CORPORATE HEALTH COVER DISCOVER THE BENEFITS OF CORPORATE COVER BUPA. FIND A HEALTHIER YOU

Transcription

1 CORPORATE HEALTH COVER DISCOVER THE BENEFITS OF CORPORATE COVER BUPA. FIND A HEALTHIER YOU

2 At Bupa, it s our purpose that makes us different helping our members to live longer, healthier, happier lives. This brochure is a summary of the cover we offer. For more information, including what's covered and what's not, you should read this together with our Important Information Guide at bupa.com.au/corporate-info Go to bupa.com.au to see our fund rules. Unsure of any words? Visit bupa.com.au/glossary For more information bupa.com.au/corporate To log in, get your username and password from your employer or call us on Visit a local Bupa centre

3 WHY HAVE PRIVATE HEALTH COVER? Reduce waiting time Get treated sooner by going to a private hospital. Choose your doctor Your choice of specialist and even where you d like to be treated. Claim on most Extras Enjoy the benefits of being able to claim for most Extras including dental, physio, optical and chiro. Save money Depending on your income you could save money by taking out hospital cover. Talk to your tax advisor or visit ato.gov.au to find out what this means for you. Avoid Lifetime Health Cover loading Avoid the Federal Government s Lifetime Health Cover (LHC) loading by taking out hospital cover by 30 June following your 31st birthday. To find out more visit bupa.com.au/lhc The Australian Government Rebate on private health insurance This could make your cover even more affordable. Find out what the Rebate means for you at bupa.com.au/rebate 1

4 SIMPLE AFFORDABLE COVER TO SUIT YOU NOW COMPETITIVE CORPORATE COVER OUTSTANDING VALUE hospital and extras cover Designed to suit different needs. Gap free same day treatment No out-of-pocket hospital or medical expenses at Members First day facilities (any excess and/or co-payments related to your level of cover will still apply. Not available in NT). Members First Provider Network Our national network of hospital and extras^ providers can help you to reduce or eliminate out-of-pocket expenses. ^Dental, optical, physio & chiro. 2

5 EASY AND CONVENIENT MORE THAN HEALTH INSURANCE mybupa online portal Manage your cover at a time that suits you. Accessible health support You can access a range of online tools and apps to help manage your health. Easy to use Extensive range of extras providers offering on-the-spot claiming. Member Discount Partners Keep your mind and body active with some great member discounts on things like gym memberships, movie vouchers and theme park entry. For further information on the range of discounts available just visit bupa.com.au/ memberexclusives Travel Benefits We offer benefits for overseas travel including a 24 hour health advice line and benefits for travel vaccines. Other insurance benefits Visit bupa.com.au/other-insurance for information around our other insurance products and discounts for Bupa members. 3

6 FIND THE RIGHT CORPORATE COVER FOR YOU Choose our Ultimate packaged cover Your choice starts here OR Create your own package 4

7 Choose Ultimate Health Cover PAGE 6 & 7 Choose your hospital cover PAGE 8 & 9 AND Choose your extras cover PAGE 12 & 13 Extras are only available when combined with a level of hospital cover. 5

8 ULTIMATE CORPORATE HEALTH COVER To see a list of what's covered and what's not covered, see page 10 and 11. There are some situations you won't be covered for and you may have to pay an out-of-pocket cost. For more info, read the Important Information Guide at bupa.com.au/corporate-info Ultimate Health Cover Our premium option for ultimate peace of mind, with top hospital and extras cover and our dedicated 24/7 advice line. Top level of hospital cover Top level of extras cover 100% Amount you get back # (limits apply) You receive: 100% back # at any Bupa recognised provider up to the first $500 per person per year for general dental 100% back at any Bupa recognised provider for major dental and orthodontics up to yearly limits per person 100% back # at any Bupa recognised provider up to the first $350 per person per year for physio and chiro. Extras General Dental Yearly limits Unlimited Major Dental $1,600 Optical $420^^ Physio $1,500 Chiro $1,000 t $1,600 Natural therapies $1,000 Ultimate Health Cover includes these hospital features: Emergency ambulance Medical cover Private hospital cover Plus more, see page 10 for the full list t Per person Per membership # For most items at all Bupa recognised providers covering dental, physio & chiro. Excludes hospital treatments. Fund and other rules apply. Waiting periods and yearly limits apply. ^^At Members First Optical providers only. A lower limit applies at other providers. 6

9 BONUS ULTIMATE CORPORATE HEALTH COVER FEATURES Medical gap bonus receive $200 when you join and every calendar year thereafter. This can be used towards a doctor or specialist s out-of-pocket costs (whilst in hospital) and any unused bonus amounts will accumulate each year 100% rebate on Ambulance subscription^ 100% back on laser eye surgery at our recognised providers. Plus: Accident benefit If you are hospitalised due to an accident an additional $2,000 per person, $4,000 per membership can be put towards extras claims once you ve reached your extras yearly limits. Gap free optical 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. No gap for kids We ll cover the cost of your kids dental and physio in most instances until they turn 25.* Private room or money back guarantee At our Members First hospitals, you ll receive a private room when you book and request a private room at least 24 hours before the overnight admission. If a private room is not available, you ll receive $50 back per night from the hospital.** ^In states where this is applicable. Excludes lens implant for eye correction. On selected optical packages. Conditions apply. Optical benefits are subject to your level of cover. Fund and other rules apply. Waiting periods and yearly limits apply. *When treatment is provided by a Members First physiotherapist or dentist. Fund and other rules apply. Waiting periods and yearly limits apply. Excludes orthodontics and hospital treatments. **Conditions apply contact us for details. 7

10 HOSPITAL COVER AT A GLANCE Hospital cover helps cover your costs as a private patient in hospital, including treatment and accommodation. Choose from our three excellent options depending on your needs and budget. There are some situations you won t be covered for and you may have to pay an out-of-pocket cost. For more info, read the Important Information Guide at bupa.com.au/corporate-info COMPREHENSIVE COVER BASIC COVER Hospital Top Comprehensive cover, with additional benefits including Family inhospital benefit and no excess for kids. Hospital Intermediate Our medium level of hospital cover, includes cover for cardiac, pregnancy and no excess for kids. Minimum benefits apply to some services. Hospital Saver Budget-friendly hospital cover, with minimum benefits on the things less likely to be needed. Top level of hospital cover Medium level of hospital cover Basic level of hospital cover NIL EXCESS $ 250 EXCESS $ 500 EXCESS NIL EXCESS $ 250 EXCESS $ 500 EXCESS NIL EXCESS $ 250 EXCESS $ 500 EXCESS Private room or money back guarantee At our Members First hospitals, you ll receive a private room when you book and request a private room at least 24 hours before the overnight admission. If a private room is not available, you ll receive $50 back per night from the hospital.^ 8

11 All covers below include these hospital features: Emergency ambulance Medical cover Private hospital cover Plus more, see page 10 for the full list Our hospital covers include Accommodation in a private hospital or as a private patient in a public hospital* Operating theatre, intensive care fees Surgically implanted prostheses up to the approved minimum benefits in the Government Prostheses List Physiotherapy, occupational therapy, speech therapy and other allied health services^^ PBS drugs supplied as an inpatient.^^ Members First Day Facilities If you are treated in a Members First day facility, there are no out-of-pocket expenses for medical services (e.g. your specialist s fees).** Bupa Medical Gap Scheme The Bupa Medical Gap Scheme is an arrangement Bupa has with some medical specialists/doctors such as an anaesthetist to help minimise the amount you ll need to pay for your medical costs in hospital. No Gap If you see a No Gap doctor that uses the Bupa Medical Gap Scheme you won t have to pay any medical costs as your medical specialist/doctor will bill Bupa directly. Check with them that they will use this for your upcoming admission upfront. Known Gap If you see a Known Gap doctor that uses the Bupa Medical Gap Scheme with you, you will need to pay up to $500 towards your medical costs. Without the Gap Scheme If your doctor is not using the gap scheme, Medicare will pay 75% and Bupa will pay 25% of the MBS fee. Any charge above that will be your gap. Medical Diagnostics (Radiology and Pathology) If your provider has an agreement with Bupa there is no charge for Medicare recognised services otherwise Medicare will pay 75% and Bupa will pay 25% of the MBS scheduled fee. Emergency ambulance Emergency ambulance cover is capped at 1 trip for single memberships, 2 trips for couples/families per year at our recognised ambulance providers. ^Conditions apply contact us for details. *If you choose to be treated as a private patient in a public hospital Bupa will pay shared room minimum benefits. If you choose a private room Bupa will pay a fixed benefit in addition to the shared room benefit. If the hospital is going to charge more than this they should advise you of the out-of-pocket charge before admission. ^^At Members First and Network Hospitals. **Any excess or co-payments related to your level of cover will still apply. Not available in NT. 9

12 COMPARE AND CHOOSE YOUR HOSPITAL COVER For full details of what's covered and what's not, see the Important Information Guide at bupa.com.au/corporate-info Packages Ultimate Health Cover Hospital Top Hospital only Hospital Intermediate Hospital Saver Cancer* Psychiatric services Rehabilitation services Pregnancy (including childbirth) IVF & assisted reproductive services Cardiac services Renal dialysis Cataract and eye lens procedures Hip/knee replacement All other joint replacements Gastric banding & obesity related treatment (includes any abdominoplasty) Knee Arthroscopy and Meniscectomy procedures All other joint Arthroscopy and Meniscectomy procedures Appendicitis Removal of Tonsils and Adenoids Minor Gynaecological Surgery All other in-patient treatments receiving Medicare Benefits Cosmetic surgery not clinically required Health subscription refunds^ Family in-hospital benefit Emergency Ambulance Excess option NIL NIL $250 $500 NIL $250 $500 NIL $250 $500 No excess for kids Want to see the extras cover that comes with your package? Go to page 14 Minimum benefits apply, see the Important Information Guide at bupa.com.au/corporate-info to find out more. Indicates the service is not included. *Some non PBS drugs may not be covered. ^Available on Hospital Top Nil and $250 excess only. 10

13 Waiting periods The following waiting periods apply: Palliative care, psychiatric and rehabilitation services 2 months Pre-existing conditions, ailments or illnesses and pregnancy (including childbirth) 12 months Laser eye surgery covered under Ultimate Health cover only 12 months All other treatments included in your cover 2 months. Excess The excess is capped at once per person, twice per membership, per calendar year. Minimum Benefits For services in a private hospital which are recognised by Medicare, we will pay minimum shared room benefits and you will have your choice of doctor. These benefits would not be adequate to cover all private hospital costs and are likely to result in large out of pocket expenses. 11

14 EXTRAS COVER AT A GLANCE Extras cover is an easy way to help maintain your health. That s why we have extras including dental, physio and natural therapies that can make all the difference to help keep your health on track. Extras are only available when combined with a level of hospital cover. COMPREHENSIVE COVER Advantage Access a wide range of services with at least 90% back at our Members First providers. Extras cover Top level of extras cover 90% Minimum amount you get back Classic Includes a wide range of extra services and generous benefits with at least 80% back at our Members First providers. Extras cover Medium level of extras cover 80% Minimum amount you get back Extras Yearly limits Extras Yearly limits General dental Unlimited General dental $400 ¾ Major dental $1,100 Major dental $500 ¾ Optical $300^ $500 ¾ Physio combined with other services Chiro $600 t $1,200 Natural therapies $400 Optical $240 $400 ¾ Physio combined with other services $500 t Chiro $1,000 Natural therapies $600 combined with other services Members First provider network With our Extras covers, you can enjoy the advantages of our extensive network of dental, optical, physiotherapy and chiropractic providers. When you choose to visit a Members First provider, in most instances you will receive higher benefits and have the certainty of knowing how much you ll get back. For most items at our Members First extras providers covering dental, physio, chiro and selected optical. Excludes orthodontics and hospital treatments. Fund and other rules apply. Waiting periods and yearly limits apply. ^At Members First optical providers only. A lower limit applies at other providers. 12

15 General dental Optical Physio Chiro Natural therapies Essentials BASIC COVER Cover for key extras services with at least 70% back at our Members First providers. Extras cover Basic level of extras cover 70% Minimum amount you get back Extras General dental Major dental Yearly limits $400 Optical $200 Physio Chiro Natural therapies $300 combined limit Set benefits A pre-defined amount you ll get back for a service when you get treatment from someone outside the Bupa Members First provider network. Yearly limits The most you can claim per person in a calendar year, depending on your cover. ¾ Loyalty Maximums We increase how much you can claim each year by 20% of the initial amount for some extras services (applies after the first 12 months up to a maximum increase of up to 100%). Gap free optical Ask us about our Gap Free Optical Packages available at Members First providers and optical partners. No gap for kids We ll cover the cost of your kids physio and dental in most instances until they turn 25.* See more details on page 14 and 15 t Per person Per membership On selected optical packages. Conditions apply. Optical benefits are subject to your level of cover. Fund and other rules apply. Waiting periods and yearly limits apply. *Available on Advantage and Classic covers when taken with hospital cover on a family membership, when treatment is provided by a Members First dentist or physiotherapist. For most items covering dental and physiotherapy. Excludes orthodontics and hospital treatments. Fund and other rules apply. Waiting periods and yearly limits apply. Child dependants only. 13

16 CHOOSE YOUR EXTRAS COVER This table shows yearly limits per person. Services Waiting periods Packaged Ultimate Health Cover Up to 100% back # (limits apply) General dental 2 months Unlimited Major dental $1, months Orthodontics $1,400 t Lifetime Limit $3,200 Optical $420 Ë $300 º Gap free optical^ Chiropractic and osteopathy $1,000 t $1,600 2 months Physiotherapy $1,500 Ante and Post Natal $500 Living Well (see page 16) 6 months $300 Pharmacy** Natural therapies $1,500 $1,000 t Massage sub-limits: $250 t $500 Psychology $1,000 Dietary $1,000 Podiatry (excludes orthotics) 2 months $1,000 Speech Therapy $1,000 Eye Therapy $1,000 Occupational Therapy $1,000 Home Nursing $400 Health aids and appliances + Hire, repair and maintenance of health aids and appliances 12 months 6 months $1,000 t combined limit for defined appliances and individual limits for other appliances. Limits and/or sub-limits may apply per item. Travel and accommodation 2 months $200 travel, $300 accommodation Accident Benefit^^ Nil $2000 t $4000 Emergency ambulance Nil 1 trip per year (singles)/2 trips per membership (couples and families) t Per person Ë Members First º Non-Members First Per membership Combined Maximum t New members # For most items at all recognised providers covering dental, physio & chiro. Excludes hospital treatments. Fund and other rules apply. Waiting periods and yearly limits apply.^on selected packages at Members First optical providers. Conditions apply. Optical benefits are subject to your level of cover. Fund and other rules apply. Waiting periods and yearly limits apply. 14

17 Year Choose your own extras Advantage Classic Essentials At least 90% Back At least 80% Back At least 70% Back Unlimited $1,100 Year Year Amount $400 $480 $560 Amount $0 t $500 $600 Year Year Amount $640 $720 $800 Amount $700 $800 $900 $1,000 $400 $400 Combined with general dental $1,200 t Lifetime Limit $2,600 Lifetime Limit for orthodontics $1,600 t $300 Ë $250 º $240 $200 $600 t $1,200 $500 t $1,000 Amount $500 $600 $700 Year Amount $800 $900 $1,000 Year Amount $400 $480 $560 Year Amount $640 $720 $800 Combined with Physiotherapy Combined with Physiotherapy $300 $100 $100 $100 $450 $300 $150 $400 Combined with Physiotherapy $500 t $1,000 $500 $600 $350 $350 $850 90% of the cost to yearly limit t Sub-limits apply. Combined with Natural therapies 80% of the cost to yearly limit t Sub-limits apply. $100 Travel $150 Accommodation $2,000 t $4,000 1 trip per year (singles) 2 trips per membership (couples and families) **Benefits for prescription items that are non PBS, TGA approved, and not appearing on our exclusions list. +A combined yearly limit applies to this service category. Limits apply. ^^When an accident requires urgent hospital treatment, you can boost annual maximums on extras or pay for your hospital excess. For most items at our Members First extras providers covering dental, physio, chiro and selected optical. Excludes orthodontics and hospital treatments. Fund and other rules apply. Waiting periods and yearly limits apply. 15

18 Living Well Provides cover for treatments which help you live a healthier lifestyle. These include: gym memberships, yoga, Pilates, nicotine replacement therapy, weight management programs. Gym memberships, yoga and Pilates require your doctor or recognised provider to complete a Living Well form to confirm the program is medically necessary for your health. Visit bupa.com.au/livingwell

19 BUPA HEALTH COVER MADE EASY Log in to bupa.com.au/corporate To log in, get your username and password from your employer or call us on Unsure of any words? Visit: bupa.com.au/glossary Other important information you should know can be found at: bupa.com.au/corporate-info Go to bupa.com.au to see our fund rules. To find out more about what the Australian Government Rebate on private health insurance means for you, visit: bupa.com.au/rebate To get a quote: bupa.com.au/corporate To log in, get your username and password from your employer or call us on Visit a local Bupa centre

20 FOR MORE INFORMATION bupa.com.au/corporate Visit your local Bupa centre Bupa PO Box MELBOURNE VIC 8001 Bupa Australia Pty Ltd ABN Effective 1 April S The World of Bupa Health Cover Health Coaching & Programs International Health Cover Health Solutions Optical Products & Services Dental Services Aged Care Medical services Travel, Home & Car Insurance Life Insurance Pet Insurance