COVER
B E N E F I T S AVA I L A B L E
O N U LT I M AT E
100% cover for laser eye surgery
100% cover for most laser eye corrective surgery when performed by
a Bupa approved provider. A three year waiting period applies and
excludes lens implant.

Gap Bonus
Receive a $200 Gap Bonus when you join, and another $200 at the
start of each calendar year per membership, to help pay for any
medical gaps charged by your doctor or specialist when admitted to
hospital. Plus, any unused bonus amounts will accumulate.

Fixed fee reimbursement
Ultimate Corporate Health Cover members will be reimbursed if charged
a fixed daily fee by any of our contracted fixed fee hospitals.^

By your side wherever you are
If the unexpected happens while you’re travelling overseas, we’re always
here to provide phone-based support and advice. Our 24-hour overseas
health advice line is exclusive to Bupa members – just look for the
number on the back of your membership card.

Gap free physio and dental for kids*
We‘ll cover the cost of your kid’s physio and general dental until
they turn 25. That means no out-of-pocket expenses for kids’
dental check-ups, teeth cleaning, fillings, x-rays and more.* And no
out-of-pocket costs for physio in most instances.* At Bupa, your kids’
health is taken care of.

No gap optical packages
You’ll have access to the ‘no gap’ range of fixed-priced packages
on glasses and contact lenses at no additional cost† if you visit our
Members First optical providers including: BLINK Optical, Kevin Paisley
Fashion Eyewear, National Pharmacies Optical, Prevue Eyewear, Stacey
and Stacey Optometrists and selected independent retailers.†
Also, at Specsavers you can choose from a range of fixed-priced frames
and lens packages with no out–of–pocket costs.†

^To see if your chosen facility has an arrangement with us, view our current Bupa Hospital
Listing on our website or call us. *Available on Ultimate Corporate Health Cover, Corporate
Advantage and Corporate Classic covers when taken with hospital cover on a family
membership, when treatment is provided by a Members First dentist or physiotherapist. Fund
rules, waiting periods and annual maximums apply. Child dependants only. Includes Major
Dental in VIC and SA only. Excludes orthodontics and hospital treatments. †Optical benefits
are subject to your level of cover, annual maximums and waiting periods. Conditions apply.




                                            39
 M EMB E R E XC LU S I V ES



MORE
VA L U E F O R
MEMBERS

We believe good health includes both                         Travel, home and car
physical and mental wellbeing. So if you                     We’re more than a health insurance provider.
need time-out, you’re keen on fitness and                     Through our partnership with CGU, we’re
sports or you’re interested in travel – you                  able to offer you a full range of insurance
can enjoy activities without it costing an                   products from travel insurance, home and
arm and a leg. Choose what suits your needs                  contents insurance, to motor vehicle and
from our range of additional benefits and                     caravan insurance. What’s more, just for being
selected discount partners.                                  a Bupa member, you’ll also get a 10% discount
                                                             on your home and contents insurance or
Shine magazine
                                                             motor vehicle insurance premiums, plus a 15%
Twice a year, we send out Shine – a free                     discount on travel insurance.†
health and wellness magazine packed full
of topical articles from travel, nutrition and               Bupa Life Insurance
exercise to profiles and giveaways. Simply                    As a Bupa member you’ll get a 10% discount
login to myBupa online and select your                       on your Life Insurance premium.*
mailing preference.
                                                             To find out more go to bupa.com.au/insurance,
Living Well                                                  call 134 135 or drop by your local Bupa centre.
Living Well provides practical support to
help you reach your goals by covering some
of the costs for health-related programs.
These include: first aid courses, nicotine
replacement therapy, weight management
programs, gym membership fees, Pilates
and yoga courses. Eligibility criteria and
conditions apply, so please contact us to
find out more.




†Insurance is issued by CGU Insurance Limited (CGU) ABN 27 004 478 371 AFSL 238291. This is general advice only and
does not take into account your individual circumstances. Product Disclosure Statements are available at bupa.com.au
and should be considered before making any decision on these products. Bupa Australia Pty Ltd ABN 81 00 057 590
and Bupa Australia Health Pty Ltd ABN 50 003 098 655 (together Bupa) are authorised representatives of CGU. *Life
Insurance products issued by ClearView Life Assurance Limited. Before making a decision about one of these products
consider the relevant Product Disclosure Statement available by calling 134 135.


                                                         40
                                                                                                            MEMBER EXCLUSIVES
 M E M B E R D I S C O U N T PA R T N E R S
 For details on how to receive these offers, full terms and conditions and a complete list of
 all of our member discount partners, please call us or visit bupa.com.au/MemberExclusives




Get up to 25% discount on movie tickets
when purchased online.                                     Get a 15% discount when you purchase
                                                           tickets online for Dreamworld, WhiteWater
                                                           World and Skypoint.
     eventcinemas.com.au




Get up to 25% discount on movie tickets
when purchased online.
                                                           Get a 10% discount at Warner Village Theme
                                                           Parks on day admission for adults, children
                                                           and pensioner passes.

Get 25% off two full priced games and shoe
hire at any AMF Bowling Centre.




                                                           Get 15% off the monthly membership fee
Delight your senses with 25% off all full price            at EFM Health Clubs.
online purchases.




Get 20% off the usual retail price on a
range of sunglasses displayed at any                       Get a 10% discount on a 12-month
BLINK Optical store.                                       membership and a waiver of the joining fee.




Get 20% off the usual retail price on a range
of sunglasses displayed at any National                    Get up to 20% off selected Guy Leech products.
Pharmacies Optical store.




                                                           Receive $30 off any RedBalloon experience
                                                           when you spend $129 or more.
Receive up to 20% off the usual retail price on
selected frames, lenses and contact lenses, and
up to 10% off the usual retail price of sunglasses.


                                                      41
 J O IN US TODAY



JOINING IS
SIMPLE

Only one form to fill in                                  Switching to Bupa is simple
Simply fill in our application form and mail it           Enjoy a hassle-free experience when you
back to us using our reply paid address, or              transfer to us from your existing health
drop it into your local Bupa centre. Or just call        fund. Simply fill in our application form and
us on 134 135 or visit bupa.com.au/corporate             cancel any direct debit arrangements you
to join online.                                          have previously made. If you already have
                                                         a clearance certificate, please send it to us
Easy ways to pay
                                                         or complete the relevant section on your
You can choose to pay via Direct Debit or                application form.
payroll deduction. If you are choosing payroll
                                                         30-Day cooling off period
deduction, check with your employer first that
this option is available to you.                         We’re confident you’ll be happy with your
                                                         cover; however, if you decide to cancel we’ll
                                                         refund any premiums you have paid within the
                                                         first 30 days of your membership commencing
                                                         provided you haven’t made a claim.




                                                    42
                                                                                                            JOIN US TODAY
CLAIMING
MADE EASY

CLAIM ON YOUR HOSPITAL                                    CLAIMING ON BOTH HOSPITAL
                                                          AND EXTRAS
Bupa Medical Gap Scheme
This is a direct billing arrangement between              By mail
Bupa and your doctor/s that in most                       Simply print a claim form off our website,
instances eliminates your out-of-pocket                   fill it in and attach any original accounts or
expenses for in-hospital doctors’ fees (the               receipts from your health care provider/s.
‘gap’). Under this scheme some doctors can                Then mail it to us at: Bupa, Reply Paid 990,
charge you a known gap which means you                    ADELAIDE SA 5001.
have some out-of-pocket expenses to pay
but they are limited to a defined amount.                  In person
Doctors need to agree to participate in this              You can submit your claims at your local
scheme for it to apply so make sure you                   Bupa centre. Most centres are able to
ask them about it before you are treated.                 process claims on the spot and provide you
Otherwise our medical benefits are limited                 with benefits, either by cash (limits apply),
to the Medicare Benefits Schedule (MBS) fee                cheque or bank transfer.
and if your doctor charges above the MBS
you will have a gap to pay.                               Claim queries
If a doctor proposes to charge you a ‘gap’                Remember that claims can only be paid
they need your informed financial consent.                 within two years of the date that the service
Please contact us for details.                            was provided and are subject to standard
                                                          conditions including waiting periods and
                                                          annual maximums.
CLAIM ON YOUR EXTRAS
                                                          Call our friendly Bupa team on 134 135, visit
On the spot                                               bupa.com.au or drop by your local Bupa
Simply swipe your membership card after your              centre if you have any questions about:
treatment at one of 40,000 providers around
Australia and your claim will automatically               ° the status of your claim
be processed. Then you just need to pay the               ° how to fill in a claim form
balance of the bill (if applicable).
                                                          ° what documents you need to attach
                                                            to your claim form.
Online or by smart phone
You can easily claim online via our website,
or by using the myBupa app. If you have a
smart phone you can also claim through our
mobile friendly website.# Payment will then
be made directly into your account.

#Thefollowing services are not claimable online: Living Well, Bupa Medical Gap, pharmacy, health aids and
appliances, ambulance services, orthodontics, travel and accommodation and hospital claims.


                                                     43
 IMP ORTA NT I NFOR M ATI ON
Over the next few pages you will find                  ° allied services including physiotherapy,
information to help you understand how your             occupational therapy and dietetics
health cover with us works. We recommend
                                                      ° dressings and other consumables
you keep this information in a safe place so
that you can always refer to it.                      ° pathology and radiology diagnostic
                                                        tests performed in hospital by Bupa
From time to time, things can change.                   contracted providers
Before you seek any treatment call us so
                                                      ° surgically implanted prostheses up to the
we can give you the most complete and                   approved benefits in the Government’s
up-to-date information.                                 Prostheses List
Please be aware that these rules apply in             ° single room where available.
addition to our Fund and Policy Rules.                We recommend you call us first before
                                                      making a booking to confirm that your
UNDERSTANDING                                         hospital of choice gives you certainty of full
YOUR HOSPITAL COVER                                   cover. We can also discuss any excess or
                                                      co-payment that may be applicable to your
What is covered?                                      level of cover. You can find out if a hospital has
                                                      an agreement with us by checking our website
Hospital costs                                        at bupa.com.au/find-a-provider
With private hospital cover, you can choose to
                                                      What happens if I choose to be a private
be treated as a private patient in either a public
                                                      patient in a public hospital or go to a
or a private hospital.
                                                      private hospital that doesn’t have an
What if I am treated in a Members First or            agreement with Bupa?
Network hospital?
                                                      With us, if you elect to be treated as a private
With us you are fully covered as a private            patient in a public hospital or are admitted
patient in most hospitals that Bupa has an            to a non-agreement private hospital, you are
agreement with known as Members First                 covered as set out below for any treatment
and Network hospitals across Australia for any        recognised by Medicare unless it is excluded
treatment that is recognised by Medicare              or restricted under your cover.
and is not either restricted or excluded under
                                                      If you choose to be treated as a private patient
your cover.
                                                      in a public hospital you are entitled to choose
A small number of these hospitals may charge          your doctor, if they are available. Depending on
a fixed daily fee, capped at a maximum number          your illness or condition, this may be the same
of days per stay. The hospitals should inform         doctor who would have been allocated to you
you of this fee when you make a booking. This         by the hospital as a public patient.
fee is in addition to any excess or co-payment
                                                      In both a public hospital and a non-agreement
you may have as part of your hospital cover.
                                                      private hospital, you are responsible for the
When admitted to a Members First or Network           cost of your stay and may be charged directly
hospital, in most cases you will be covered for       for your hospital accommodation, doctor’s
all in-hospital charges when provided as part of      services (including diagnostic tests), surgically
your in-hospital treatment including:                 implanted prostheses (e.g. artificial hips)
                                                      and personal expenses such as TV hire and
° accommodation for overnight or                      telephone calls. Some of these hospitals bill
  same-day stays                                      Bupa directly for the limited benefits we pay
° operating theatre, intensive care and               for your hospital stay under your policy.
  labour ward fees
                                                      The amount we will pay towards your
° pharmaceuticals supplied under the                  accommodation in a public or non-agreement
  Pharmaceutical Benefits Scheme                       private hospital is limited to a minimum shared


                                                     44
                                                                                                        IMPORTANT INFORMATION
room benefit. In some cases this may cover            medical costs and we will cover the remaining
the full cost of a public hospital’s charges but     25%. If your specialist charges more than the
for a non-agreement private hospital this will       MBS fee there will be a ‘gap’ for you to pay.
only partially cover the full cost and you will      However, the Bupa Medical Gap Scheme can
have significant out-of-pocket expenses. If           help eliminate or reduce the gap for you if your
you request a single room in a public or a           doctor/s choose to use it. If a doctor proposes
non-agreement private hospital, and you              to charge you a ‘gap’ they need your informed
receive one, you will incur out-of-pocket            financial consent. Please contact us for details.
expenses as the hospital may charge you more
for the room than the benefit that Bupa pays.         At Members First day facilities, not only
It is important to note that in public hospitals,    will you be fully covered for the facility
single rooms are generally allocated to people       accommodation and theatre fees but there
who medically need them the most.                    are no out-of-pocket expenses for medical
                                                     treatments (e.g. your specialist’s fees).
If required we will also cover any prostheses
that are surgically implanted in you during your
hospital stay up to the approved benefit listed           To ensure peace of mind, ask your
on the Government’s Prostheses List.                     doctor about their fees and whether
We will cover you for your in-hospital medical           they participate in our Medical Gap
costs incurred during an admission in public or          Scheme for your hospital treatment
non-agreement hospital in the same way as                prior to admission. Remember to also
set out under the heading “Medical Costs” in             ask your doctor about the fees for other
this brochure.                                           practitioners that may be involved in
The hospital and the treating doctor should              your hospital treatment such as: the
let you know what you’ll be billed for and how           anaesthetist and assistant surgeons.
much you will be charged, i.e. they should
obtain your Informed Financial Consent before
you receive the treatment – if they don’t, make      What is not covered?
sure to ask for full details. Call us to confirm
                                                     Hospital costs
what benefits we’ll pay for your public hospital
or non-agreement private hospital stay.              Situations when you are likely not to be
                                                     covered include:
Medical costs
                                                     ° during a waiting period
These are the fees charged by a doctor,
surgeon, anaesthetist or other specialist for        ° when specific services or treatments are
any treatment given to you in hospital. Private        paid at minimum benefits or excluded
health insurance provides you with the choice          from your level of cover
of your own doctor, and you decide whether           ° when you are treated at a non-agreement
you will go to a public or a private hospital          hospital you will not be fully covered
that your doctor attends. You may also have
                                                     ° for the fixed fee charged by a fixed
more choice as to when you are admitted                fee hospital or a hospital that has a
to hospital.                                           fixed fee service
You are covered for:                                 ° when you have not been admitted into a
                                                       hospital and are treated as an outpatient
° the cost of these medical treatments up to           (e.g. emergency room treatment, outpatient
  the Medicare Benefit Schedule (MBS) fee.              ante-natal consultations with an obstetrician
The MBS fee is the amount set by the Federal           prior to child birth)
Government for each medical service covered          ° hospital treatment provided by a
by Medicare. You must be eligible for Medicare         practitioner not authorised by a hospital to
in order to be covered up to the MBS fee. If you       provide that treatment
choose to be treated as a private patient in a
hospital (public or private), Medicare will cover
you for 75% of the MBS fee for associated


                                                    45
° hospital treatment for which Medicare             Waiting periods
  pays no benefit, including: medical costs in       The following waiting periods apply for
  relation to surgical podiatry (including the      hospital cover:
  fees charged by the podiatric surgeon); most
  cosmetic surgery; respite care; experimental      ° laser eye surgery, covered only under
  treatment and/or any treatment/procedure            Ultimate Corporate Health Cover
  not approved by the Medical Services                – three years
  Advisory Committee (MSAC)                         ° palliative care, psychiatric and
° personal expenses such as: pay TV, non-local        rehabilitation services – two months
  phone calls, newspapers, boarder fees, meals      ° pre-existing conditions, ailments or
  ordered for your visitors, hairdressing and         illnesses and pregnancy related services
  any other personal expenses charged to you          (including childbirth) – 12 months
  unless included in your cover
                                                    ° all other treatments included in your cover
° if you are in hospital for more than 35 days        – two months.
  and you have been classified as a ‘nursing
  home type’ patient. In this situation you may     When to contact us
  receive limited benefits and be required to        If you have been a Bupa member for less than
  make a personal contribution towards the          12 months on your current hospital cover,
  cost of your care                                 it is important to contact us before you are
° for pharmacy items not opened at the point        admitted to hospital and find out whether the
  of leaving the hospital                           pre-existing condition waiting period applies
                                                    to you. We need about five working days to
° if you choose to use your own allied health       make the pre-existing condition assessment,
  provider (e.g. chiropractors, dieticians or
                                                    subject to the timely receipt of information
  psychologists) rather than the hospital’s
                                                    from your treating medical practitioner/s.
  practitioner for services that form part of
                                                    Make sure you allow for this timeframe when
  your in-hospital treatment
                                                    you agree to a hospital admission date. If you
° where compensation, damages or benefits            proceed with the admission without confirming
  may be claimed by another source (e.g.            benefit entitlements and we (the health fund)
  workers compensation)                             subsequently determine your condition to
° any amount charged by a public or                 be pre-existing, you will be required to pay
  non-agreement hospital which is not               all hospital charges and medical charges not
  covered by us or which is above the               covered by Medicare.
  benefit that we pay
                                                    Planning for a baby
° any treatment or service rendered
  outside Australia                                 If you are thinking about starting a family
                                                    we recommend that you contact us to check
° some non-PBS, high cost drugs.
                                                    whether your current level of cover includes
Medical costs                                       pregnancy and other related services in
                                                    advance. This is because there is a 12-month
You will not be covered for:
                                                    waiting period applied to all pregnancy
° medical services for surgical procedures          related services (including childbirth) and
  performed by a dentist, surgical podiatrist, or   assisted reproductive services.
  any other practitioner or a service that is not
                                                    No waiting periods will apply to the newborn
  eligible for a rebate through Medicare.
                                                    provided they have been added to the
Inpatient vs outpatient                             appropriate family hospital cover within two
                                                    months of their birth.
If you are admitted as a private inpatient, you
will be covered for the services listed in your
chosen level of hospital cover. If you receive
treatment as an outpatient (i.e. you are not
admitted), in most instances you will not be
covered by private health insurance. If eligible
these services may be claimed from Medicare.

                                                   46
                                                                                                      IMPORTANT INFORMATION
UNDERSTANDING                                         ° for any treatment or service rendered
YOUR EXTRAS COVER                                       outside Australia
                                                      ° when you have reached the maximums on
What is covered?                                        your product including annual, lifetime or
With extras cover, you can claim benefits for            service limits for the service you
those services listed on your cover and that            are claiming.
are not claimable elsewhere (e.g. from a third
                                                      Waiting periods
party like Medicare).
                                                      The following waiting periods apply for
For example, Medicare does not provide                extras cover:
benefits for:
                                                      ° initial waiting period – two months
° most dental examinations and treatment
                                                      ° hire, repair and maintenance of health aids
° most physiotherapy, occupational therapy,             and appliances; and Living Well Programs
  speech therapy, eye therapy, chiropractic             – six months
  services, podiatry or psychology services
                                                      ° major dental, orthodontics, selected health
° acupuncture (unless part of a doctor’s                aids and appliances – 12 months.
  consultation) or other natural therapies
° glasses and contact lenses                          UNDERSTANDING
° most health aids and appliances                     YOUR AMBULANCE COVER
° home nursing.
                                                      Emergency Ambulance definition
Extras cover allows you to claim benefits for
extras services as long as:                           When you take out our hospital cover, extras
                                                      cover or packaged cover, you will receive
° the treatment is given by a private practice        cover for recognised emergency ambulance
  provider who is recognised and registered           transport and on-the-spot treatment. This
  with us for benefit purposes                         is capped at one emergency service each
° they meet the criteria set out in our Policy and    calendar year for a singles membership and
  Fund Rules.                                         two for a couples/families membership.

We recommend you contact us before                    An emergency is when there is reason to
making a booking to confirm how much you               believe that the patient’s life may be in
can claim and to check that your chosen               danger or the patient should be attended to
provider is registered with us.                       without undue delay.

What is not covered?                                  Transportation will mean a journey from the
                                                      place where immediate medical treatment
Extras benefits will not be payable:
                                                      is sought to the casualty department of a
° during a waiting period                             receiving hospital.
° where a third party, including Medicare,            Emergency ambulance transportation is
  a Government body, or an insurance                  defined as air or road transportation by
  company provided a benefit (except for               a Recognised Ambulance Provider of an
  hearing aids and breast prosthesis items)           unplanned and of a non-routine nature for
° for different services within the same service      the purpose of providing immediate medical
  type from the same provider on the same             attention to a person.
  day. For example, if you went to see an
  acupuncturist and then received a massage           Whether the transportation is deemed an
  from the same provider on the same day,             emergency is determined by the paramedic
  you cannot claim for both services                  and usually recorded on the account.

° when a prescribed treatment is not fully            Benefits are not payable for:
  custom made (e.g. orthotics, surgical shoes)
                                                      ° transportation from a hospital to your home
° when a provider is not recognised by us for
  benefit purposes                                     ° transportation from a hospital to a
                                                        nursing home

                                                     47
° transportation from a hospital to another        you will be covered by Bupa up to the annual
  hospital where the customer has been             cap, as long as your level of cover contains
  admitted to the transferring (first) hospital     ambulance cover and the services are provided
                                                   by a recognised provider.
° transportation from the person’s home, a
  nursing home or hospital for ongoing medical
                                                   Recognised Ambulance Providers
  treatment, (e.g. chemotherapy, dialysis).
                                                   Bupa will only pay benefits towards
Ambulance Cover                                    ambulance services when they are provided
We recommend that you take out an                  by any of the following recognised providers:
ambulance subscription with your recognised
                                                   ° ACT Ambulance Service
State Ambulance Provider if it’s available in your
state (VIC, SA, NT and rural postcodes in WA).     ° Ambulance Service of NSW
                                                   ° Ambulance Victoria
We will only provide ambulance benefits, in
accordance with your level of cover, when you      ° Queensland Ambulance Service
do not hold a subscription with an ambulance       ° South Australia Ambulance Service
provider and a state ambulance scheme does         ° St John Ambulance Service NT
not provide cover.
                                                   ° St John Ambulance Service WA
NSW and ACT members: If you reside in              ° Tasmanian Ambulance Service.
New South Wales or the Australian Capital
Territory and you have hospital cover, you pay     Certain types of concession cards issued by
an ambulance levy as part of your premium.         Centrelink or the Department of Veterans
This entitles you to free emergency ambulance      Affairs (DVA) entitle the cardholders to free
transport under the State Government               ambulance services. These arrangements
ambulance transport schemes. When you              also vary per state so should be checked
receive an account for ambulance transport,        directly with Centrelink or the DVA.
simply send it to us and we’ll endorse it for you
to send back to the appropriate ambulance          CHANGING YOUR COVER
transport scheme.
QLD and TAS members: If you reside in              Switching from another health fund
Queensland or Tasmania, you are covered            If you’re changing from another Australian
under your state service scheme.                   health fund to Bupa, you’ll continue to be
                                                   covered for all benefit entitlements that you
VIC, SA, WA and NT members: If you reside          had on your old cover, as long as these services
in Victoria, South Australia, Western Australia    are offered on your new cover with us. This is
or the Northern Territory you will receive         referred to as ‘continuity of cover’. To receive
cover for recognised emergency ambulance           continuity of cover, you’ll need to transfer to us
transport and on-the-spot treatment from us.       within 60 days of leaving your old fund.
This is as long as you don’t have an ambulance
subscription with your state ambulance service     When changing health funds, extras benefits
or cover through a state-based arrangement.        paid by your old fund will be counted towards
                                                   your annual maximums in your first year of
Most state schemes cover their respective          membership with us. Any benefits paid by your
residents within their state of residence only.    old fund also count towards lifetime limits.
However, some states have entered into
reciprocal agreements that allow you to be       It’s important to note that when you change
covered for ambulance services when you travel   to Bupa from another fund you may need to
outside your state of residence. You should      wait before you can receive your new benefits.
check with your state ambulance provider for     In this situation, your benefit entitlements are
when these reciprocal arrangements apply and     based on our nearest equivalent cover to what
the level of cover offered.                      you previously held. Where your new cover is
                                                 higher than what you had with your old fund,
If you fall outside your state-based arrangement the lower benefit (including different excess
(including any reciprocal agreement) and are     levels) will apply for the waiting period relevant
not covered for emergency ambulance services,

                                                  48
                                                                                                            IMPORTANT INFORMATION
for that service. Please refer to the listed waiting   72 hours) medical advice or treatment from
periods included under the Understanding Your          a registered practitioner other than
Extras Cover and Understanding Your Hospital           the policyholder.
Cover sections of this guide.
                                                       Annual maximums and service limits
If you choose a lower level of cover than you
                                                       An annual maximum is the maximum amount
held previously, then the lower benefits on your
                                                       you can claim in a service category per person
new cover will apply immediately. This may
                                                       and per calendar year (unless otherwise
include a different excess level or minimum
                                                       stated). For certain services, service limits also
benefits. You may also need to serve waiting
                                                       apply on the number of times that benefits
periods for services or treatments that weren’t
                                                       are payable for the same service (e.g. initial
covered on your previous cover. In this case you
                                                       consultations). These maximums apply from
won’t be covered during the waiting period.
                                                       the date of service or purchase. Some services
Changing your cover with us                            also have lifetime limits or periodic annual
                                                       maximums (e.g. orthodontics). Per person
If you change your health cover, you may
                                                       annual maximums are not transferable to any
need to wait before you can receive your
                                                       other member on your policy.
new benefits. Where your new level of cover
is higher than what you previously held, the           Bupa Medical Gap Scheme
lower level of benefit applies. Please refer
                                                       This is a direct billing arrangement between
to the listed waiting periods included under
                                                       Bupa and your doctor/s that in most instances
the Understanding Your Extras Cover and
                                                       eliminates your out-of-pocket expenses for
Understanding Your Hospital Cover sections of
                                                       in-hospital doctors’ fees (the ‘gap’).
this guide.
                                                       If your doctor charges up to the Medicare
During this time you will be covered, however
                                                       Benefits Schedule (MBS) fee or is participating
you will receive the lower benefits of the two
                                                       in the Bupa Medical Gap Scheme, in most cases
covers (this includes any applicable excess).
                                                       you will have no medical gap costs to pay.
If you choose a lower level of cover than you
                                                       For doctors who are not participating in our
previously held, then the lower benefits on
                                                       Medical Gap Scheme and are charging above
your new cover will apply immediately and
                                                       the MBS fee, we will pay the difference
may include different excess levels or minimum
                                                       between the Medicare benefit and the MBS
benefits. You may also need to serve waiting
                                                       fee. Any amount above the MBS fee will be
periods for services or treatments that weren’t
                                                       the amount you are required to pay and this
covered on your previous cover. In this case you
                                                       is referred to as the ‘Medical Gap’.
won’t be covered during the waiting period.
                                                       If a doctor proposes to charge you a ‘gap’ they
If you have any questions about transfers or
                                                       need your informed financial consent. Please
waiting periods, just contact us.
                                                       contact us for details.
Ending your membership
                                                       Calendar year
We have the right to end a person’s membership
                                                       A calendar year is 1 January to 31 December.
as set out in our Fund Rules, including where
premiums have not been paid or on notice at the
                                                       Emergency admissions
reasonable discretion of Bupa.
                                                       In an emergency, we may not have time
                                                       to determine if you are affected by the
DEFINITIONS                                            pre-existing condition rule before your
                                                       admission. Consequently, if you have been
Accidents                                              a Bupa member for less than 12 months
An accident is an unforeseen event,                    you might have to pay for some or all of the
occurring by chance and caused by an                   hospital and medical charges if:
unintentional and external force or object
resulting in involuntary hurt or damage to
the body, which requires immediate (within


                                                   49
° you are admitted to hospital and you                Living Well Programs
  choose to be treated as a private patient,          Our Living Well Programs help cover
  and we later determine that your condition          health-related programs from approved,
  was pre-existing.                                   recognised providers. You can visit our website
Excess                                                for a list of our recognised providers. A Living
                                                      Well Program’s approval form must be
To lower the cost of your hospital cover, on
                                                      completed by your doctor for gym memberships,
selected covers you can choose to include an
                                                      children’s swimming lessons (eligible products
excess. Excesses are only payable on overnight
                                                      only), yoga and Pilates to confirm that the
and same-day inpatient hospital admissions in
                                                      program is medically necessary. Other benefit
any hospital.
                                                      and recognition criteria apply. Visit our website
° An excess is a set amount you pay upfront           or contact us to find out more.
  before your benefit is paid. The excess is paid
  when you are admitted into hospital, and is         Minimum Benefits
  capped at $500 for singles and $1,000 for           For services paid at minimum benefits there will
  single parents and families per calendar year.      be full cover in a shared room with your choice
                                                      of doctor in a public hospital and minimum
° No excess applies to your children on
  certain hospital covers. See pages 15-19 for        benefits in a private hospital which would not be
  more details.                                       adequate to cover all hospital costs and are likely
                                                      to result in large out-of-pocket expenses.
° Excess waivers apply for first one or two
  admissions on selected covers, see page 18          Out-of-pocket expenses
  for details.
                                                      You are likely to experience out-of-pocket
Exclusions                                            expenses when you are not fully covered for
If a service is not covered by Medicare there will    services and benefits, or when a set benefit
be no benefit payable from your hospital cover         applies. You should refer to what is and isn’t
so you should always check with us to see if          covered for your relevant level of cover to
you’re covered before receiving treatment.            determine when an out-of-pocket expense
                                                      may occur. You should also refer to our
Health aids and appliances                            Fund Rules for any additional information on
                                                      benefits payable. A copy of our Fund Rules
To receive benefits for health aids and
                                                      can be found on our website or in our retail
appliances you’ll need to visit one of our
                                                      centres. It is important to ensure when being
recognised providers. You’ll also need to
                                                      admitted to hospital that Informed Financial
meet the eligibility criteria, provide proof of
                                                      Consent is provided to you for a pre-booked
purchase and a clinical referral where required.
                                                      admission to allow you to understand any
It is important to note that benefits are not
                                                      out-of-pocket expenses upfront. If you have
payable when a prescribed treatment is not
                                                      received any out-of-pocket expenses and
fully custom made (e.g. orthotics). Visit our
                                                      require clarification, please contact us directly.
website or contact us to find out more.
Benefits for hire, repair and maintenance of           Pharmacy
health aids and appliances are not payable            Your extras pharmacy entitlement covers
in the first 12 months after purchasing an             you for prescription only items that are not
item; within 12 months following a repair;            supplied under the PBS (Pharmaceutical
or on items where hire and repair are                 Benefits Scheme); are TGA (Therapeutic Goods
deemed inappropriate.                                 Administration) approved; are prescribed by a
                                                      registered medical practitioner; supplied by a
Home nursing                                          Bupa recognised, registered pharmacist; and not
Benefits are payable towards some home                 otherwise excluded by Bupa.
nursing services that do not need to take
                                                      When you make a claim, we will deduct a
place in a hospital and are provided in the
                                                      pharmacy PBS co-payment and pay the remaining
home. Please contact us to find out more.
                                                      balance up to the set amount under your chosen
                                                      level of cover.


                                                     50
                                                                                                          IMPORTANT INFORMATION
There are some additional items that are             ° fully complete the application process and
not covered by our pharmacy benefit and                 pay your premiums one month in advance.
these include:                                         Or, if you’re on a corporate plan, it’s up
                                                       to you to make sure payments are made
° over the counter or non-prescription items           during times of unpaid leave or if your
° compounded items                                     employment ends
° weight loss medication (some weight loss           ° ensure that newborns are enrolled onto a
  medications are covered under the Living             family membership within two months of
  Well Programs)                                       their birth to avoid any waiting periods for
                                                       your baby
° body enhancing medications (e.g.
  anabolic steroids).                                ° enrol your adult children under their own
                                                       names within 60 days after they no longer
Pharmacy in-hospital                                   qualify under your cover (to avoid a break
When in hospital, if you are treated with drugs        in their cover)
that are not PBS approved, you may not be fully
                                                     ° provide proof of purchase of what you
covered and the hospital may charge you for all        have spent before we can reimburse you
or part of the cost. You should be advised by the      for any services received
hospital of any charges before treatment.
                                                     ° submit your claims within two years of when
                                                       the service was given (we don’t pay benefits
Pre-existing conditions
                                                       for any claims that are older than this).
A pre-existing condition is any condition,
ailment or illness that you had signs or             Proof of identity and/or age
symptoms of during the six months before you
                                                     Bupa may require you to provide proof of
joined or upgraded to a higher level of cover
                                                     identity and/or age when joining, changing
with us. It is not necessary that you or your
                                                     your level of cover or in relation to any other
doctor knew what your condition was or that the
                                                     transaction with us.
condition had been diagnosed.
A condition can still be classed as pre-existing     Special Benefits
even if you hadn’t seen your doctor about it         If you’re on a cover that provides Special
before joining or upgrading to a higher level        Benefits cover, you could receive benefits
of cover.                                            for accommodation and meal costs if your
                                                     partner, immediate family member, carer
If you knew you weren’t well, or had signs of a
                                                     or next of kin is required to stay at hospital
condition that a doctor would have detected (if
                                                     with you or a person on your membership.
you had seen one) during the six months prior to
                                                     They will be covered for $60 per night for
joining or upgrading, then the condition would
                                                     accommodation in hospital and up to $30
be classed as pre-existing. A doctor appointed
                                                     a day for hospital meals. Hospital meals are
by us decides whether your condition is pre-
                                                     covered when provided at a hospital cafeteria,
existing, not you or your doctor. The appointed
                                                     kiosk or patient meal menu. A $1,000 per
doctor must consider your treating doctors’
                                                     person, per calendar year annual maximum
opinions on the signs and symptoms of your
                                                     applies to Special Benefits.
condition, but is not bound to agree with them.
                                                     Surgically implanted prostheses
Premium and benefits
                                                     You will be covered up to the benefit set out in
You must pay the premium and the Lifetime
                                                     the Government’s Prostheses List for a listed
Health Cover Loading that applies to you.
                                                     prosthesis which is surgically implanted as part
Premiums differ from state to state due
                                                     of your hospital treatment.
to different state charges. If you move to
another state your premium will change too.          The Prostheses List includes: pacemakers,
Therefore you must let us know about any             defibrillators, cardiac stents, joint replacements,
change of address.                                   intraocular lenses and other devices. If a
                                                     hospital proposes to charge you a ‘gap’ for your
To receive the benefits available on your
                                                     prosthesis, they need your informed financial
cover, you need to:
                                                     consent. Please contact us for further details.

                                                    51
Suspension rules                                   OTHER IMPORTANT
A membership may be suspended when                 INFORMATION
travelling overseas for work or leisure. You
can suspend your cover under the following         Direct Debit Service Agreement
circumstances:                                     If you’ve chosen to pay your premiums by direct
                                                   debit then you’ve accepted the terms of our
° for a minimum period of two months’
  travel; and                                      Direct Debit Service Agreement.

° for a maximum period of two years               This agreement outlines the responsibilities
  per suspension.                                 of Bupa Australia Pty Ltd (“we”, “us”, our”)
You can only suspend your policy twice            and you. We will confirm the direct debit
per calendar year. Your membership will be        arrangements prior to the first drawing
cancelled if not resumed.                         (including the premium amount and frequency)
                                                  and debit your nominated account. Deductions
One month contributions are required between will occur on the nominated day, except for
each suspension period.                           deductions nominated for the 28th, 29th, 30th
To be eligible to suspend your cover you must:    or 31st, which will occur on the first day of the
                                                  following month. If the nominated day falls on
° have been a financial member for at least
   12 months                                      a weekend or public holiday, deductions will be
                                                  made on the closest business day. We will debit
°  be financial at the time of suspension
                                                  all payments in advance and will automatically
° apply for suspension prior to the               vary the deduction amount if your premiums or
   departure date                                 level of cover change. If we vary the deduction
° provide overseas travel documentation           amount, we will give you at least 14 days written
   showing your departure and return dates        notice, except when the previous deduction is
                                                  dishonoured, when we will deduct the previous
° notify us of your return to Australia within
   30 days of your arrival; and                   period’s payment together with the current
                                                  amount due. If you pay premiums at three,
° complete an overseas travel suspension form. six, and 12 month intervals, then should your
Your membership will be cancelled if              financial institution dishonour a drawing, we will
not resumed.                                      draw the payment on the nominated day of the
                                                  following month. If two or more drawings are
Travel and accommodation                          returned unpaid by your financial institution, we
On select levels of extras cover, if you’re       will also stop deducting your premiums from
travelling for essential medical or hospital      your nominated account and will start sending
treatment because treatment you need cannot       you renewal notices, pending further instructions
be provided by your own doctor, we will help      from you. We will maintain the privacy and
cover the cost when the total return distance is  confidentiality of your billing information (unless
200 kilometres or more from your normal place     you have requested or consented that we can
of residence.                                     disclose it to a third party or the law requires or
                                                  allows us to do so). We may provide information
We also give a benefit towards your                to our or your financial institution to resolve a
overnight accommodation outside of hospital for dispute on your behalf. You must ensure your
you and a caregiver. Check your extras cover to   nominated account permits direct debiting
determine if you are covered for these benefits.   and that sufficient cleared funds are available
                                                  in that account on the due date to cover the
Waiting periods
                                                  premiums due. Your financial institution may
A waiting period is the time between when         charge a fee if the payment cannot be met. You
you joined us and when you are covered for a      must ensure the authorisation given to draw
service or treatment. If you receive a service or on the nominated account is identical to the
treatment during this time, you are not eligible  account signing instruction held by the financial
to receive a benefit payment from us, regardless institution where the account is based. You must
of when you submit the claim. Different waiting notify us if the nominated account is transferred
periods apply for different services.             or closed. You must pay your premium by an


                                                 52
                                                                                                          IMPORTANT INFORMATION
alternative method if either you or we cancel       personal information as set out here and in our
the direct debit arrangements. You must ensure      Information Handling Policy. Each person on a
your payments are up-to-date, whether a notice      policy aged 17 or over may complete a ‘Keeping
is received from us or not.                         your personal information confidential’ form
                                                    to specify who should receive information
If paying by credit card, you need to advise us     about their health claims. You are entitled to
of your new expiry date prior to expiry. You        reasonable access to your personal information.
may request that we cancel or alter the debit       We reserve the right to charge a reasonable fee
drawing arrangements by contacting us and           for collating such information. If you or any other
providing at least five working days notice          person on your membership do not consent
of any requested changes. These changes             to the way we handle personal information,
may include deferring the debit, altering the       or do not provide us with the information we
debit dates, stopping an individual debit,          require, we may be unable to provide you with
suspending the direct debit arrangement or          our products and services. We may use your
cancelling the direct debit completely. You         personal (including health) information to
can dispute any debit drawing or terminate          offer you health management programs and
the deductions at any time by notifying us in       services. When you take out cover with us, you
writing not less than seven days before the         consent to us using your personal information
next scheduled debit drawing. If you have any       to contact you (by phone, email, SMS or post)
queries about your direct debit agreement,          about products and services that may be of
please contact us. We undertake to respond          interest to you. If you do not wish to receive this
to queries concerning disputed transactions         information, you may opt out by contacting us.
within five working days of notification.
                                                    Can we help?
Privacy and your personal information
                                                    If you have any questions we’re always happy
Your privacy and maintaining the confidentiality     to help. Simply refer to the back cover for our
of your personal information is important to        contact details and call us, visit our website
Bupa Australia Pty Ltd (“we”, “us”, “our”). This    or pop by your local centre. If you would like
statement provides a summary of how we              more information about our Fund Rules or the
handle your personal and health information.        Federal Government’s Private Health Insurance
For further information about how we handle         Industry Code of Conduct, you can find this
your personal information, you should refer         information on our website. The Federal
to our Information Handling Policy, available       Government’s Private Patient’s Hospital
on our website or by calling us. We will only       Charter is available at privatehealth.gov.au
collect personal information (including health
information) about you and those people insured     Resolution of problems
under your policy to provide, manage and
                                                    If you have any concerns or you don’t
administer our products and services to you and
                                                    understand a decision we have made, we’d
to operate an efficient and sustainable business.
                                                    like to hear from you.
We are required to collect and maintain certain
information about you and those on your policy      You can contact us by:
to comply with the Private Health Insurance
Act 2007 (Cth) and related legislation. We may      Telephone:   1800 802 386
also collect personal and health information        Fax:         1300 662 081
about you from health service providers for         Email:       customerrelations@bupa.com.au
the purposes of administering or verifying          Mail:        Customer Relations Manager
any claim. We may disclose your personal                         Bupa Australia
information to our related entities and bodies                   PO Box 14639
corporate, or to third parties such as healthcare                Melbourne VIC 8001
providers, government and regulatory bodies,        If you’re still not satisfied with your
other private health insurers and any persons or    outcomes from Bupa you may contact
entities engaged by us or acting on our behalf.     the Private Health Insurance Ombudsman
If you are the policyholder, you’re responsible     on 1800 640 695 or visit them at
for ensuring that each person on your policy        privatehealth.gov.au
is aware that we collect, use and disclose their


                                                 53
54
                                          Mailing details:
                                         Mailing details:
FOR MO R E IN FO R MAT I O N              Bupa
                                         Bupa
                                          PO Box 14639
                                         600 Glenferrie Road
                                          MELBOURNE VIC 8001
   Call us on 134 135                    HAWTHORN VIC 3122
                                          Bupa Australia Pty Ltd
                                         Bupa Australia Pty Ltd
   Visit bupa.com.au/corporate            ABN 000 057 590
                                         ABN 8181 000 057 590
   Drop by your local Bupa centre          Effective 1 July 2012
                                         Effective 1 November 2011
                                           10283-07-12S
                                         10283-10-11S




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