Bupa health insurance review: Everything you need to know

Are you looking into a few different health providers to see which one you should go with for your private health insurance? You’ve come to the right place. Here’s the rundown of what you can expect from Bupa, one of Australia's top health insurers.

With a history that spans several decades, Bupa has slowly but surely been positioning itself as one of the go-to options for Aussies seeking the best health insurance around. But are they the right company for you? Let’s explore what they can offer you, how much is actually covered, as well as how to manage your policy with Bupa over the long term.

Bupa (short for the British United Provident Association) first came into the market in 1947 and it’s since grown into a global healthcare powerhouse. In Australia today, Bupa is one of the biggest health insurers, with over 4 million members.

Bupa Australia operates as part of the international Bupa Group, which in partnership with Blue Cross Blue Shield delivers healthcare and insurance services across more than 190 countries. While Bupa is a for-profit company in Australia, it’s owned by a non-profit parent company that reinvests its earnings back into the business with the intention of improving its services and expanding its offering.

Bupa Australia is part of the larger Bupa Group, which operates worldwide. The Bupa Group itself is a non-profit entity, meaning its profits are reinvested back into the business for the benefit of its customers. Having such a structure allows Bupa to focus on long-term growth and customer satisfaction rather than short-term profits.

Despite being under the umbrella of a non-profit, Bupa manages its Australian health insurance arm on a for-profit basis, so it can be more competitive in the Aussie market while still being part of a globally recognised healthcare brand.

Like most private health insurers in the country, Bupa has a suite of health insurance products that include hospital and extras cover. These are different types of cover (as well as there being different tiers of hospital cover) designed to meet different healthcare needs. So if you’re thinking about switching private health insurance, you’ll be able to choose a policy that best suits your circumstances, whether that’s hospital-only, extras-only or a combination of both.

Hospital cover with Bupa will give you benefits for a wealth of in-hospital treatments, depending on the level of cover you choose. Here are the tiers they are separated into and some of the things they’ll include:

• Gold hospital cover: This is the most all-encompassing level, covering all clinical categories mandated by the government, including joint replacements, heart surgery, pregnancy and obstetrics, and more.
• Silver hospital cover: A mid-range option with a broad range of services covered, excluding some of the higher-cost treatments like pregnancy and cataracts.
• Bronze hospital cover: A more affordable option that covers essential treatments like heart and vascular system, appendix removal and more.
• Basic hospital cover: The entry-level option covers only the essential treatments like hospital-based psychiatric services and palliative care.

Bupa also has extras cover, which includes benefits for out-of-hospital healthcare services not covered by Medicare. Depending on your policy, extras cover might include:

• Dental services: From basic check-ups and cleanings to more complex procedures like crowns and orthodontics.
• Optical services: Includes cover for glasses, contact lenses and eye exams.
• Physiotherapy: Helps cover the costs of physical therapy for injuries, rehabilitation, chronic conditions, etc.
• Chiropractic: Coverage for spinal adjustments and other chiropractic treatments.
• Natural therapies: Your policy might include acupuncture, remedial massage and other alternative therapies under its coverage.

While Bupa does have quite extensive cover available, it all comes down to the type of policy and level of cover you choose. Here’s a quick breakdown of what Bupa generally covers:

• Hospital-related charges covered: Bupa covers an average of 90.1% of hospital-related charges, which includes fees for accommodation, surgery and other hospital services.
• Medical services with no gap: For 91.1% of medical services, Bupa members pay no gap, meaning there is no out-of-pocket expense beyond what Medicare and Bupa cover.
• Medical services with no gap or known gap payment made: Bupa covers 98.1% of medical services with either no gap or a known gap, meaning you won’t be hit with unexpected costs.
• General treatment (extras) charges covered: On average, Bupa covers 49.6% of the cost of extras services, which can include dental, optical, physiotherapy, etc

Making a claim through Bupa is pretty easy to do, with a few different methods available to you:

1. Online or in-app claims: You can submit claims directly through the Bupa website or mobile app. This is the quickest and most convenient way to claim for most extras services.
2. On-the-spot claims: Many healthcare providers now have a HICAPS system so you can claim instantly. Just swipe your Bupa membership card and have your benefit processed straight away.
3. Manual claims: If you prefer, you can fill out a physical claim form and submit it via mail or at a Bupa store. You’ll need to include the original receipts and other supporting documents for faster processing.

Cancelling private health insurance can be done at any time. With Bupa, there are just a few steps to follow to make it happen:

1. Contact Bupa: Cancel your policy by calling Bupa’s customer service line or visiting a Bupa store. They’ll be able to guide you through the cancellation process.
2. Provide written notice: In some cases, Bupa might need you to give them written notice to process the cancellation. It’s usually done via email or post.
3. Keep an eye on when your cover ends: Make sure you know when your current coverage will end so you aren’t surprised by any gaps in your health insurance.
4. Consider rejoining conditions: If you decide to rejoin Bupa in the future, be aware that waiting periods might apply, especially for pre-existing conditions.

While millions of Aussies swear by Bupa, it’s just one of many other private health insurers on the market. Take the time to review multiple policies first – then, if you feel like Bupa has all the options and benefits you want in private health insurance, you can take out a flexible policy that meets your needs.