COVER FOR OVERSEAS VISITORS WORKING VISAS

Transcription

1 CVER FR VERSEAS VISITRS WRKING VISAS Effective 1 April 2011

2 WELCME T AUSTRALIA If you re visiting Australia to work, the last thing you want to worry about is what happens if you get sick or have an accident. The healthcare system in Australia is regarded by many as one of the best, but the cost of treatment can be expensive. And as an international visitor, you may not be eligible for cover with Medicare, Australia s public healthcare system. That s why we offer a range of covers made especially to suit the needs of international visitors. So wherever your travels take you within Australia, you can rely on us to keep you covered. ABUT BUPA AUSTRALIA Bupa Australia is a leading private health insurer providing Australians with affordable, high-quality health cover. Bupa Australia provides national coverage for our members. With a presence in every Australian state and territory, we operate under the trusted and respected brands HBA, MBF and Mutual Community, covering over three million Australians. We provide real value for members across a wide range of health services including: hospital; medical; extras; ambulance and pharmacy. As part of this, our members can save by using our extensive, national network of hospital and extras providers. More good news we are about more than health insurance. ur vision is to help our members lead longer, healthier, happier lives. As part of this we have created a range of health programs and online resources, in conjunction with experts, to support our members. If you would like to discuss any information in this brochure: Call for HBA and Mutual Community enquiries or for MBF enquiries Visit hba.com.au, mbf.com.au or mutualcommunity.com.au Pop by your local centre

3 WELCME Hospital Cover If you want cover for treatment in hospital, we ve got a range of visitors covers to choose from. You can take out visitors cover on its own, but many people choose to combine it with extras cover. We want to make it as simple as possible for you to find health cover that suits your needs and allows you to focus on the important things like enjoying life. This brochure and the Extras Premium and Benefits Guide for Visitors enclosed contain the information you need to find the cover to suit you. It is important information and should be carefully read and retained. Extras Cover We call them extras because they are services that Medicare often doesn t cover. Extras services include: dental; physiotherapy; chiropractic; optical; massage and much more. There are five levels of extras cover to choose from. You can take out extras cover on its own, or in combination with a level of visitors cover. CNTENTS Let s get started 2 Why get private health insurance? 3 Visitors Cover Choosing your Visitors Cover 4 Visitors Cover at a glance 7 What might suit you? 8 Understanding Visitors Cover 10 Visitors Cover options 14 Extras Cover 26 Extras comparison 28 Understanding Extras Cover 31 Get more back on 34 your Extras Cover Using your Cover Health programs 36 Additional member benefits 38 Join today 40 Easy ways to claim 42 Important information 44 Application form 51 Using your Cover ur health cover affords members more than you might think. We offer a range of health programs and online resources to support our members long term. Look out for our member discounts too! Join Today There are a number of easy ways to join. Simply fill out the application form included, go online, call us or pop into your local centre. Also find out how easy we make it to claim. 1

4 LET S GET STARTED We understand healthcare systems differ from country to country. So we ve provided some information to help you better understand how the Australian healthcare system works, and what this might mean for you. About Australia s healthcare system The healthcare system in Australia is made up of Medicare and private health insurance. Medicare is Australia s public healthcare system, which provides free or subsidised cover for many healthcare costs and is available to all Australian citizens and permanent residents.* If you are visiting Australia on a working visa you will not be eligible for Medicare unless you are from a country that has a Reciprocal Health Care Agreement (RHCA) with Australia see opposite to find out if this applies to you. It is important to note that even if you are eligible, you will generally only be covered for the very basics that is, for necessary medical treatment. This doesn t include treatment in a private hospital, treatment that is considered ongoing or for elective surgery; and you may be unable to choose your own doctor in hospital. That s where private health insurance comes in, and we have a range of covers made especially to suit the needs of international visitors on working visas. ur visitors cover can provide greater control in choosing where you are treated, who treats you and your preference for the timing of your treatment. It also provides cover for visits to the doctor or specialists in private practice. Plus you can receive extras cover for a wide range of health services including dental, physiotherapy, massage and much more. In short, private health insurance can help to cover the cost of your medical and hospital expenses while you are in Australia, providing security, protection and peace of mind. So, if your health is important to you, talk to us. *Norfolk Island does not participate in the Medicare program. Reciprocal Health Care Agreements Some countries have a Reciprocal Health Care Agreement (RHCA) with Australia. If you are from the United Kingdom, Ireland, Malta, Sweden, Finland, Italy, New Zealand, Norway, Belgium or the Netherlands, you may be eligible for limited benefits from Medicare. The level of protection Medicare gives you depends on which country you come from. To find out whether you have access to Medicare and what level of protection you are eligible for, you should call Medicare on What could this mean for you? If you are covered under a Reciprocal Health Care Agreement and are eligible for a Reciprocal Medicare Card you will have to pay the Medicare Levy Surcharge. The Medicare Levy Surcharge is an additional 1% tax on top of the 1.5% Medicare Levy payable by all eligible taxpayers in Australia. Reciprocal Health Cover is an additional cover option that you can purchase to help eliminate the Medicare Levy Surcharge. For more information refer to page 22. If you re not eligible for a Reciprocal Medicare Card, you should be exempt from paying the surcharge. In this instance, please contact Medicare on to apply for a Medicare Levy Surcharge exemption. 2

5 WHY GET PRIVATE HEALTH INSURANCE? Better peace of mind, when you call Australia home. As a visitor to Australia with no or limited access to Medicare, private health insurance means better peace of mind. It s an important asset to have during your stay, freeing you up from worry about the possible cost of medical treatment and allowing you to more fully enjoy your time in Australia. More control over your treatment. ur visitors cover can provide greater control in choosing where you are treated and who treats you. It also provides cover for visits to the doctor or specialists in private practice. Plus, our top-level cover also provides extras cover for a wide range of health services including dental, physiotherapy, massage and much more. We are part of the international Bupa group. Bupa Australia is part of the global Bupa Group, currently serving the healthcare needs of more than 10 million people across approximately 190 countries. Bupa Australia is the largest privately managed health insurer in Australia. Better still, the Bupa Group has no shareholders so all profits are reinvested to improve services and facilities for our members. Avoid paying more at tax time. If you re eligible to take out Reciprocal Health Cover, you may be exempt from paying the Medicare Levy Surcharge. See page 22 for more details. 333

6 CHSING YUR VISITRS CVER Want to know more details about what is and isn t covered? See pages Whilst you re in Australia it is important to have the right level of visitors cover to suit your needs and give you peace of mind. PLATINUM VISITRS CVER Platinum Visitors Cover is our highest level packaged option for visitors on working visas. You ll enjoy a combination of comprehensive cover for excess-free private hospital and medical expenses, and visits to a doctor or specialist in private practice, plus top level extras cover. You can also choose an excess option that can help reduce your premium. GLD VISITRS CVER Gold Visitors Cover provides comprehensive cover for private hospital and medical expenses, and visits to a doctor or specialist in private practice. Plus, you can choose an excess option that can help reduce your premium. CLASSIC VISITRS CVER With Classic Visitors Cover, you will receive cover for all your hospital and medical expenses in any public hospital in Australia, and visits to a doctor or specialist in private practice. Membership Types Single covers the individual member only. Couple covers the member and their partner. Family covers the member, their partner plus their single children under 21 years and single full-time students under 25 years.* *If you have any non full-time students (aged between inclusive) they will be required to purchase their own single health insurance cover. 4

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9 VISITRS CVERS AT A GLANCE VISITRS CVER Here s a quick comparison of our working visitors covers: Please note: If you are applying for a 457 Long Stay Working Visa, the below covers meet the minimum level of insurance required as set out by the Department of Immigration and Citizenship (DIAC). Your cover options Platinum ~ Gold ~ Includes cover for utpatient medical costs* Extras Public and private hospitals Public and private hospitals Classic Public hospitals only All covers include full ambulance transport services and repatriation expenses. Suitable for the following visa types: Long stay working (457); Educational (418); Regional sponsored (475); ccupational (442); Holiday working (417). Please remember that this is a guide only, so if your visa type is not on this list, or if you would like to speak with a Customer Service Consultant, call us or visit your local centre. What are extras? Extras covers expenses for everyday services including dental, optical and physiotherapy. If you select a cover that doesn t automatically include extras (that is, Classic or Gold), you can still take out a separate extras cover with us. Refer to the Extras Cover section of this brochure and the accompanying Extras Premium and Benefits Guide for Visitors to find out more about our great range of extras cover options. For more details call us or visit your local centre. * Includes General Practitioner visits Includes dental, optical, physiotherapy and more ~ Platinum and Gold Visitors Cover have a nil excess and $500 excess option to choose from. 7

10 WHAT MIGHT SUIT YU? To get a quick idea of which kind of cover might be right for you, check out the profiles below: I d like an all-in-one solution that covers both hospital and extras. You may be interested in our Platinum Visitors Cover or Platinum Visitors Cover with Excess on page 14. I d like to have comprehensive cover with a wide choice of hospitals for treatment including private hospitals. You may be interested in our Gold Visitors Cover or Gold Visitors Cover with Excess on page 18. 8

11 VISITRS CVER I m young, fit and healthy and looking for basic budget priced cover. You may be interested in our Classic Visitors Cover on page 20. I m from a Reciprocal Health Cover Agreement country and have to pay the Medicare Levy Surcharge. Do you have a cover for me? See Reciprocal Health Cover on page 22. 9

12 UNDERSTANDING VISITRS CVER What is covered? Hospital costs With private health insurance, you can choose to be treated as a private patient in either a public or a private hospital. Depending on your chosen level of cover you can be fully covered as a private patient in all Members First, Network and public hospitals in Australia. There are a small number of fixed fee hospitals that charge a fixed daily fee for a maximum number of days per stay. These hospitals should inform you of this fee when you make a booking. When admitted to hospital, in most cases you will be covered for all in-hospital charges including: accommodation for overnight or sameday stays operating theatre, intensive care and labour ward fees supplied pharmaceuticals approved by the Pharmaceutical Benefits Scheme and provided as part of your in-hospital treatment allied services including physiotherapy, occupational therapy and dietetics medication, dressings and other consumables most diagnostic tests (e.g. pathology, radiology) no gap prosthesis that are surgically implanted, Government recognised and remain in-situ upon discharge single room where available. An excess may apply depending upon your selected cover. Inpatient medical costs These are the fees charged by your doctor, surgeon, anaesthetist or other specialist for any treatment given to you when you are admitted to a hospital as an inpatient. Put simply, we pay 100% of the Australian Medical Association (AMA) Schedule fee. This is the fee determined by the AMA as the appropriate fee for a specific service. To ensure peace-of-mind, ask your doctor prior to your admission about their fees for your hospital treatment. Remember to also ask your doctor about the fees for other practitioners that may be involved in your hospital treatment such as the anaesthetist, radiologist, pathologist and assistant surgeons. utpatient medical costs This is cover for any treatment you receive from a doctor or specialist in private practice, or as a hospital outpatient anywhere in Australia. Depending on what is set out in your level of cover we cover you for 100% to 150% of the Medicare Benefits Schedule (MBS). The MBS fee is set for each specific service by the Federal Government. utpatient medical cover is available on all of our visitors covers within this brochure. You can also receive benefits on selected pharmacy items prescribed as a hospital outpatient or by a doctor or specialist. Please check your chosen level of cover for more details. What is not covered? Hospital costs Situations when you are likely not to be covered include: during a waiting period when specific services or treatments are excluded or restricted from your level of cover 10

13 Please ensure you also read the Important Information section on pages VISITRS CVER when you are treated at a non-agreement or fixed fee hospital hospital treatment provided by a practitioner not authorised by a hospital to provide that treatment hospital treatment for which Medicare would not pay any benefits, including most cosmetic surgery if you are in hospital for 35 days and you have been classified as a nursing home type patient. In this situation you may receive limited benefits or be required to make a personal contribution towards the cost of your care benefits for pharmaceuticals supplied upon discharge from the hospital some pharmaceutical items and high cost drugs, including compound and experimental items if you choose to use your own allied health provider rather than the hospitals practitioner for services that form part of your in-hospital treatment (e.g. chiropractors, dieticians or psychologists) where compensation, damages or benefits may be claimed by another source (e.g. workers compensation) any treatment or service rendered outside Australia. Medical costs You will not be covered for: medical services for surgical procedures performed by a dentist, surgical podiatrist or any other practitioner or service that is not normally eligible for a rebate by Medicare costs for medical examinations, x-rays, inoculation or vaccinations and other treatments required relating to acquiring a visa for entry into Australia or permanent residency visa. Waiting periods A waiting period is the time between when you joined us and when you are covered for a service or treatment. If you receive a service or treatment during this time, you are not eligible to receive a benefit payment from us, regardless of when you submit the claim. Different waiting periods apply for different services, please see below. the initial waiting period and the waiting period for palliative care, psychiatric and rehabilitation is two months the waiting period for pre-existing ailments, illnesses or conditions and pregnancy related services (including childbirth) is 12 months. Pre-existing ailments A pre-existing ailment is any ailment, illness, or condition that you had signs or symptoms of during the six months before you joined or upgraded to a higher level of cover with us. It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as preexisting even if you hadn t seen your doctor about it before joining or upgrading to a higher level of cover. If you knew you weren t well, or had signs of an ailment that a doctor would have detected (if you had seen one) during the six months prior to joining or upgrading, then the ailment would be classed as pre-existing. A doctor appointed by us decides whether your ailment is pre-existing, not you or your doctor. The appointed doctor must consider your treating doctors opinions on the signs and symptoms of your ailment, but is not bound to agree with them. Please note pre-existing ailments waiting periods apply to all inpatient and outpatient hospital and medical expenses. 11

14 Medical Gap This refers to the difference between what your doctor charges and the amount we will pay for inpatient and outpatient services. If your doctor charges up to the Medicare Benefits Schedule (MBS) fee or is participating in our Medical Gap Scheme, in most cases you will have no medical gap costs to pay. For doctors who are not participating in our Medical Gap Scheme and are charging above the MBS fee, we will cover up to the Schedule fee (MBS or AMA, depending on your chosen cover) and any amount above that fee you will be required to pay. This is referred to as the Medical Gap. Certainty when you go to hospital We ve negotiated with most private hospitals and day surgeries to ensure you experience certainty about the costs associated with the hospital treatment you receive there. Most of the time you will receive a no out-of-pocket experience when you use our Members First and Network hospitals. At Members First day surgeries, a no out-of-pocket expenses agreement extends to medical treatment (treatment from medical practitioners) too. A small number of hospitals may charge a fixed daily fee, capped at a maximum number of days per stay. These hospitals should inform you of this fee when you make a booking. We recommend you call us first before making a booking to confirm that your hospital of choice gives you certainty of full cover and we can discuss any excess that may be applicable to your level of cover. You can also find out if a hospital has an agreement with us by checking our website. Excess To lower the cost of your visitors cover, you have the option to apply an excess on Platinum or Gold Visitors Cover. The excess is only payable on inpatient hospital treatment and in any hospital. An excess is a set amount you pay upfront before your benefit is paid. The excess is paid each time a person on your membership is admitted into hospital, to a maximum of $500 per Single membership and $1,000 per Family membership in a calendar year. What s the Medical Gap? Gap Schedule fee Schedule fee If your specialist charges up to the Schedule fee, we can cover it completely. You won t need to pay anything further. If your specialist charges above the Schedule fee, there will be a gap. This gap is an extra amount which you will have to pay. 12

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16 VISITRS CVER PTINS Platinum Visitors Cover Platinum Visitors Cover is our highest level all-in-one solution for visitors, giving you a top level of benefits on hospital, medical treatment and extras, should you become ill or require medical treatment while you re in Australia. Plus you can choose an excess option that can help reduce your premium. Platinum Visitors Cover gives you: comprehensive hospital cover for inpatient services at Members First, Network and public hospitals in Australia medical cover outside of hospital, whilst in Australia. Details of hospital outpatient benefits are covered under What is covered? extras cover for dental, optical, physiotherapy and more. What is covered? You will receive: full cover for inpatient hospital costs, including accommodation and theatre fees. For more details, see page 10 of this brochure cover for the cost of inpatient medical services up to 100% of the Australian Medical Association (AMA) Schedule fee. This is the amount determined by the AMA as the appropriate fee for a specific service medical cover as a hospital outpatient or by a doctor or specialist in private practice anywhere in Australia, for up to 150% of the Medicare Benefits Schedule (MBS). This is the amount determined by the Federal Government as the appropriate fee for a specific service benefits for selected pharmacy items prescribed as a hospital outpatient or by a doctor or specialist. You ll receive 90% of the balance per script item, up to a maximum of $500 per person per calendar year, after you pay the Pharmaceutical Benefit Scheme patient co-payment fee. This is provided the items usage is approved by the Therapeutic Goods Administration (TGA) full ambulance cover (please refer to the Important Information section for more details on ambulance cover) benefits on crutches and wheelchairs, where provided by a recognised provider, covered up to a $500 limit per person per calendar year full cover for repatriation if terminally ill to your country of origin or return of mortal remains once authorised by Bupa Australia. You will also receive cover for repatriation if you suffer a substantial lifealtering illness or injury to your country of origin. This is up to a commercially reasonable amount once the repatriation is authorised by Bupa Australia. 14

17 Special benefits You will also be covered for special benefits including accommodation (up to $60 per night) and meal costs (up to $30 per day) if your partner, immediate family member, carer or next of kin is required to stay at hospital with you. These benefits are capped at $1,000 per person per calendar year. For more details on what is covered and if you re eligible for these benefits, please refer to the Important Information section of this brochure. You can choose an excess option of: Nil $500 Excess payable per hospital admission (this is capped per calendar year at $500 for single memberships and $1,000 for family memberships). What is not covered? While you are on Platinum Visitors Cover you will not receive cover for assisted reproductive services (including IVF). There are also other occasions when you will not be fully covered and may incur out-of-pocket expenses. Refer to the Important Information section within this brochure and page 10 for What is not covered. Hospital waiting periods the initial waiting period and the waiting period for palliative care, psychiatric and rehabilitation is two months the waiting period for pre-existing ailments, illnesses or conditions and pregnancy related services is 12 months (including childbirth). VISITRS CVER 15

18 Your extras cover You receive cover for the services listed below at any healthcare provider you choose that is recognised by us, up to your Loyalty Maximums. It s a top level of cover, where you get back 90% of the cost of treatment great cover when you need it most. Services covered You get back Loyalty Maximums per person per calendar year General Dental 90% of cost Year 1 $1,100 Year 4 $1,430 Year 2 $1,210 Year 5 $1,540 Major Dental Year 3 $1,320 Year 6 $1,650 rthodontics 90% of cost Including dentures, crowns, bridgework and precious restorations. Benefits for the replacement of dentures are payable every 3 years. 90% of cost No benefits are payable for Major Dental and rthodontics in the first year of membership. ptical 90% of cost Access a wide range of fixed price lens and frame packages at network optical providers. Contact us for more details. $300 Physiotherapy 90% of cost Year 1 $550 Year 4 $700 Year 2 $600 Year 5 $750 Year 3 $650 Year 6 $800 Chiropractic/steopathy 90% of cost Year 1 $550 Year 4 $700 Year 2 $600 Year 5 $750 Year 3 $650 Year 6 $800 Living Well 90% of cost $100 Speech Therapy 90% of cost Year 1 $700 Year 4 $850 Eye Therapy 90% of cost Year 2 $750 Year 5 $900 Year 3 $800 Year 6 $950 ccupational Therapy 90% of cost Dietary Pharmacy Psychology Podiatry Health Aids and Appliances Hire, Repair and Maintenance of Health Aids and Appliances Natural Therapies 90% of cost 90% of cost (less PBS fee) Covers selected items. You pay a set amount, we refund 90% of the remaining balance per script. See Important Information for full details. 90% of cost 90% of cost 90% of cost 90% of cost up to $100 90% of cost Including acupuncture, Alexander Technique, Chinese herbalism, Exercise Physiology, Feldenkrais, homeopathy, iridology, massage, naturopathy, western herbalism. Massage includes aromatherapy, Bowen Technique, kinesiology, reflexology, shiatsu, and therapeutic massage. Home Nursing 90% of cost up to $350 Antenatal and Postnatal by Midwife 90% of cost $400 16

19 More from your membership Loyalty maximums recognise you for your loyalty with us. For most extras services, we increase the amount you can claim up to in a year each year up to a maximum of six years. Additional benefit You will also be covered for travel and accommodation benefits for essential medical treatment: $100 for travel expenses and $40 per night up to $150 for accommodation expenses per year. To confirm if you re eligible for this benefit, please refer to the Important Information section of this brochure. Extras waiting periods the initial waiting period is two months the waiting period for Living Well benefits, hire, repair and maintenance of health aids and appliances is six months the waiting period for major dental, orthodontics, pre-existing ailments, illnesses or conditions and selected health aids and appliances is 12 months. VISITRS CVER 17

20 Gold Visitors Cover Gold Visitors Cover offers top-level protection with benefits on hospital and medical treatment, should you become ill or require medical treatment while you re in Australia. Plus, you can choose an excess option that will help reduce your premium. Many people also choose to combine a level of visitors cover with extras cover. Refer to the Extras Premium and Benefits Guide for Visitors at the back of the brochure for more information on extras cover. Gold Visitors Cover gives you: comprehensive hospital cover for inpatient services at Members First, Network and public hospitals in Australia medical cover outside of hospital, whilst in Australia. Details of hospital outpatient benefits are covered under What is covered?. What is covered? You will receive: full cover for inpatient hospital costs, including accommodation and theatre fees. For more details, see page 10 of this brochure cover for the cost of inpatient medical services up to 100% of the Australian Medical Association (AMA) Schedule fee. This is the amount determined by the AMA as the appropriate fee for a specific service medical cover as a hospital outpatient or by a doctor or specialist in private practice anywhere in Australia, for up to 150% of the Medicare Benefits Schedule (MBS). This is the amount determined by the Federal Government as the appropriate fee for a specific service benefits for selected pharmacy items prescribed as a hospital outpatient or by a doctor or specialist. You ll receive 90% of the balance per script item, up to a maximum of $500 per person per calendar year, after you pay the Pharmaceutical Benefit Scheme patient co-payment fee. This is provided the items usage is approved by the Therapeutic Goods Administration (TGA) full ambulance cover (please refer to the Important Information section for more details on ambulance cover) benefits on crutches and wheelchairs, where provided by a recognised provider, covered up to a $500 limit per person per calendar year full cover for repatriation if terminally ill to your country of origin or return of mortal remains once authorised by Bupa Australia. You will also receive cover for repatriation if you suffer a substantial lifealtering illness or injury to your country of origin. This is up to a commercially reasonable amount once the repatriation is authorised by Bupa Australia. Special benefits You will also be covered for special benefits including accommodation (up to $60 per night) and meal costs (up to $30 per day) if your partner, immediate family member, carer or next of kin is required to stay at hospital with you. These benefits are capped at $1,000 per person per calendar year. For more details on what is covered and if you re eligible for these benefits, please refer to the Important Information section of this brochure. You can choose an excess option of: Nil $500 Excess payable per hospital admission (this is capped per calendar year at $500 for single memberships and $1,000 for family memberships). What is not covered? While you are on Gold Visitors Cover you will not receive cover for assisted reproductive services (including IVF). There are other occasions when you will not be fully covered and may incur out-of-pocket expenses. Please refer to the Important Information section within this brochure and page 10 for What is not covered?. Waiting periods the initial waiting period and the waiting period for palliative care, psychiatric and rehabilitation is two months the waiting period for pre-existing ailments, illnesses or conditions and pregnancy related services (including childbirth) is 12 months. 18

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22 Classic Visitors Cover Classic Visitors Cover is a basic value cover option. It helps to ensure you have control of your healthcare, should you need hospitalisation or medical treatment as well as being great value. Many people also choose to combine a level of visitors cover with extras cover. Refer to the Premium and Benefits Guide at the back of the brochure for more information on extras cover. Classic Visitors Cover gives you: hospital and medical cover for inpatient services in any public hospital in Australia medical cover outside of hospital, whilst in Australia. Details of hospital outpatient benefits are covered under What is covered?. What is covered? You will receive: cover for inpatient hospital costs in a public hospital, including accommodation (shared room only) and theatre fees, except where exclusions apply. If you choose to be treated in a private hospital, you ll receive minimum benefits only, which may result in large out-of-pocket expenses. For more details, see page 10 of this brochure cover for the cost of inpatient medical services in public hospitals up to 100% of the Australian Medical Association (AMA) Schedule fee. This is the amount determined by the AMA as the appropriate fee for a specific service medical cover as a hospital outpatient or by a doctor or specialist in private practice anywhere in Australia, up to 100% of the Medicare Benefits Schedule (MBS). This is the amount determined by the Federal Government as the appropriate fee for a specific service up to a maximum of $500 per person per calendar year, after you pay the Pharmaceutical Benefit Scheme patient co-payment fee. This is provided the items usage is approved by the Therapeutic Goods Administration (TGA) no excess full ambulance cover (please refer to the Important Information section for more details on ambulance cover) full cover for repatriation if terminally ill to your country of origin or return of mortal remains once authorised by Bupa Australia. In addition, you ll receive cover for repatriation if you suffer a substantial life-altering illness or injury to your country of origin, up to a commercially reasonable amount once authorised by Bupa Australia. What is not covered? While you are on Classic Visitors Cover you will not receive cover for assisted reproductive services (including IVF). There are other occasions when you will not be fully covered and may incur out-of-pocket expenses. Please refer to the Important Information section within this brochure and page 10 for What is not covered?. Waiting periods the initial waiting period and the waiting period for palliative care psychiatric and rehabilitation is two months the waiting period for pre-existing ailments, illnesses or conditions and pregnancy related services (including childbirth) is 12 months. benefits for selected pharmacy items prescribed as a hospital outpatient or by a doctor or specialist. You ll receive 90% of the balance per script item, 20

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24 Reciprocal Health Cover Reciprocal Health Cover is an additional cover option that you can purchase to help eliminate the Medicare Levy Surcharge. The Medicare Levy Surcharge is an additional 1% tax on top of the 1.5% Medicare Levy payable by all eligible taxpayers in Australia. See page 2 for a quick overview of Reciprocal Health Care Agreements (RHCA) and what that could mean for you. Do you have to pay Australia s Medicare Levy Surcharge? How does Reciprocal Health Cover work? ur Reciprocal Health Cover provides an exemption to the Medicare Levy Surcharge. It doesn t offer any additional cover and can only be purchased in conjunction with Platinum, Platinum with Excess, Gold, Gold with Excess or Classic Visitors Cover. At the end of the financial year, you ll receive a tax statement which can be provided to the Australian Tax ffice to exempt you from paying the Medicare Levy Surcharge. If you: are from a RHCA country and eligible for a Reciprocal Medicare Card in Australia earn over the threshold* amount of $77,000 a year (for singles) or $154,000 a year (for families^) don t have private hospital cover you may be required to pay the Medicare Levy Surcharge. If you re unsure, please discuss with your accountant. Note: if you take out Platinum, Platinum with Excess, Gold, Gold with Excess or Classic Visitors Cover without also taking out Reciprocal Health Cover, you may be required to pay the Medicare Levy Surcharge. Reciprocal Health Cover can help to eliminate the Medicare Levy Surcharge. See page 2 for more details. * Thresholds are applicable as at 1 July 2010 and are indexed annually. ^ Increases by $1,500 per child, after the first child. 22

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26 Premiums The table below shows the premiums for our visitors cover options. For any further information, simply contact us or visit your local centre. Platinum Platinum with Excess Gold Gold with Excess Classic Reciprocal Health Cover Singles Families Singles Families Singles Families Singles Families Singles Families Singles Families Weekly $52.62 $ $45.19 $90.38 $40.32 $80.63 $34.32 $68.64 $19.64 $39.27 $13.00 $26.00 Monthly $ $ $ $ $ $ $ $ $84.98 $ $56.40 $ Yearly $2, $5, $2, $4, $2, $4, $1, $3, $1, $2, $ $1, Premiums include a 10% Goods and Services Tax (GST) on hospital cover, except for Reciprocal Health Cover which has no GST applicable. Save with the Federal Government rebate The Federal Government provides a 30% rebate on private health insurance premiums, helping to make quality healthcover affordable and accessible. You are eligible for the rebate if you hold a Reciprocal Medicare card. It s available on the extras component of Platinum Visitors Cover and Platinum Visitors Cover with Excess and our other extras cover options, as well as Reciprocal Health Cover. Better still, if you re aged between 65 69, the rebate increases to 35% and if you re aged 70 or more, it s 40%. Contact us for further details on extras premiums. Platinum Visitors Cover with the Federal Government 30% Rebate Platinum Visitors Cover with Excess with the Federal Government 30% Rebate Reciprocal Health Cover with the Federal Government 30% Rebate Singles Families Singles Families Singles Families Weekly $45.77 $91.58 $38.34 $76.73 $9.10 $18.20 Monthly $ $ $ $ $39.45 $78.95 Yearly $2, $4, $1, $3, $ $ Premiums include a 10% Goods and Services Tax (GST) on hospital cover, except for Reciprocal Health Cover which has no GST applicable. Like more information? Please refer to the accompanying Extras Premium and Benefits Guide for Visitors for further details about extras premiums, call us or visit your local centre. 24

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28 EXTRAS CVERS Please refer to the following Extras pages in this brochure along with your Extras Premium and Benefits Guide for Visitors for details on extras. PLATINUM EXTRAS A wide range of services with the highest benefits and annual maximums from our extras covers. INCLUDES BENEFIT BNUSES! GLD EXTRAS A wide range of services with high benefits and annual maximums. INCLUDES BENEFIT BNUSES! SILVER EXTRAS A wide range of services with a good level of benefits and annual maximums. INCLUDES BENEFIT BNUSES! YUR CHICE EXTRAS A competitively priced extras cover for people who want the freedom to choose four services to suit their needs. INCLUDES LYALTY MAXIMUMS! BRNZE EXTRAS For the young, fit and healthy on a budget this covers a limited range of services. 26

29 Finding a network provider for your extras cover is easy! Simply go to our website and enter your state and postcode to find one near you. Also, you can now search for a provider using our iphone application which is available on itunes. iphones, ipod touch, itunes and App Store are a trademark of Apple Inc. EXTRAS CVER 27

30 EXTRAS CMPARISN Services General Dental Major Dental rthodontics ptical Physiotherapy Chiropractic and steopathy Antenatal and Postnatal Waiting periods 2 months 12 months 12 months 2 months 2 months 2 months 2 months Bronze Extras At least 60% cover $350 per person $700 per policy $210 per person $420 per policy (network) $150 per person $300 per policy (non-network) $350 per person $700 per policy Combined annual maximum Your Choice Extras** At least 60% cover Year Amount Year Year $700 $840 $980 $1,120 $1,260 $1,400 Amount $0 $500 $600 $700 $800 $900 $1,000 Amount $0 $450 $540 $630 $720 $810 $900 Lifetime Limit: $1,300 $260 (network) $180 (non-network) Year Year Amount $450 $540 $630 $720 $810 $900 Amount $350 $420 $490 $560 $630 $700 $350 sub-limit. Combined with physiotherapy. Silver Extras At least 60% cover Gold Extras At least 75% cover Platinum Extras At least 90% cover Unlimited Unlimited Unlimited $1,000 $1,100 $1,200 $700 Lifetime Limit $2,000 $290 (network) $200 (nonnetwork) $800 Lifetime Limit $2,600 $340 (network) $240 (nonnetwork) $900 Lifetime Limit $2,800 $380 (network) $280 (nonnetwork) $700 $800 $900 $500 $600 $700 $350 $400 $450 All limits are based on per person per calendar year for Your Choice, Silver, Gold and Platinum. Bronze has per person and per policy limits. **You may only select four services at any one time under Your Choice extras and receive benefits for those selected services. nce a selection is made, the selected services are locked in for a period of at least 12 months before you are able to change them. = Loyalty Maximums. For most items at network providers. Annual maximums apply.

31 Services Natural Therapies Includes acupuncture, Alexander Technique, Chinese herbalism, exercise physiology, Feldenkrais, homeopathy, iridology, naturopathy and Western herbalism. Massage includes aromatherapy, Bowen Technique, kinesiology, reflexology, shiatsu, and remedial massage. Waiting periods 2 months Bronze Extras $100 sub-limit. Combined with physiotherapy, chiropractic, osteopathy, antenatal and postnatal. Your Choice Extras** Year Amount $500 $600 $700 $800 $900 $1,000 Includes sub-limits for massage: $100 per person Living Well (see page 36) 6 months Pharmacy^^ 2 months Dietary 2 months Psychology 2 months Podiatry 2 months Speech Therapy Eye Therapy 2 months ccupational Therapy Home Nursing 2 months Health Aids and Appliances (verall) + $50 per person $100 $100 per person $200 per policy Year Year Amount $300 $360 $420 $480 $540 $600 Amount $400 $480 $560 $640 $720 $800 Sub-Limits Asthma Pumps Blood Glucose Monitors or INR Blood Testing Devices (Coagucheck) Defined Appliances^ 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 Emergency Ambulance Services # 6 months 2 months No waiting period 29 1 service per calendar year 1 service per calendar year All limits are based on per person per calendar year for Your Choice, Silver, Gold and Platinum. Bronze has per person and per policy limits. **You may only select four services at any one time under Your Choice extras and receive benefits for those selected services. nce a selection is made, the selected services are locked in for a period of at least 12 months before you are able to change them. = Loyalty Maximums.

32 Silver Extras Gold Extras Platinum Extras $400 Includes sub-limits for massage: $150 per person $500 Includes sub-limits for massage: $200 per person $500 Includes sub-limits for massage: $200 per person EXTRAS CVER $100 $100 $100 $500 $600 $700 $400 $500 $500 $400 $500 $500 $400 $500 $500 $400 $500 $500 $400 $500 $500 $400 $500 $500 $350 $350 $400 $800 $1,000 $1,200 1 claim every 2 years up to $200 1 claim every 2 years up to $300 1 claim every 2 years up to $400 1 claim per year up to $400 1 claim per year up to $500 1 claim per year up to $600 $500 $800 $1,000 $100 $100 $100 1 claim every 2 years up to $500 1 claim every 2 years up to $750 1 claim every 2 years up to $1,000 1 claim every 3 years up to $500 1 claim every 3 years up to $800 1 claim every 3 years up to $850 $125 per item $150 per item $200 per item $125 per item $150 per item $200 per item $100 $100 $100 $100 Travel $150 Accommodation $100 Travel $150 Accommodation $100 Travel $150 Accommodation 1 service per calendar year 1 service per calendar year 1 service per calendar year ^^Benefits for prescription items that are non-pbs, TGA approved for the use of that condition and not appearing on our exclusions list. +A combined annual maximum applies to this service category. ^Defined appliances includes: insoles, orthopaedic and corrective footwear, pressure garments, braces and artificial limbs. Annual maximums apply per item. # Subject to eligibility. Call us for details. *There are different state ambulance arrangements across Australia. Please see p45 for details. 30

33 UNDERSTANDING EXTRAS CVER Please ensure you also read the Important Information section on pages What is covered? Extras cover provides you with benefits for services that are not claimable by a third party (e.g. Medicare). Medicare does not provide benefits for the below: most dental examinations and treatment most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services acupuncture (unless part of a doctor s consultation) or other natural therapies glasses and contact lenses most health aids and appliances home nursing. With extras cover you can claim benefits for extras services which are listed as part of your chosen level of cover. You will receive benefits as long as: the treatment is given by a private practice provider who is recognised by us the provider meets the criteria set out in our Policy and verseas Visitors Rules. What is not covered? Extras benefits will not be payable: where a third party has provided a benefit including Medicare or other Government bodies (except for hearing aids and breast prosthesis items) for different services within the same modality from the same provider on the same day. For example, if you went to see an acupuncturist and then received a massage from the same provider on the same day, you cannot claim for both services when a prescribed treatment is not custom-made (e.g. orthotics, surgical shoes) when they do not meet the criteria set out in our Policy and verseas Visitors Rules. Please refer to the Extras Premium and Benefits Guide for Visitors in the back of this brochure for specific details about the level of extras cover available to you

34 Waiting periods A waiting period is the time between when you joined us and when you are covered for a service or treatment. If you receive a service or treatment during this time, you are not eligible to receive a benefit payment from us, regardless of when you submit the claim. Different waiting periods apply for different services, please see below: initial waiting period two months hire, repair and maintenance of health aids and appliances; and Living Well Programs six months major dental; orthodontics; selected health aids and appliances and preexisting ailments 12 months. Pre-existing ailments A pre-existing ailment is any ailment, illness, or condition that you had signs or symptoms of during the six months before you joined or upgraded to a higher level of cover with us. It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as preexisting even if you hadn t seen your doctor about it before joining or upgrading to a higher level of cover. If you knew you weren t well, or had signs of an ailment that a doctor would have detected (if you had seen one) during the six months prior to joining or upgrading, then the ailment would be classed as pre-existing. A doctor appointed by us decides whether your ailment is pre-existing, not you or your doctor. The appointed doctor must consider your treating doctors opinions on the signs and symptoms of your ailment, but is not bound to agree with them. 32

35 33 EXTRAS CVER

36 GET MRE BACK N YUR EXTRAS CVER If you select any of the Extras Covers included in this brochure you will have access to the following features and benefits. Save with our Australia-wide provider networks ur extensive MBF MemberCare and Members First provider networks offer nation-wide access to dental; optical; physiotherapy and chiropractic services at set prices. If you have extras cover with us, you can save money by choosing these providers, rather than nonnetwork providers, because their fees and any discounts have been negotiated and agreed upfront. Plus you can expect less out-ofpocket expenses and upfront notice of any gap amounts in most instances. Visit our website to find a network provider near you. Also, keep an eye out for the following logos at your providers: Get more back on Extras These are just some of the great benefits you can get by using our MBF MemberCare and Members First network providers: up to 100% and at least 60% back on all general dental treatment^ up to 100% and at least 60% back on most optical, physiotherapy and chiropractic services^ higher annual maximums on optical than non-network providers less out-of-pocket expenses and upfront notice of any gap amounts discounts at optical providers a range of fixed-priced packages on glasses and contact lenses at no additional cost* up to $100 off a wide range of fashion frames 20% off a variety of sunglasses and nonstandard contact lenses. # 70 % 80 % 90 % 60 % 100 % Choose from thousands of network providers across Australia and enjoy on-thespot claiming! ^The percentage you get back on general dental treatment is dependant on your level of cover and up to your annual maximums.*ptical benefits are subject to your level of cover, annual maximums and waiting periods. # Not in conjunction with any other offer. ther non MBF MemberCare/Members First optical benefits ur optical partnership with Specsavers, means you benefit from a choice of fixedprice frames and lenses packages, depending on your level of cover, annual maximums and waiting periods. Visit our website to find an optical partner store near you. 34

37 Great product features Loyalty maximums on selected covers, we increase the amount you can claim each year by 20% for most services (applies after the first 12 months up to a maximum increase of 100%) Benefit bonus on selected covers, you get 2% more back on your extras claims each year, up to a maximum of 10% (applies each calendar after the first 12 months). Gap Free Dental For Kids We cover the cost of your kids general dental up until they turn 25. This means you ll benefit from no out-of-pocket costs on most dental services like check-ups, teeth cleaning, fillings, x-rays and more. ~ ~ Available only for treatment provided by a network Members First or MBF MemberCare dentist, on benefits payable. Available on Platinum or Platinum Visitors Cover with Excess and Gold, Gold with Excess and Classic Visitors Cover when taken out with Silver, Gold or Platinum Extras. Family memberships only. Includes Major Dental in VIC and SA only. Excludes orthodontics and hospital treatments. Dental fund rules, waiting periods and annual maximums apply. Child dependants only. ngoing support for members We are committed to helping our members lead longer, happier, healthier lives. This means giving ongoing support to help you get value from your cover. We also offer preventative health and wellness programs for their long-term benefit such as Living Well and Positive Health. See page 36 for more details. Exciting member discounts Get discounts on movie tickets, theme parks, airfares, fitness programs and much more! See page 38 for more details about our in2life deals. Get up to 100% and at least 60% back when treated by our network providers.^ EXTRAS CVER 35

38 HEALTH PRGRAMS Positive Health programs If you have a chronic health condition, we d like to help you get on the road to recovery as soon as possible. ur Positive Health Programs provide valuable information on how to help better manage your condition together with your doctor or health professional. ur programs are created using evidencebased medicine and research, in consultation with health experts and top national health organisations. They include action plans to further assist you in managing your condition; help you reduce the symptoms you may experience; and help minimise any impact on your everyday life. The following programs are available on selected levels of visitors cover: Arthritis Management Program Asthma Management Program Back Pain Management Program Chronic bstructive Pulmonary Disease Management Program Congestive Heart Failure Program Coronary Artery Disease and Angina Management Program Depression Management Program Diabetes Management Program steoporosis Management Program. Living Well Programs ur Living Well Programs help cover health related programs from approved, recognised providers on selected extras covers. These programs include: first aid courses nicotine replacement therapy weight management programs fees only and some weight loss drugs gym membership fees yoga courses Pilates. Please note that a Living Well programs approval form must be completed by your doctor for gym memberships, yoga and Pilates to confirm the program is medically necessary. ther benefit and recognition criteria apply. Subject to annual limits. To find out more visit us online or talk to one of our customer service consultants. Bowel cancer is the most frequently occurring cancer in Australia to affect both men and women. The good news is that it s one of the most curable types of cancer if detected early.* We will pay a benefit towards selected bowel cancer screening kits. Contact us for details. *Sourced from the Bowel Cancer Australia website. 36

39 We are committed to helping members to better manage their health for the long term. USING YUR CVER 37

40 ADDITINAL MEMBER BENEFITS in2life partners in2life brings you a range of discounts and deals from specially selected partners to help you enjoy some health and wellness perks at an affordable price. Whether it s fitness and sports you re interested in or rest, relaxation and travel you can choose what suits your needs from our range of in2life partner discounts. For a complete list of in2life partner discounts and full terms and conditions, visit one of the following websites: MBF members mbf.com.au/in2life HBA members hba.com.au/in2life Mutual Community members mutualcommunity.com.au/in2life FF Get great value with up to 25% off Hoyts, Event Cinemas, Greater Union, Birch, Carroll & Coyle and Village Cinemas tickets when you purchase online through in2life (website listed above). FF Receive a 10% discount on a 12 month membership, one month membership at a reduced price R a free health assessment and personal training session at Goodlife Health Clubs. Visit in2life (website listed above) for more information. UP T FF FF Save up to 10% on selected fares when you book online and fly with British Airways. Visit in2life (website listed above) for more information. FF Take a self-help approach to health and fitness with 20% off tailored home fitness programs when you purchase online at guyleechfitness.com. Visit in2life (website listed above) for more information. 38

41 FF Enjoy $30 off any RedBalloon experience when you spend $129 or more and purchase online through in2life (see web address on opposite page). FF Simply present your membership card to receive a 20% discount off the usual retail price on a range of sunglasses displayed at any Blink ptical or National Pharmacies ptical store. USING YUR CVER FF FF Simply present your membership card to receive up to 20% off the usual retail price on selected frames, lenses and contact lenses; and up to 10% off the usual price of sunglasses. Simply present your membership card and enjoy two full-priced games and shoe hire with 25% off at any AMF Bowling Centre. FF FF Warner Village theme parks will give you a 10% discount on day admission for adults, children and pensioner passes. Just present your membership card at the entry gate. Another benefit for members Receive a 15% discount on the admission price to Dreamworld and WhiteWater World on the Gold Coast, when you purchase tickets online through in2life (see web address on opposite page). Travel Insurance FF As a member you can receive up to 15% off your travel insurance. See the back of the brochure for contact details. 39

42 JIN TDAY It s easy to join but before you do, please read the details of your chosen cover in this brochure. This includes the Important Information section on pages Also refer to the Extras Premium and Benefits Guide for Visitors enclosed. We have also included an application form at the back of this brochure for your convenience. nly one form to fill in Fill in the application form and: mail it to us using our reply paid address or drop it into one of our local centres r you can simply: join over the phone join online Easy ways to pay You can choose to pay via Direct Debit, online at any retail centre, Australia Post, via BPAY or over the phone. Transferring is simple Transferring to us from your existing Australian health fund or Bupa Group health fund from overseas is simple. Just fill in our application form and cancel any direct debit arrangement you may have with your existing fund. We will contact your existing fund on your behalf to make all the other arrangements for you. If you have received a clearance certificate from your previous fund, please send it to us with your application form. 40

43 Top 3 reasons to join now: 1. Peace of mind, when you call Australia home. 2. More control over your treatment. 3. We are part of the international Bupa Group. See the front of this brochure for more information. JIN TDAY 41

44 EASY WAYS T CLAIM Save time and effort by claiming on the spot at over 40,000 provider locations throughout Australia Claiming for Extras n the spot n-the-spot electronic claiming is the easiest way to claim on your extras cover. Simply swipe your membership card after your treatment at one of the 40,000 provider locations around Australia, and your claim is processed automatically. You may be asked to then pay the balance of the bill. nline claiming ur online claims service is a quick and convenient way for you to claim on selected extras, where you have paid the provider in full*. In many instances you ll receive fast payment into your bank account. Claiming is subject to the standard conditions of your cover including waiting periods and annual maximums. Claiming for Hospital Medical Gap Scheme ur Medical Gap Scheme is a direct billing system designed to help our members reduce or eliminate any out-of-pocket expenses for hospital treatment. If your specialist uses our Medical Gap Scheme they will bill us directly. So you either won t pay any out-of-pocket expenses or even receive a bill or you ll know about any gap payable for that specialist prior to treatment. All specialists that are registered with us can choose to use the Medical Gap Scheme. Ask your specialist about it before undergoing treatment. * The following services are not claimable online: Medical Gap, pharmacy, health aids and appliances, ambulance services, orthodontic, travel & accommodation, hospital claims. 42

45 Claiming for both Hospital and Extras By mail You can make a hospital or extras claim by mail. Simply print out a claim form from our website and complete it, then attach the original account(s) or receipt(s) that you received from your healthcare provider(s). Then mail it to us at: GP BX 9809 Brisbane QLD In person You can submit your claims at your local centre. Most centres are able to process claims on the spot and provide you with benefits, either by cash (limits apply), cheque or bank transfer. Claim queries Remember that claims can only be paid within two years of the date on which the service was rendered. Contact us if you have a question about: the status of your claim how to fill in a claim form what documents you need to attach to your claim form See the back of this brochure for full contact details. 43

46 IMPRTANT INFRMATIN ver the next few pages you will find information to help you understand how your health cover with us works. We recommend you keep this information in a safe place so that you can always refer to it. From time to time, things can change. Before you seek any treatment call us so we can give you the most complete and up-to-date information. Please be aware that these rules apply in addition to our Policy and verseas Visitors Rules. 1. Premiums and benefits You must pay the premium that applies to you. In addition, if you take out extras cover as an add-on to visitors cover, please note premiums for extras covers differ from state to state due to different state charges. If you move to another state, your premium on extras will change too. Therefore you must let us know about any change of address. To receive the benefits available on your cover, you need to: fully complete the application process and pay your premiums one month in advance ensure that newborns are enrolled onto a family membership within two months of their birth to avoid any waiting periods for your baby enrol your adult children under their own names within 60 days after they no longer qualify under your cover (to avoid a break in their cover) provide proof of purchase of what you have spent before we can reimburse you for any services received submit your claims within two years of when the service was given (we can t pay benefits for any claims that are older than this). 2. Accidents An accident is an unforeseen event, occurring by chance and caused by an unintentional and external force or object resulting in involuntary hurt or damage to the body, which requires immediate (within 72 hours) medical advice or treatment from a registered practitioner other than the policyholder. 3. Suspension rules A membership may be suspended when travelling overseas for work or leisure. If you are travelling overseas, you may choose to suspend your membership during this period of time. You can suspend your cover for the following period of time: a minimum period of one months travel; and a maximum period of three months per suspension. A limit of one suspension per calendar year is permitted, with no further suspensions allowed after the fifth year of membership. ne month contributions are required between each suspension period. To be eligible to suspend your cover you must: have been a financial member for at least six months; apply for suspension prior to the departure date; provide overseas travel documentation showing your departure and return dates; notify us of your return to Australia within 14 days of your arrival; and complete an overseas travel suspension form. 44

47 4. Ambulance cover You receive full ambulance cover, including uncapped emergency and non-emergency transportation and on-the-spot treatment. If you need to make a claim for emergency ambulance benefits, we will give you a Patient Ambulance Transportation Form to complete. 5. Recognised ambulance providers For all overseas visitors covers we will only pay benefits towards ambulance services when they are provided by any of the following recognised providers: ACT Ambulance Service Ambulance Service of NSW Ambulance Victoria Queensland Ambulance Service South Australia Ambulance Service St John Ambulance Service NT St John Ambulance Service WA Tasmanian Ambulance Service. 6. Repatriation benefits We pay benefits for you, and an accompanying family member, for medical repatriation if you are terminally ill or suffer a substantial life-altering illness or injury to your home country, when this is deemed necessary by your medical practitioner and in consultation with us. We ll also pay benefits for the cost of returning your body to your home country. Please note, you must contact us before repatriation will be organised. The decision to repatriate will only be made between us and the treating doctor. 7. No Gap or Known Gap prostheses Surgically implanted prostheses are classified by the Government as No Gap or Known Gap prostheses. Prostheses include pacemakers, defibrillators, cardiac stents, joint replacements, intraocular lenses and other devices that are surgically implanted during a stay in hospital. If your doctor chooses a No Gap prosthesis you will not have any out-ofpocket expenses where the prosthesis item is implanted as part of hospital treatment. If the prosthesis item used is listed as a Known Gap prosthesis you ll have to pay any gap charged by the hospital. You can ask your specialist to choose a No Gap prosthesis as there is one available for every surgical treatment. 8. ut-of-pocket Expenses You are likely to experience out-of-pocket expenses when you are not fully covered for services and benefits, or when a set benefit applies. You should read the section on what is and what isn t covered within this brochure for your relevant level of cover to determine when an out-of-pocket expense may occur. You should also refer to our verseas Visitors Rules for any additional information on benefits payable. A copy of our verseas Visitors Rules can be found on our website. It is important to ensure when being admitted to hospital that Informed Financial Consent is provided to you for a pre-booked admission to allow you to understand any out-of-pocket expenses upfront. If you have received any out-of-pocket expenses and require clarification, please contact us directly. 9. Exclusions Exclusions for specific procedures or services means you will not be covered and may have significant out-of-pocket costs should you require treatment for an excluded service. All visitors covers do not provide any benefits for services not covered by Medicare. Always check with us to determine if your treatment will be covered. 10. Pharmaceuticals If you choose to be treated with drugs that are not approved by the Pharmaceuticals Benefits Scheme you may not be fully covered and the hospital may charge you for part of the cost. You ll be advised by the hospital of any charges before treatment. 11. Pre-existing ailments A pre-existing ailment is any ailment, illness, or condition that you had signs or symptoms of during the six months before you joined or upgraded to a higher level of cover with us. It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as pre-existing even if you hadn t seen your doctor about it before joining or upgrading to a higher level of cover. 45

48 If you knew you weren t well, or had signs of an ailment that a doctor would have detected (if you had seen one) during the six months prior to joining or upgrading, then the ailment would be classed as pre-existing. A doctor appointed by us decides whether your ailment is pre-existing, not you or your doctor. The appointed doctor must consider your treating doctors opinions on the signs and symptoms of your ailment, but is not bound to agree with them. 12. When to contact us If you have less than 12 months membership on your current visitors cover, make sure you contact us before you are admitted to hospital and find out whether the pre-existing ailment waiting period applies to you. We need about 5 working days to make the pre-existing ailment assessment, subject to the timely receipt of information from your treating medical practitioner(s). Make sure you allow for this timeframe when you agree to a hospital admission date. If you proceed with the admission without confirming benefit entitlements and we (the health fund) subsequently determine your condition to be pre-existing, you will be required to pay all hospital charges and medical charges you incur by the hospital and your doctors. 13. Emergency admissions In an emergency, we may not have time to determine if you are affected by the preexisting ailment rule before your admission. Consequently, if you have less than 12 months membership on your current visitors cover you might have to pay for some or all of the hospital and medical charges if: you are admitted to hospital and you choose to be treated as a private patient, and we later determine that your condition was pre-existing. 14. Special Benefits If you re on a cover that provides Special Benefits cover, you could receive benefits for accommodation and meal costs if your partner, immediate family member, carer or next of kin is required to stay at hospital with you or a person on your membership. They will be covered for $60 per night for accommodation in hospital and up to $30 a day for hospital meals. Hospital meals are covered when provided at a hospital cafeteria, kiosk or patient meal menu. These benefits are capped at $1,000 per person, per calendar year. This benefit is available on Platinum, Platinum with Excess, Gold and Gold with Excess Visitors Covers only. 15. No gap dental for kids We offer cover for the cost of your kids general dental at Members First and MBF MemberCare dentists, right up until they turn 25. That means you ll benefit from no out-ofpocket costs when you visit a Members First dentist including check-ups, teeth cleaning, fillings, x-rays and more! Available only for treatment provided by a Members First or MBF MemberCare dentist, on benefits payable. Available on Platinum and Platinum Visitors Cover with Excess, and Gold, Gold with Excess and Classic Visitors Cover when taken out with Silver, Gold or Platinum Extras. Family memberships only. Includes Major Dental in VIC and SA only. Excludes orthodontics and hospital treatments. Dental fund rules, waiting periods and annual maximums apply. Child dependants only. 16. Great discounts with Pharmacy Saver Add Pharmacy Saver to any visitors cover with extras and enjoy savings on your pharmaceutical and healthcare purchases all year round at National Pharmacies stores. You ll get a 20% discount on a variety of health-related products.* Pharmacy Saver is not available for prescriptions on which the Government does not allow discounts. Visit a National Pharmacies store for more information (outlets located in VIC, SA and NSW; online discounts available nationally). * These are products designed to manage or prevent disease, injuries or a condition, or prescribed in connection with an episode of hospital treatment. Pharmacy Saver may not be available if you are on a corporate plan. 17. Extras Cover With extras cover, you can claim benefits for services which are listed on your cover and not claimable elsewhere. To receive benefits for your extras services, you must visit professionals who are recognised by us. If you would like to check that your provider is registered with us please call us, drop into your local centre, or visit our website. 46

49 You re also able to claim more than once in a day at the same provider for different services, as long as that provider is recognised by us in each profession. For example, if you went to see a practitioner for a dietary consultation and then a massage, you could claim for both services as long as your practitioner is a recognised provider with us in both the dietary and massage professions. However, you cannot claim for two or more of the same services, for example two chiropractic consultations or two natural therapies consultations at the same provider on the same day. No benefits are payable for items that are not custom-made as a result of a prescribed treatment. 18. Calendar year We pay benefits based on the calendar year and between the periods of 1 January to 31 December. 19. Health aids and appliances To receive benefits for health aids and appliances you ll need to visit one of our recognised providers. You ll also need to meet the eligibility criteria, provide proof of purchase and a clinical referral where required. It is important to note that benefits are not payable when a prescribed treatment is not custom-made (e.g. orthotics). Visit our website for more information. 20. Hire, repair and maintenance of health aids and appliances Benefits are not payable in the first 12 months after purchasing an item; within 12 months following the repair; or on items where hire and repair are deemed inappropriate. 21. Home nursing Benefits are payable towards some home nursing services that do not need to take place in a hospital and are provided in the home. 22. Living Well Programs ur Living Well Programs help cover health related programs from approved, recognised providers. You can visit our website for a list of our recognised providers. A Living Well Programs approval form must be completed by your doctor for gym memberships, yoga and Pilates to confirm that the program is medically necessary. ther benefit and recognition criteria apply. 23. Pharmacy Pharmacy covers you for prescription items that are non PBS (Pharmaceutical Benefits Scheme) listed drugs and are TGA (Therapeutic Goods Administration) approved for that condition. There are some items that are not covered by our pharmacy benefit and these include: over the counter items compounded items non-prescription items weight loss medication (some weight loss medications are covered under the Living Well Programs) body enhancing medications (e.g. anabolic steroids); and erectile dysfunction drugs, unless prescribed by a specialist. When you make a claim, we will deduct a pharmacy co-payment and pay the remaining balance up to the set amount under your chosen level of cover. 24. Travel and accommodation If you re travelling for essential medical or hospital treatment because treatment you need cannot be provided by your own doctor, we will help cover the cost when the total return distance is 300 kilometres or more. We also give a benefit towards your overnight accommodation outside of hospital for you and a caregiver. Check your extras cover to determine if you are covered for this benefit. 25. Changing from another Australian health insurer If you re changing from another Australian health fund or general insurer to Bupa Australia, you ll continue to be covered for all benefit entitlements that you had on your old cover, as long as these services are offered on your new cover with us. This is referred to as continuity of cover. To receive continuity of cover, you ll need to transfer to us within 60 days of leaving your old fund. When changing health funds, extras benefits paid by your old fund will be counted towards yearly maximums in your first year of membership with us. 47

50 It s important to note that when you change to Bupa Australia from another fund you may need to wait before you can receive your new benefits. In this situation, your benefit entitlements are based on our nearest equivalent cover to what you previously held. Where your new cover is higher than what you had with your old fund, the lower benefit (including different excess levels) will apply as follows: For extras cover: When changing to a higher level of extras cover, a lower level of benefit applies for: the initial two-month waiting period; six months for Living Well Program benefits; and hire, repair and maintenance of health aids and appliances; and 12 months on pre-existing ailments, illnesses or conditions; major dental, orthodontics; health aids and appliances. For visitors cover: When changing to a higher level of visitors cover, a lower level of benefit applies for: two-months for palliative care, psychiatric and rehabilitation services; and 12 months on pre-existing ailments, illnesses or conditions and pregnancy related services (including childbirth). If you choose a lower level of cover than you held previously, then the lower benefits on your new cover will apply immediately. This may include a different excess level. You may also need to serve waiting periods for services or treatments that weren t covered on your previous cover. In this case you won t be covered during the waiting period. 26. Changing from an overseas Bupa health fund If you transfer to us from an overseas Bupa health fund you will be required to cancel the policy yourself, however all you have to do is provide us with your overseas Bupa membership details and we can ensure continuity of your cover on an equivalent level of cover. 27. Changing from a recognised overseas Health Insurer or General Insurer If you had previous cover with an overseas Health Insurer recognised under the International Federation of Health Funds or General Insurer recognised by our fund, you will be required to cancel the policy yourself and provide us with a Certificate of Currency. We will also provide continuity of cover on an equivalent product. 28. Becoming a permanent resident If you become a permanent Australian resident, you can change to one of our nonoverseas visitor policies. You will continue to be covered for all benefit entitlements on your old cover, as long as you change over within 60 days of ceasing your visitors cover. Don t forget that you will need to transfer to a non-overseas visitor policy within 12 months of becoming a permanent resident otherwise you may be required to pay the Lifetime Health Cover (LHC) Loading. Ask us for more details. 29. Changing your cover with us If you change your health cover, you may need to wait before you can receive your new benefits. Where your new level of cover is higher than what you previously held, the lower level of benefit applies as follows: For extras cover: When changing to a higher level of extras cover, a lower level of benefit applies for: the initial two-month waiting period six months for Living Well Program benefits and hire, repair and maintenance of health aids and appliances; and 12 months on pre-existing ailments, illnesses or conditions; major dental; orthodontics; health aids and appliances. For visitors cover: When changing to a higher level of visitors cover, a lower level of benefit applies for: two months for palliative care, psychiatric and rehabilitation services; and 12 months on pre-existing ailments, illnesses or conditions and pregnancy related services (including childbirth). 48

51 During this time you will be covered, however you will receive the lower benefits of the two covers (this includes any applicable excess). If you choose a lower level of cover than you previously held, then the lower benefits on your new cover will apply immediately and may include different excess levels. You may also need to serve waiting periods for services or treatments that weren t covered on your previous cover. In this case you won t be covered during the waiting period. If you have any questions about transfers or waiting periods, just contact us. 30. Proof of identity and/or age Bupa Australia may require you to provide proof of identity and/or age when joining, changing your level of cover or in relation to any other transaction with us. Proof of arrival such as an airline boarding pass may be required before you can make a claim subject to waiting periods. 31. Privacy and your personal information Your privacy and maintaining the confidentiality of your personal information is important to Bupa Australia Pty Ltd ( we, us, our ). This statement provides a summary of how we handle your personal and health information. For further information about how we handle your personal information, you should refer to our Information Handling Policy, available on our website or by calling us. We will only collect personal information (including health information) about you and those people insured under your policy to provide, manage and administer our products and services to you and to operate an efficient and sustainable business. We are required to collect and maintain certain information about you and those on your policy to comply with the Private Health Insurance Act 2007 (Cth) and related legislation. We may also collect personal and health information about you from health service providers for the purposes of administering or verifying any claim. We may disclose your personal information to our related entities and bodies corporate, or to third parties such as healthcare providers, government and regulatory bodies, other private health insurers and any persons or entities engaged by us or acting on our behalf. If you are the policy holder, you re responsible for ensuring that each person on your policy is aware that we collect, use and disclose their personal information as set out here and in our Information Handling Policy. Each person on a policy aged 17 or over may complete a Keeping it confidential form to specify who should receive information about their health claims. You are entitled to reasonable access to your personal information. We reserve the right to charge a reasonable fee for collating such information. If you or any other person on your membership do not consent to the way we handle personal information, or do not provide us with the information we require, we may be unable to provide you with our products and services. We may use your personal (including health) information to offer you health management programs and services. When you take out cover with us, you consent to us using your personal information to contact you (by phone, , SMS or post) about products and services that may be of interest to you. If you do not wish to receive this information, you may opt out by contacting us. 32. Direct Debit Service Agreement If you ve chosen to pay your premiums by direct debit then you ve accepted the terms of our Direct Debit Service Agreement. This agreement outlines the responsibilities of Bupa Australia Pty Ltd ( we, us, our ) and you. We will confirm the direct debit arrangements prior to the first drawing (including the premium amount and frequency) and debit your nominated account. Deductions will occur on the nominated day, except for deductions nominated for the 28th, 29th, 30th or 31st, which will occur on the first day of the following month. If the nominated day falls on a weekend or public holiday, deductions will be made on the closest business day. We will debit all payments in advance and will automatically vary the deduction amount if your premiums or level of cover change. If we vary the deduction amount, we will give you at least 14 days written notice, except when the previous deduction is dishonoured, when we will deduct the previous period s payment together with the current amount due. If you pay premiums at three, six, and twelve month intervals, then should your financial institution dishonour a drawing, we will draw the payment on the nominated day of the following month. If two or more drawings are returned unpaid 49

52 by your financial institution, we will also stop deducting your premiums from your nominated account and will start sending you renewal notices, pending further instructions from you. We will maintain the privacy and confidentiality of your billing information (unless you have requested or consented that we can disclose it to a third party or the law requires or allows us to do so). We may provide information to our or your financial institution to resolve a dispute on your behalf. You must ensure your nominated account permits direct debiting and that sufficient cleared funds are available in that account on the due date to cover the premiums due. Your financial institution may charge a fee if the payment cannot be met. You must ensure the authorisation given to draw on the nominated account is identical to the account signing instruction held by the financial institution where the account is based. You must notify us if the nominated account is transferred or closed. You must pay your premium by an alternative method if either you or we cancel the direct debit arrangements. You must ensure your payments are up-to-date, whether a notice is received from us or not. If paying by credit card, you need to advise us of your new expiry date prior to expiry. You may request that we cancel or alter the debit drawing arrangements by contacting us and providing at least five working days notice of any requested changes. These changes may include deferring the debit, altering the debit dates, stopping an individual debit, suspending the direct debit arrangement or cancelling the direct debit completely. You can dispute any debit drawing or terminate the deductions at any time by notifying us in writing not less than seven days before the next scheduled debit drawing. If you have any queries about your direct debit agreement, please contact us. We undertake to respond to queries concerning disputed transactions within five working days of notification. 33. Ending your membership You can contact us to cancel your health cover at any time and you ll receive a refund of any premiums paid in advance from the date you ve contacted us to cancel. We have the right to end a person s membership as set out in our verseas Visitors Rules, including where contributions have not been paid or on notice at the reasonable discretion of Bupa Australia. 34. Can we help? If you have any questions we re always happy to help. Simply refer to the back cover for our contact details and call us, visit our website or pop by your local centre. If you would like more information about our verseas Visitors Rules or the Federal Government s Private Health Insurance Industry Code of Conduct, you can find this information on our website. The Federal Government s Private Patient s Hospital Charter is available at privatehealth.gov.au 35. Resolution of problems If you have any concerns or you don t understand a decision we have made, we d like to hear from you. You can contact us by: Telephone: Fax: [email protected] Mail: Customer Relations Manager P Box Melbourne VIC 8001 If you re still not satisfied with your outcomes from Bupa Australia you may contact the Private Health Insurance mbudsman on

53 YUR VERSEAS VISITRS CVER APPLICATIN 1 Please complete this form USING BLACK INK and write within the boxes in CAPITAL LETTERS. Mark appropriate answer boxes with a CRSS. Start at the left of each answer space and leave a gap between words. PLEASE D NT STAPLE. 2 Please complete all details that are relevant to you on both sides of this form. 3 Read the declaration and sign all the relevant signature panels. SECTIN A: I M APPLYING T X X Join as a new applicant. Transfer from another health fund or insurer. You ll also need to fill in the clearance certificate request see Section G: Transferring from another Australian health fund? X X X Transfer from Bupa overseas. see Section H: Transferring from Bupa overseas? Add someone to my membership. You, as the Policyholder, will need to fill in this form to add someone to your membership. Change my level of cover or other membership details. SECTIN B: YUR DETAILS Membership number (if relevant) Surname First name Note: The person named opposite is the Policyholder and has legal responsibility for the membership and for ensuring that premiums are kept up-to-date. nly the Policyholder is authorised to operate the membership and collect benefits on behalf of another insured person, unless they nominate an authorised person (see Section D). All correspondence will be directed to the Policyholder. Which state will you be living in? X NSW/ACT X NT X QLD X SA X TAS X VIC X WA Title Initial Date of birth D D / M M / Y Y Sex (M/F) What is the purpose of your visit? (If for work purposes please include the name of your company) Visa type and sub-class SECTIN C: CNTACT DETAILS Your home address in Australia (if known) Unit number Street number If you are applying from outside of Australia, what is your home country address? Unit number Street number Street name Street name Suburb Suburb Postcode Postcode Australian postal address (if different from home address) Unit number Street number P Box number Country Home phone number (including area code) Street name Mobile phone number Suburb Fax number Postcode address (Mandatory for sending your visa info) X From time to time, we may contact you (by phone, post, sms or ) to notify you about products, services, member updates and special offers that may be of interest to you. If you do not wish to receive this information please cross this box. SECTIN D: YUR PARTNER S DETAILS Existing membership number (if relevant) X If you would like to receive your bills (if applicable), payment reminders, tax statements, standard information statements or benefit statements (when available) via , and be kept up-to-date with news, services and other member updates (as applicable) via please cross this box. Visa type and sub-class Surname First name Title Initial Date of birth Sex (M/F) D D / M M / Y Y Partner Authority SECTIN E: YUR ADDITINAL FAMILY MEMBER DETAILS If you need to add more than three children, please enclose a separate page with their details. By providing the details of your additional family members, you acknowledge that you have the consent of each person aged 17 or over to provide this information to us. All children will be covered under this membership until the age of 21. X If you wish to give your partner (as listed on this form) authority to operate this membership please cross this box. By authorising your partner you acknowledge that they will have the same rights and obligations as you, including access to health information, however they will not be able to cancel the policy or remove you from the policy. You also acknowledge that you remain responsible for your membership and for the actions of the authorised person, that authorisation is given at your own risk and that you will have no recourse against Bupa for any acts or omissions by the authorised person. This authority will remain in place until you contact us to revoke it. If you would like to authorise someone other than your partner, please contact us. Surname First name Date of birth Gender (M/F) Relationship Child 1 / / Child 2 / / Child 3 / / Any full-time students can continue to be covered under this membership until age 25. Note: If you have any non full-time students(aged between inclusive) they will be required to purchase their own single health insurance cover. Name of tertiary institution Child 1 Child 2 Child 3 Expected date of completion / / / / / / SECTIN F: YUR CVER REQUIREMENTS Which kind of cover would you like? X Single X Couple/Family Package X Platinum Visitors Cover X Platinum Visitors Cover with Excess Hospital X Gold Visitors Cover X Gold Visitors Cover with Excess X Classic Visitors Cover X Extras Reciprocal Health Cover# (MLS Cover) X Platinum Extras X Gold Extras X Silver Extras X Your Choice Extras* X Bronze Extras *If you choose Your Choice Extras, please indicate your four services below: Add-on X I would like my membership to commence (please choose one option) as soon as my application has been accepted (an initial payment is X required upon application and/or an adjusting payment may be required at a later date) X Pharmacy Saver This product is not available in conjunction with hospital-only cover. from the date covered by the first direct debit deduction I ve indicated overleaf in Section I: Paying your premium X from this date in the future D D / M M / Y Y # This cover is to avoid the Medicare Levy Surcharge only and must be taken in conjunction with another hospital product. 4. SECTIN G: TRANSFERRING FRM ANTHER AUSTRALIAN HEALTH FUND? Name of existing health fund Existing health fund cover/membership number Please cross the appropriate box (if applicable): I am/we are currently eligible for the following Federal Government Rebate on private health insurance: X 30% X 35% X 40% PLEASE D NT DETACH Your health cover details with existing health fund Surname First name Date of birth D D / M M / Y Y Level of cover Title If you or anyone on your membership are under 65 years of age and believe the higher rebate applies to you then it is essential that we receive a Savings Provision Clearance Certificate from your previous health fund. I authorise Bupa Australia Pty Ltd to terminate my health cover with your organisation (if still current) from the following date and obtain details about my health cover. Please issue a clearance certificate to Bupa Australia Pty Ltd. Please urgently refund any excess premiums owing to the undersigned. Please do not contact me further about this request. Cancellation date D D / M M / Y Y Signature of Policyholder D D / M M / Y Y The other health fund cover relates to: X myself X my partner X my children X my parents I confirm that I/we have held this cover for a minimum of 12 months from the date I/we request to join Bupa Australia Pty Ltd. If not, date joined: Date to which health cover is paid: D D / M M / Y Y D D / M M / Y Y If you are transferring from a recognised verseas Health Insurer or General Insurer you will need to supply us with either; an International Clearance/Member Certificate or a Certificate of Currency. We will need to see: your previous level of cover, what you were covered for, your join date, the date you were paid to and the details of all persons covered. This will allow us to determine if we can offer you continuity of cover from your previous insurer. Note: The signatory above must have legal responsibility for the health cover at the existing fund. Signature of partner D D / M M / Y Y Note: This signature is required if your partner is covered on the health cover at the existing fund. FFICE USE NLY Join date D D / M M / Y Y Member number: PLEASE TURN VER Bupa Australia Pty Ltd ABN , providing health cover through our trusted and respected brands HBA, MBF and Mutual Community.

54 SECTIN H: TRANSFERRING FRM BUPA VERSEAS? Your overseas Bupa membership number Date of birth D D / M M / Y Y Level of cover Your Partner s overseas Bupa membership number (if relevant) Surname First name Title The overseas Bupa cover relates to: X myself X my partner X my children X my parents I confirm that I/we have held this cover for a minimum of 12 months from the date I/we request to join Bupa Australia Pty Ltd. If not, date joined: Date to which health cover is paid: D D / M M / Y Y D D / M M / Y Y SECTIN I: PAYING YUR PREMIUM Membership number (if relevant) X ption A: my bank, building society or credit union account (Australian statement accounts only), or X ption B: my credit card account I d like to pay my premiums automatically by a recurring direct debit from: Please choose only one of these options, and fill in your frequency preference and account details below. Please allow up to 14 days for processing. Please note that we require at least five working days to cancel or amend a direct debit payment. Note: If you don t select any of the ongoing payment methods (listed here) you will receive renewal notices in the mail as your premium becomes due. I d like my premiums to be deducted every: X fortnight on this day (Mon Fri) X month X quarter X 6 months X year I would like the first debit to occur on or after: D D / M M / Y Y If the payment date is a weekend or a public holiday, we will debit your account on the next business day. I understand Bupa Australia Pty Ltd may deduct a payment after receiving this form that will cover me until my nominated start date for direct debit. ption A bank / building society / credit union (Australian statement accounts only) Name of financial institution Name(s) of account holder(s) ption B credit card I authorise Bupa Australia Pty Ltd to charge my: X Visa X MasterCard Credit card number Cardholder s name (as shown on card) BSB number Bank account number - I/We request and give authority to Bupa Australia Pty Ltd to arrange funds to be direct debited from my/our account in accordance with the terms described in the Bupa Australia Pty Ltd direct debit service agreement. Account holder s signature Expiry date D D / M M / Y Y Cardholder s signature Note: if joint account, all signatures required. D D / M M / Y Y D D / M M / Y Y Joint account holder s signature D D / M M / Y Y SECTIN J: APPLICATIN T RECEIVE THE FEDERAL GVERNMENT REBATE AS A REDUCED PREMIUM If you are from a country with a Reciprocal Health Care Agreement with Australia, you may be eligible to receive the Federal Government Rebate on private health insurance. The rebate is available on Extras Cover and Reciprocal Health Cover. Please complete this section to receive the Federal Government Rebate on private health insurance as a reduced premium. If you do not complete this section, full premiums apply. 1. Are all the people on your membership eligible for a current Medicare card? X Yes. Please complete the remainder of this section. X No. You cannot apply for the rebate until you obtain a card from Medicare. 2. Are you covered by this membership? X X Yes. No. Employers and trustees of organisations cannot claim the Federal Government Rebate on memberships on behalf of employees. APPLICANT, PLEASE READ THEN SIGN THIS DECLARATIN Privacy Statement Your privacy and maintaining the confidentiality of your personal information is important to Bupa Australia Pty Ltd ( we, us, our ). This statement provides a summary of how we handle your personal and health information. For further information about how we handle your personal information, you should refer to our Information Handling Policy, available on our website or by calling us. We will only collect personal information (including health information) about you and those people insured under your policy to provide, manage and administer our products and services to you and to operate an efficient and sustainable business. We are required to collect and maintain certain information about you and those on your policy to comply with the Private Health Insurance Act 2007 (Cth) and related legislation. We may also collect personal and health information about you from health service providers for the purposes of administering or verifying any claim. We may disclose your personal information to our related entities and bodies corporate, or to third parties such as healthcare providers, government and regulatory bodies, other private health insurers and any persons or entities engaged by us or acting or our behalf. If you are the policy holder, you re responsible for ensuring that each person on your policy is aware that we collect, use and disclose their personal information as set out here and in our Information Handling Policy. Each person on a policy aged 17 or over may complete a Keeping it confidential form to specify who should receive information about their health claims. You re entitled to reasonable access to your personal information. We reserve the right to charge a reasonable fee for collating such information. If you or any other person on your membership do not consent to the way we handle personal information, or do not provide us with the information we require, we may be unable to provide you with our products and services. We may use your personal (including health) information to offer you health management programs and services. When you take out cover with us, you consent to us using your personal information to contacting you (by phone, , SMS or post) about products and services that may be of interest to you. If you do not wish to receive this information, you may opt out by contacting us. Direct Debit Service Agreement This agreement outlines the responsibilities of Bupa Australia Pty Ltd ( we, us, our ) and you. We will confirm the direct debit arrangements prior to the first drawing (including the premium amount and frequency) and debit your nominated account. Deductions will occur on the nominated day, except for deductions nominated for the 28th, 29th, 30th or 31st, which will occur on the first day of the following month. If the nominated day falls on a weekend or public holiday, deductions will be made on the closest business day. We will debit all payments in advance and will automatically vary the deduction amount if your premiums or level of cover change. If we vary the deduction amount, we will give you at least 14 days written notice, except when the previous deduction is dishonoured, when we will deduct the previous period s payment together with the current amount due. If you pay premiums at three, six, and twelve month intervals, then should your financial institution dishonour a drawing, we will draw the payment on the nominated day of the following month. If two or more drawings are returned unpaid by your financial institution, we will also stop deducting your premiums from your nominated account and will start sending you renewal notices, pending further instructions from you. We will maintain the privacy and confidentiality of your billing information (unless you have requested or consented that we can disclose it to a third party or the law requires or allows us to do so). We may provide information to our or your financial institution to resolve a dispute on your behalf. You must ensure your nominated account permits direct debiting and that sufficient cleared funds are available in that account on the due date to cover the premiums due. Your financial institution may charge a fee if the payment cannot be met. You must ensure the authorisation given to draw on the nominated account is identical to the account signing instruction held by the financial institution where the account is based. You must notify us if the nominated account is transferred or closed. You must pay your premium by an alternative method if either you or we cancel the direct debit arrangements. You must ensure your payments are up-todate, whether a notice is received from us or not. If paying by credit card, you need to advise us of your new expiry date prior to expiry. You may request that we cancel or alter the debit drawing arrangements by contacting us and providing at least five working days notice of any requested changes. These changes may include deferring the debit, altering the debit dates, stopping an individual debit, suspending the direct debit arrangement or cancelling the direct debit completely. You can dispute any debit drawing or terminate the deductions at any time by notifying us in writing not less than seven days before the next scheduled debit drawing. If you have any queries about your direct debit agreement, please contact us. We undertake to respond to queries concerning disputed transactions within five working days of notification. Transferring from another fund I am transferring from another private health insurer and hereby authorise Bupa Australia Pty Ltd to cancel my previous membership with that other insurer and obtain information about my previous policy on my behalf from other private health insurers as applicable. Terms and Conditions I accept to be bound by the verseas Visitors Rules of Bupa Australia Pty Ltd (available on our website, or by calling us), as amended from time to time. I acknowledge that I have read the brochure in full and understand the terms and conditions Signature of Policyholder of my cover, including those relating to pre-existing conditions, waiting periods, restricted benefit periods or any exclusions that apply to my cover. I declare that the information I have provided is true and correct. I have read and consent to the collection, use and disclosure of my personal information as set out in this Privacy Statement and in the Information Handling D D / M M / Y Y Policy (available on our website, or by contacting us). I acknowledge that, where practicable, information is provided with the consent of the individual to whom it relates. JUST BEFRE YU SEND Your Medicare card number Your name exactly as it appears on your Medicare card Valid to M M / Y Y Y Y Some of the information provided on this form will be used for the purpose of registering you for the Federal Government Rebate on private health insurance. Its collection is authorised by law, and information collected will be disclosed to the Department of Health and Ageing, Medicare and the Australian Taxation ffice. X Check that you have signed all the signature boxes relevant to your application, including the declaration above. Please mail your application to us by placing it in an envelope (no postage stamp required) addressed to: Reply paid, Bupa Australia, GP Box 9809 BRISBANE QLD 4001 Alternatively, you can pop by our retail centres or fax to If you would like any assistance, please call us on for HBA and Mutual Community or for MBF. Bupa Australia Pty Ltd ABN Trading as HBA, MBF and Mutual Community S FFICE USE NLY Document name Consultant Retail centre no. Brand joining X HBA X MBF X Mutual Community Bupa Australia Pty Ltd ABN , providing health cover through our trusted and respected brands HBA, MBF and Mutual Community.

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56 For more information Call HBA and Mutual Community enquiries MBF enquiries Visit hba.com.au mbf.com.au mutualcommunity.com.au Pop by your local centre Mail to GP Box 9809 BRISBANE QLD 4001 Bupa Australia Pty Ltd ABN Trading as HBA, MBF and Mutual Community S