Overseas Student Your Important Information Guide - Bupa
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Overseas Student Your Important Information Guide This guide is here to help you navigate our healthcare system and health cover. For further information on your overseas student health cover (OSHC) policy with us, please read your policy information. Effective 24 November 2021
Welcome to Bupa How Australia’s
healthcare system works
It’s our purpose that makes us different – helping Australia is said to have one of the best health systems in the world. However, the
our members to live longer, healthier, happier lives. system is complex and we understand that accessing healthcare can be confusing
We focus on your health, so you can get back to for new visitors. That’s why we aim to provide the best advice and support to help
your everyday life. you find what’s right for your needs, so you can be confident you are getting the
best healthcare services, when you need them.
Things to know
The Australian Government has arrangements in place to ensure Australian
Take time to read this guide to further understand
residents have access to public hospitals at minimal cost and to subsidised medical
and learn about your overseas student cover with us.
services, pharmacy and some additional services.
As a Bupa member, knowing how your cover works
will help you to get the most value from your The private sector, which includes private health insurance, provides an extensive
health insurance. range of services to complement these.
Bupa makes it possible for an overseas student to access a broad range of health
services across both the public and private sectors.
Contents What is Medicare? There are two kinds of cover:
Medicare is Australia’s universal system • Hospital cover pays benefits towards
How Australia’s healthcare system works 3 available for Australian citizens and the costs of hospital treatment as a
What to do when you feel sick 4 permanent residents and visitors from private patient.
countries that have reciprocal healthcare
Understanding your student health cover 5 agreements (subject to the terms of • General treatment (‘ancillary’
those agreements), that subsidises or ‘extras’) cover for some non-
What is covered - Hospital cover 8 medical fees and some services by medical health services not covered
dentists and allied health professionals. by Medicare – such as dental,
Ambulance cover 10
In addition, under the arrangements physiotherapy and optical services.
What is not covered 10 between the Australian and State
What are you covered
When to contact us 12 governments, when you’re treated as
for with Bupa?
a ‘public’ (free) patient, you may be
Additional benefits 13 treated by doctors in training, although We pay benefits towards hospital care
under supervision from qualified in private or public hospitals, choice of
Extras cover 14 specialists. doctor, out-of-hospital medical and allied
health professional fees, pharmacy, and a
Changing your cover 16
What is private health insurance? range of additional services.
Definitions 17 Many Australians pay extra towards the
cost of their health care and have private
This guide is in addition to our Fund Rules health insurance. This provides access
available online or by contacting us. to benefits towards treatment in private
hospitals and a range of additional dental
Visit bupa.com.au/fundrules/oshc
and allied health services, not available
through Medicare.
When you use your private health
insurance you can choose the doctor
who will be primarily responsible for your
treatment and you will be covered for
a private room if you request one and
where one is available.
2 3
Understanding your
What to do when you feel sick student health cover
What is covered? At a small number of Network Hospitals,
an additional set amount or ‘fixed fee’ may
Hospital costs
Emergency Non-Emergency With Overseas Student Health Cover
be charged by the hospital, capped at a
maximum number of days per stay. The
health issues health issues (OSHC) and Advantage Overseas Student hospital should inform you of this fee when
Health Cover, you can choose to be treated you make a booking. This fee is in addition to
as a private patient in either a private or a any excess or co-payment you may have as
Visit your local public hospital. part of your hospital cover.
Visit your local GP
hospital emergency
or medical centre What if I am treated in a When admitted to hospital, in most cases you
department
Members First or Network Hospital? will be covered for in-hospital charges when
With OSHC you are covered as a private provided as part of your inpatient hospital
patient in most hospitals that Bupa has an treatment including:
Call 000 agreement with, known as Members First and • Accommodation for overnight
Receive treatment
(triple zero) Network Hospitals, across Australia for any or same-day stays.
from your GP
for an ambulance treatment which is recognised by Medicare
and is not excluded under your cover. • Operating theatre, intensive care
and labour ward fees.
At our Members First Hospitals, you’ll receive
a private room if a private room is available. • Supplied pharmaceuticals approved for the
GP refers you to a
If a private room is not available, you’ll receive condition to be treated by the Australian
specialist or other Government’s Pharmaceutical Benefits
$50 back per night from the hospital. Please
health service Scheme (PBS) Schedule, and provided as
note that the following conditions apply:
You must book and request a private room part of your inpatient hospital treatment.
in a Members First Hospital at least 24 hours • Physiotherapy, occupational therapy,
before admission. It applies to overnight speech therapy and other allied health
admissions only. It excludes ‘nursing home services provided as part of an inpatient
Need to visit a GP or doctor? type patients’, admissions via an Emergency hospital admission.
Find a Bupa friendly doctor to help reduce or eliminate out-of-pocket expenses. Department, same day admissions or where a
Visit bupa.com.au/find-a-doctor for more details. • Surgically implanted prosthesis up to
private room is medically inappropriate
the approved benefit published on the
(e.g. medical practitioner requires the patient
Australian Government’s Prostheses List.
to an Intensive Care Unit or other particular
If you’re not sure if it’s an emergency health Do some non-residents have access ward rather than a private room). You’ll also • Private room where available where
issue, it’s better to treat it as an emergency. to Medicare? get complimentary local calls, TV usage and available and clinically appropriate.1
If you need more advice about your health Yes, the Australian Government has a daily newspaper. If you are treated in a Members First Day
issue, you could also: Reciprocal Health Care Agreements If you are treated in a Members First Day Hospital, there are no out-of-pocket expenses
• See a GP (RHCA) with a selected number of countries. Hospital, there are no out-of-pocket expenses for inpatient medical services charged by
These agreements enable residents of these for inpatient medical services charged by a surgeon, anaesthetist or other specialists
• Visit healthdirect.gov.au countries to receive Medicare benefits when when admitted to hospital for included
a surgeon, anaesthetist or other specialists
• Call the Australian Government’s health studying in Australia. when admitted to hospital for included services (not available in NT). Any co-
advice line on 1800 022 222 services. (Not available in NT). Any co- payment or excess related to your level of
The level of Medicare cover and the period
payment or excess related to your level of cover will still apply.
If it’s a mental health issue, you can also call for which you receive it varies depending on
LifeLine on 13 11 14. which country you are from. cover will still apply. We recommend you call us first before
making a booking to confirm that your
For more information and for a list of
hospital of choice gives you certainty of full
countries visit humanservices.gov.au
cover. You can find out if a hospital has an
or contact us.
agreement with us by checking our website
bupa.com.au/find-a-provider
4 1
Conditions apply. Contact us for more information. 5
What happens if I choose a private If this benefit is less than the hospital charge, Cover outside of hospital (outpatient)
hospital that Bupa doesn’t have an the hospital should let you know what out- Also known as outpatient medical services, this
agreement with? of-pocket expenses you will have to pay. is cover for any treatment you receive where
If you are admitted to a private hospital Bupa also pays benefits for prosthesis up you are not admitted into hospital in Australia
that Bupa does not have an agreement to the approved benefit in the Australian from a doctor or specialist in private practice
with, you will have restricted cover for your Government Prostheses List. The above (including diagnostic services such as radiology
hospital costs, and cover for prosthesis up applies for any treatment recognised by and pathology). We will cover you for up to
to the approved benefit in the Australian Medicare unless it is excluded or restricted 100% of the Medicare Benefits Schedule Fee
Government Prostheses List. This will apply
for any treatment recognised by Medicare,
under your level of cover. It is important to
note that in public hospitals, private rooms are
generally allocated to people who medically
(MBS Fee) for outpatient services. The MBS
Fee is the amount determined by the Australian Help reduce
your medical
unless it is excluded or restricted under your Government for a specific service for Australian
level of cover. The amount we pay will only need them. residents. If your doctor or specialist charges
partially cover the full cost and you will have more than the MBS Fee there will be a gap for
costs with the
As a private patient in a public hospital you
significant out-of-pocket expenses. will also be responsible for personal expenses you to pay.
It is important to note that you will be such as TV hire and telephone calls together To find out the Medicare Benefit Schedule
responsible for the cost of your stay and
may be charged directly for your hospital
with any fee doctor/surgeon charges above
the benefit Bupa pays and Prostheses charges
(MBS) fee visit mbsonline.gov.au
Bupa Medical
Gap Scheme
accommodation, doctor’s services (including above the approved benefit in the Australian Medicines
any diagnostic tests), surgically implanted Government Prostheses List. You can also receive benefits on selected
prosthesis (such as artificial hips) and personal Please also refer to the Inpatient and pharmacy items including discharge medication
expenses such as TV hire and telephone calls. Outpatient Medical Costs section of this guide. prescribed as an outpatient by a doctor or
Some of these hospitals bill Bupa directly for specialist. This is provided the item’s usage Bupa’s Medical Gap Scheme helps to
the limited benefits we pay. Please also refer Inpatient medical costs is approved by the Therapeutic Goods remove or reduce the costs you pay for
to the Inpatient and Outpatient Medical Costs These are the fees charged by your doctor, Administration. your treatment in hospital.
section of this guide. surgeon, anaesthetist or other specialist Where a doctor chooses to use the
See page 18 for more details.
for any treatment given to you when you scheme for your treatment, they agree
What happens if I choose to be a are admitted to a hospital as an inpatient. Repatriation benefit to only charge up to a certain fee. We’ll
private patient in a public hospital? This includes most inpatient diagnostic then pay a much higher amount than
If you are on Advantage OSHC, you will receive
Whether a public hospital will accept or tests recognised by Medicare as medically we normally would to help cover the
cover for repatriation to your country of origin
admit a patient, or whether a doctor provides necessary (e.g. pathology, radiology). extra cost. If a doctor uses the no-gap
if you become terminally ill or if you suffer
treatment at a public hospital, or performs a We cover you for 100% of the Medicare option, we cover all of the extra charges,
a substantial life altering illness/injury up to
particular procedure in a public hospital, Benefits Schedule (MBS). This is the amount so you pay nothing for that doctor’s
$100,000. Or for the return of mortal remains
is outside of Bupa’s control. determined by the Australian Government for medical fees. Otherwise, for each doctor
up to $10,000. Benefits are only payable once
As a private patient in a public hospital you a specific service for Australian residents. approved by Bupa. choosing to use the Gap Scheme, the
are entitled to choose your doctor, if they If your doctor or specialist charges more most you’ll pay is up to $500 out-of-
than the MBS Fee there will be a ‘gap’ for No Repatriation Benefit will be paid if, within
are available. However, it is important to pocket on medical costs. Each doctor
you to pay. six months prior to the date your policy
understand that you may still be subject to involved in your treatment can choose
commenced, the insured was:
public hospital waiting lists. Depending on to use the Bupa Medical Gap Scheme for
your illness or condition, this may be the same • first diagnosed as Terminally Ill; or, your admission in a Public Hospital, or a
doctor who would have been allocated to you • a reasonable person would have first become Private Hospital with which Bupa has an
by the hospital as a public patient. aware of the Terminal Illness; or, agreement.
If you are admitted as a private patient in a • suffering a substantial Life Altering For more info visit
public hospital, you will have cover for your Illness/Injury. bupa.com.au/medicalgapscheme
hospital costs, and cover for prosthesis up
to the approved benefit in the Australian Mental health benefits
Government Prostheses List. If you are on Advantage OSHC, you can access
mental health benefits including psychology
and counselling1 services without having a GP
care plan in place.
1
Receive up to $75 per consultation for psychology and up to $40 for
6 counselling, up to a maximum of $150 per person per calendar year by 7
recognised providers. Waiting periods, policy and fund rules apply.What is covered - Hospital Cover
The below is a guide on the in-hospital treatments your student cover provides.
For further information, refer to your policy information.
Student Cover
Hospital & Medical services OSHC Advantage OSHC
Rehabilitation P P
Hospital psychiatric services P P Choosing a hospital? Call us first
Palliative care P P We recommend you call us first on
Brain and nervous system P P 1800 888 942 (within Australia) or
Blood P P +613 9937 4223 (outside Australia) to
Bone marrow transfusion or transplant P P discuss your hospital options and to get
Chemotherapy, radiotherapy and immunotherapy for cancer P P the most out of your students cover.
Eye (not cataracts) P P You can also find out if a hospital has
Cataracts P P an agreement with us by visiting
Ear, nose and throat P P bupa.com.au/find-a-provider
Implantation of hearing devices P P
Tonsils, adenoids and grommets P P
Bone, joint and muscle P P
Joint reconstructions P P
Joint replacements (other than Hip and Knee) P P
Joint replacements (Hip and Knee) P P
Back, neck and spine P P
Kidney and bladder P P
Organ transplant P P
Dialysis for chronic kidney failure P P
Digestive system P P
Hernia and appendix P P
Gastrointestinal endoscopy P P
Weight loss surgery P P
Heart and vascular system P P
Lung and chest P P
Gynaecology P P
Miscarriage and termination of pregnancy P P
Pregnancy and birth P P
Assisted reproductive services O O
Male reproductive system P P
Diabetes management (excluding insulin pumps) P P
Insulin pumps P P
Pain management P P
Pain management with device P P
Breast surgery (medically necessary) P P
Plastic and reconstructive surgery (medically necessary) P P
Skin P P
Dental surgery P P
Sleep studies P P
Podiatric surgery (provided by a registered podiatric surgeon) # P P
8 #Limited hospital accommodation and approved prosthesis benefits only. 9Ambulance What is not
Cover covered
Emergency Ambulance Cover Hospital costs not covered of care associated with an early discharge Medical costs not covered
As part of your cover you receive Situations when you are likely not to be from hospital. You will not be covered for:
unlimited emergency only ambulance covered or to have large out-of-pocket • For pharmaceuticals items supplied upon • Medical services for surgical procedures
cover for emergency ambulance air and expenses include: discharge from the hospital unless covered performed by a dentist, podiatrist, or any
road transportation and on-the-spot on your OSHC or Extras cover. other practitioner or service that is not
• During a waiting period.
emergency treatment by a Recognised eligible for a rebate through Medicare.
Ambulance Provider. • When you are treated at a non-agreement • If you choose to use your own allied health
provider (e.g. chiropractors, dieticians or • Costs for medical examinations, x-rays,
hospital.
You’ll receive cover for ambulance psychologists) rather than the hospital’s inoculation or vaccinations and other
transport provided by an approved • For the fixed fee charged by a fixed practitioner for services that form part of treatments required relating to acquiring a
ambulance service where medically fee hospital or a hospital that has a fixed your inpatient hospital treatment. visa for entry into Australia or permanent
necessary for admission to hospital fee service. residency visa.
or for Emergency Treatment. You’re • Where compensation, damages or benefits
• When you have not been admitted into a may be claimed by another source
not covered for non-emergency hospital and are treated as an outpatient
Waiting periods
transportation from a hospital to your (e.g. workers compensation). A waiting period is the time when you are not
(e.g. emergency room treatment, outpatient
home, a nursing home or another antenatal consultations with an obstetrician • For any amount charged by a public or covered for a particular service. It starts on
hospital. Whether the transportation is prior to childbirth) you may not be covered. non-agreement private hospital which is not the date that you enter Australia or the date
deemed an emergency is determined by covered by us or which is above the benefit that you start your membership, whichever is
the paramedic and usually recorded on • For psychiatric and rehabilitation day that we pay. the later date.
the account. programs, at a hospital that Bupa does not
have an agreement with. • Treatment for any children on a family If you receive treatment that falls within
If you need to make a claim for membership if they are over 18 years of age. a waiting period, you will have to pay for
emergency ambulance benefits, • Hospital treatment provided by a practitioner some or all of the hospital and medical
not authorised by a hospital to provide that • Additional charges applied for private room
we will give you an Ambulance Claim charges unless the treatment is classed
treatment. accommodation in a public hospital.
Form to complete. as Emergency Treatment.
• Hospital treatment for which Medicare pays • Non-PBS, high cost drugs.
Transportation means a journey from The following waiting periods apply to
the place where immediate medical no benefit, including: medical costs in relation • For any treatments or services rendered Overseas Student Health Cover:
treatment is sought to the casualty to surgical podiatry (including the fees outside Australia. This includes:
department of a receiving hospital. charged by the podiatrist); cosmetic surgery; Hospital cover Waiting period
- Treatment arranged before you
respite care; experimental treatment and/or
arrived in Australia
Recognised Ambulance Providers any treatment/procedure not approved by Palliative care,
the Medical Services Advisory Committee - Treatment while travelling to
We will generally only pay benefits rehabilitation and hospital 2 months2
(MSAC). or from Australia
towards ambulance services when they psychiatric services
are provided by any of the following • Personal expenses such as: pay TV, - Expenses for treatment
recognised providers: non-local phone calls, newspapers, boarder outside of Australia
Pre-existing conditions,
• ACT Ambulance Service. fees, meals ordered for your visitors, - Transportation into or out of 12 months
aliments or Illnesses
hairdressing and any other personal expenses Australia in any circumstance
• Ambulance Service of NSW/PTS.
charged to you unless included in your cover. • Cosmetic surgery.
• Ambulance Victoria. Pregnancy and birth
• If you are in hospital for more than 35 days See definitions on page 17 for more 12 months
• Queensland Ambulance Service. (obstetrics)
and you have been classified as a ‘nursing information.
• South Australia Ambulance Service. home type’ patient. In this situation you may
• St John Ambulance NT. receive limited benefits and be required to No waiting period applies to a pre-existing
make a personal contribution towards the condition, ailment or illness of a psychiatric
• St John Ambulance WA.
cost of your care. nature for Advantage OSHC customers.
• Ambulance Tasmania.
• Some hospital-substitute treatment and Please refer to the Deed for Overseas Student
operative services that are a continuation Health Cover and see definitions on page 17
for more information.
2
The standard 2 months waiting period for pre-existing conditions, ailments or illnesses of a psychiatric nature is not enforced by Bupa
10 on Overseas Student Health Cover until further notice. 11When to contact us Additional benefits
If you have been a Bupa member for less Eligibility and Types of membership
than 12 months on your current OSHC, it To be eligible for OSHC, you must hold a
is important to contact us before you are student visa, be in a process of applying for
admitted to hospital and find out whether the a student visa or be on a bridging visa whilst
pre-existing condition waiting period applies applying to extend your student visa. There
to you. We need about five working days to are 3 different types of OSHC membership
review the Clinical information you submit to
us and we’ll contact you if we require more
available: 24 hour Student Bupa health and wellness
information to determine your eligibility. • Single – Cover for student only. Student is Advice Line • Find reliable health information.
defined as the primary student visa holder.
Make sure you allow for this timeframe Our 24 hour Student Advice Line • Track and manage health goals.
when you agree to a hospital admission date. • Couples – Cover for student and provides advice and assistance, in 180
their partner as listed on the student’s • Get a snapshot of your health status
If you proceed with the admission without languages, for a range of emergency
dependant visa. and explore your ‘real’ health age.
confirming benefit entitlements and we situations including:
(the health fund) subsequently determine • Family – Cover for student, their partner • Medical and accident assistance. Visit bupa.com.au/health
your condition to be pre-existing, you will and their dependent children under 18 years • Home and property inquiries.
be required to pay all hospital charges and of age if they live with the student
medical charges not covered by Medicare. in Australia. • General tax and legal enquiries.
• Personal safety, drug or
Planning for a baby Note, student’s partner and/or dependent
alcohol issues.
children as listed on the student’s dependant
If you are thinking about starting a family • Trauma counselling.
visa must be on the same membership as
we recommend that you contact us to
the student. Call 1300 884 235
check whether your current cover includes
pregnancy and birth in advance. This is myBupa
because there is a 12-month waiting period myBupa.com.au is our member
applied to pregnancy and birth conditions. self service area. It helps you easily
No waiting periods will apply to the newborn manage and understand your Health
provided they have been added to the Insurance online.
appropriate family cover within 90 days of Once you register, simply log in
their birth. using your secure log-in details to:
With offers from over 40 partners, • Access your policy documents
Bupa Plus is our way of saying thanks and tax information.
to everyone who chooses Bupa as • Submit an Extras claim and see
their health insurer. your claim history.
Visit myBupa.com.au/offers to find out • Update your personal details.
more. Terms and conditions apply. • Access exclusive health tools
and discounts.
• Put Bupa in your pocket with the
myBupa App.
12 13Extras Cover
What is covered? Members First Provider Network What is not covered?
With OSHC Extras or any Domestic Extras cover, you can claim benefits for some Bupa Members First is an extensive network Extras benefits will not be payable:
services that may not be covered by Medicare. You can claim for the services listed that of healthcare professionals including • During a waiting period.
are included on your cover, as long as benefits are not claimable from a third party. dental, physiotherapy, chiropractic and
• Where a service is not included on your
podiatry providers. OSHC Extras is available
For example, Medicare may not provide benefits for: product.
exclusively through this network with the
benefit of 100% cover on the set number • Where a third party, including Medicare,
of included services (subject to yearly visit a Australian Government body, or an
limits). This means you won’t have to pay insurance company provided a benefit
any out-of-pocket expenses when you (except for hearing aids and breast
visit a Members First Network provider for prosthesis items).
these services. OSHC Extras does not cover • For different services within the same
Dental Physiotherapy Chiropractic Occupational
examinations services therapist any services at non-Bupa Members First service type from the same provider on the
and treatment healthcare providers. same day. For example, if you went to see an
acupuncturist and then received a massage
Members First Extras - Yearly from the same provider on the same day,
What’s Covered visits you cannot claim for both services.
P Dental check up2 1 • When a provider is not recognised by us
for benefit purposes.
Physio, chiro and/or • For any treatment or service rendered
P 3
podiatry consultations outside Australia.
Speech therapy Podiatry Mental health Acupuncture1
Services or other natural Bonus Dollars - $50 for • When you have reached the limits on your
(includes psychology therapies P 1
singles, $100 for couples product including yearly, lifetime or service
and counselling)
limits for the service you are claiming.
Consultations via phone
P 2
with Bupa Dietitians3 Waiting periods
A 2 month initial waiting period An initial waiting period of 2 months applies
for Extras services applies for OSHC Extras cover. The following waiting
periods apply for Domestic Extras cover:
Eye therapy Glasses Health aids Home nursing Bonus Dollars
and contact lenses and appliances Extras cover Waiting period
We will contribute a total of $50 ($100 for
couple and family memberships), payable
All other Extras services 2 months
once per year, that can be shared across
your extras services to put towards out-of-
Hire and repair of health
pocket (extras) expenses at Members First 6 months
Extras cover allows you to claim Optical Partners aids and appliances
healthcare providers (e.g. for a filling or
benefits for extra services as long as: Optical Partners give you access to flexibility additional physio treatment).
and choice as well as discounts and offers (up Health management
• The treatment is given by a provider in a 6 months
programs
private practice who is recognised by us for to your yearly limits). You can choose where to Bupa Optical
benefit purposes. shop at over 400 locations Australia-wide and $50 voucher available at Bupa Optical stores.4
have access to offers that suit your individual Major dental 12 months
• They meet the criteria set out in our policies For a list of Bupa Optical providers near you,
optical needs. Details of these offers may change
and Overseas Student Health Cover rules and visit bupa.com.au/find-a-provider or find out
from time to time. Orthodontics 12 months
Fund Rules. more at bupaoptical.bupa.com.au
Visit bupa.com.au/opticalpartners for more.
We recommend you contact us before making Purchase of health aids
a booking to confirm how much you can claim 12 months
and appliances
and to check that your chosen provider is
recognised by us. 2
Includes exam, scale and clean, fluoride and two bitewing x-rays only.
3
Bupa Dietitian consultations are available and conducted in English
14 1
Unless part of a doctor’s consultation. only. 4Provision of email address required for voucher delivery. 15Changing your cover Definitions
Switching from another OSHC provider During this time you will be covered, however Agents Emergency Treatment
If you’re changing from another OSHC provider you will receive the lower benefits of the two A third party such as a broker or agent ‘Emergency Treatment’ is any treatment
to Bupa, you’ll continue to be covered for all covers (this includes any applicable excess). may establish and administer your policy required where a person:
benefit entitlements that you had on your old If you choose a lower level of cover than or corporate health plan. In these cases, • Is in a life threatening situation and requires
cover, as long as these services are offered on you previously held, then the lower benefits some information about you such as your urgent assessment and resuscitation.
your new cover with us, and there is no gap on your new level of cover will apply name, address and other policy information
• Has suspected acute organ or system failure.
between your previous OSHC and your Bupa immediately and may include different excess will be given and received from the agent
cover. This is referred to as ‘continuity’. levels. You may also need to serve waiting to help Bupa HI administer your policy or • Has an illness or injury where the function of
periods for services or treatments that weren’t corporate health plan. This will not include a body part or organ is acutely threatened.
When changing health funds, extras benefits
covered on your previous cover. In this case personal claims information (also see • Has a drug overdose, toxic substance
paid by your old fund will be counted
you won’t be covered during the waiting Privacy Statement on page 20). or toxin effect.
towards your yearly limits in your first year of
membership with us. Any benefits paid by your period. If you have any questions about • Has psychiatric disturbance whereby the
waiting periods, just contact us. Calendar year
old fund also count towards lifetime limits. health of the person or other people are at
A calendar year is 1 January to 31 December.
immediate risk.
Changing your visa Ending your membership
Bupa-friendly doctors • Has severe pain and the function of a body
If you change your overseas student visa to It is a condition of your student visa that you
A Bupa-friendly doctor agrees to submit part or organ is suspected to be acutely
another visa which allows you to continue your maintain a current OSHC policy while you are
your claim directly to Bupa to help reduce or threatened.
stay in Australia, you will no longer be eligible studying in Australia. Bupa will only refund any
premium paid for your OSHC policy under the eliminate your out-of-pocket expenses.1 • Has acute haemorrhaging and requires
for OSHC. You can however, change to one of
following circumstances: Visit bupa.com.au/find-a-doctor to find your urgent assessment and treatment.
our overseas visitor covers. You will continue to
be covered for all benefit entitlements on your • You decide not to come to Australia nearest Bupa Friendly Doctor. • Has a condition that requires immediate
old cover, as long as you change over within to commence your studies. admission to avoid imminent threat to their
60 days of your OSHC end date. Contact us Cosmetic Surgery life and where a transfer to another hospital
• Your student visa extension is refused by
for more details. A cosmetic treatment is one which is is impractical.
the Department of Home Affairs (DHA).
concerned with altering the appearance of
Becoming a permanent resident • You are transferring to another visa type a body part or tissue which lies within the Exclusions
If you become a permanent Australian resident, (e.g. temporary or permanent residency). bounds of normal variation. If you require treatment for a specific
you can change to one of our domestic health • You are ceasing your studies and going procedure or service that is excluded under
Examples of Cosmetic Surgery:
covers. You will continue to be covered for back home overseas early. your level of cover you will not receive any
• Rhinoplasty (nose reconstruction) without benefits towards your hospital, medical and
all benefit entitlements on your old cover, • You are transferring to another previous trauma or congenital defect. prosthesis costs and you may have significant
as long as you change over within 60 days of OSHC provider.
your OSHC end date. Don’t forget that, unless • Breast enlargement. out-of-pocket expenses.
• If your student visa is cancelled.
you transfer to a domestic health cover policy • Liposuction. If a service is not covered by Medicare there
within 12 months of becoming eligible for full You will need to provide proof of any of the will be no benefit payable from your student
Medicare benefits, you may be required to pay above circumstances along with your refund Emergency admissions
cover so you should always check with us
the Lifetime Health Cover (LHC) loading. request. For example, a copy of a letter from In an emergency, we may not have time to see if you’re covered before receiving
Ask us for more details. Department of Home Affairs explaining that to determine if you are affected by the treatment.
your student visa is cancelled, or proof of pre‑existing condition rule before your
Changing your cover with us membership with another OSHC provider. admission. Consequently, if you have been Life Altering Illness/Injury
If you change your health cover, you may a Bupa member for less than 12 months An illness/injury considered to be a serious
To cancel your OSHC membership, and obtain
need to wait before you can access your you might have to pay for some or all of medical condition leading to a reduction
a refund, simply complete a refund form and
new benefits. Where your new level of cover the hospital and medical charges if you are in life expectancy to less than 12 months,
attach any relevant supporting documents.
is higher than what you previously held, the admitted to hospital and you choose to be a requirement for ongoing care support or
lower level of benefit applies. Please refer to We are obligated to inform Department of treated as a private patient, and we later continuous inpatient hospitalisation, or any
the listed waiting periods included earlier in Home Affairs if your OSHC membership is determine that your condition was pre-existing. other deficit or health care need as assessed
this guide. cancelled and/or we refund your premium.
We tell you more about pre-existing conditions by a Medical Practitioner appointed by Bupa
on page 18. as warranting support for repatriation.
16 An out-of-pocket expense may be incurred should the Doctor charge higher than the Bupa benefit. This expense is not covered by Bupa.
1 17Medical Practitioner If you take out optional Extras cover, your Premium and benefits for OSHC reconstruct the breast back to an acceptable
extras pharmacy entitlement pays benefits on To access the benefits available on your level appearance for you, whereas changing the
A person registered or licensed as a medical
prescription items that are only non-PBS listed of cover, you need to: appearance of the breast for most other
practitioner under a law of a State or Territory.
and TGA approved and not appearing on our • Complete the application process and pay reasons would be cosmetic in nature and intent.
This does not include anyone whose registration
or licence to practise has been suspended or exclusions list. your premium in full before the start date of Other examples of ‘Reconstructive Surgery’:
cancelled following an inquiry relating to his or When you make a claim, we will deduct a PBS your level of cover. • Repairing a scar resulting from an accident
her conduct and whose registration or licence co-payment fee and pay the remaining balance • Advise us of any change of address. or previous surgery (unless it was cosmetic
has not been reinstated. up to the set amount under your OSHC or • Ensure that newborns are enrolled onto surgery).
chosen level of Extras cover. a family membership within 90 days of • Facial reconstructive surgery following severe
Mortal Remains their birth to avoid any waiting periods trauma, cancer surgery or a major congenital
The body of the deceased person for There are some items that are not covered by
for your baby. problem (from birth).
the purposes of Repatriation benefits. our OSHC or extras pharmacy benefits and
• Contact us to remove your adult children from • Repairing a body part after a trauma injury.
Does not include cremation or ashes of a these include:
your OSHC membership when they turn 18
deceased person. • Over-the-counter and non-prescription items. years of age as they no longer qualify under Surgically implanted prostheses
• Compounded items. your level of cover. You will be covered up to the approved
Out-of-pocket expenses
• Provide proof of purchase of what you have benefit set out in the Australian Government’s
You are likely to experience out-of-pocket • Weight loss medication.
spent before we can reimburse you for any Prostheses List for a listed prosthesis which is
expenses when you are not fully covered for • Body enhancing medications surgically implanted as part of your hospital
services and benefits, or when a set benefit (e.g. anabolic steroids). services received.
treatment.
applies. You should refer to what is and isn’t • Submit your claims within two years of when
covered on your OSHC and any Extras cover Pharmacy in-hospital the service was given (we don’t pay benefits The Prostheses List includes: pacemakers,
you hold to determine when an out-of-pocket When in hospital, if you are treated for any claims that are older than this). defibrillators, cardiac stents, joint replacements,
expense may occur. You should also refer to with drugs that are not approved by the intraocular lenses and other devices. If a
our Overseas Student Health Cover Rules Pharmaceutical Benefits Scheme (PBS) Private room in a public hospital hospital proposes to charge you a ‘gap’ for your
for any additional information on benefits Schedule, you may not be fully covered and the From 1 October 2017, for the purposes of a prosthesis, they need your informed financial
payable. A copy of our Overseas Student Health hospital may charge you for all or part of the private room in a public hospital, this is a room consent. Please contact us for further details.
Cover Rules can be found on our website or cost. You should be advised by the hospital of in a hospital which is purpose built and suitable
any charges before treatment. for no one other than a single admitted adult Terminally Ill
in our local Bupa Health Insurance store. It is
important to ensure when being admitted to patient; holds one single sized bed; and has a Someone with a life expectancy of less than 6
hospital that Informed Financial Consent is Pre-existing conditions dedicated ensuite. months as diagnosed by a Medical Practitioner
provided to you for a pre-booked admission A pre-existing condition is any condition, and determined by a Medical Practitioner
ailment or illness that you had signs or Proof of identity and/or age appointed by Bupa, after consideration of any
to allow you to understand any out-of-pocket
symptoms of during the six months before you Bupa may require you to provide proof of relevant clinical information.
expenses upfront. If you have received any
joined or upgraded to a higher level of cover identity, visa details and/or age when joining,
out-of-pocket expenses and require Waiting periods
with us. It is not necessary that you or your changing your level of cover or in relation to any
clarification, please contact us directly.
doctor knew what your condition was or that other transaction with us. A waiting period is the time when you are not
Pharmacy the condition had been diagnosed. covered for a particular service. It starts on the
Reconstructive Surgery date that you enter Australia or the date that
On OSHC you may receive benefits for Keep in mind that a doctor appointed by us will Surgery to restore function or typical you start your membership, whichever is the
selected prescription items prescribed as an decide whether your condition is pre-existing. appearance by reconstructing defective organs later date. If you receive a service or treatment
outpatient that are Australian Government’s That said, the appointed doctor must consider or parts. The reason for the surgery is what’s during this time, you are not eligible to receive
Pharmaceutical Benefit Scheme (PBS) Schedule your treating doctors’ opinions on the signs and important. It would usually follow a previous a benefit payment from us, regardless of when
listed or non-PBS listed and TGA approved, symptoms of your condition, although they’re medically necessary surgery, a traumatic event you submit the claim. Different waiting periods
prescribed by a doctor or a specialist and not not bound to agree with them. that caused a change in the appearance and/ apply for different services.
appearing on our exclusions list. Refer to your
or function of a part of the body or a significant
cover details for more information.
congenital problem (something you were born For more terms explained visit
with), that created problems with how your bupa.com.au/glossary
body works. For example, after a mastectomy
for breast cancer, there may be a desire to
18 19Other important information
Privacy and your personal information Complaints or feedback
Your privacy is important to Bupa. personal information as set out here and in If you have any concerns or you don’t
This statement summarises how we handle our Information Handling Policy. Each person understand a decision we have made,
your personal information. For further on a policy aged 18 or over may complete we’d like to hear from you.
information about our information handling a ‘Keeping your personal information
practices or our complaints handling confidential’ form to specify who should You can contact us by:
process, please refer to our Information receive information about their health claims. Email: customerrelations@bupa.com.au
Handling Policy, available on our website at You are entitled to reasonable access to your
Phone: 134 135
bupa.com.au or by calling us on 1800 888 942. personal information within a reasonable
When you join, you agree to the handling of timeframe. We reserve the right to charge a Fax: 1300 662 081
your personal information as set out here and fee for collating such information. Mail: Customer Relations Manager Bupa
in our Information Handling Policy. If you or any insured person does not consent GPO Box 9809
to the way we handle personal information, Brisbane QLD 4001
We will only collect personal information
or does not provide us with the information
that we require to provide, manage and
we require, we may be unable to provide If you’re still not satisfied with your
administer our products and services and to
you with our products and services. We outcomes from Bupa you may contact
operate an efficient and sustainable business.
may use your personal (including health) the Commonwealth Ombudsman on
We are required to collect certain information
information to contact you to advise you 1300 362 072 or visit them at
from you to comply with the Private Health
of health management programs, products ombudsman.gov.au
Insurance Act 2007 (Cth). We may also collect
and services. When you take out cover with
information about you from health service If your concerns aren’t resolved when you
us, you consent to us using your personal
providers for the purposes of administering or first raise them, and you’d like to discuss
information to contact you (by phone, email,
verifying any claim, and from your employer, it further, you can find our full complaints
SMS or post) about products and services
broker or agent if you are on a corporate process online for how to go about it.
that may be of interest to you. If you do not
health plan or have joined through a broker
wish to receive this information, you may opt
or agent. We may disclose your personal
out by contacting us.
information to our related entities, and to
third parties including healthcare providers,
Here to help
Australian Government and regulatory bodies,
If you have any questions we’re always happy
other private health insurers, and any persons
to help. Simply refer to the back cover for our
or entities engaged by us or acting on our
contact details and call us, visit our website
behalf. If we send your information outside of
or pop by your local Health Insurance store.
Australia, we will require that the recipient of
If you would like more information about our
the information complies with privacy laws
Overseas Student Rules or the Australian
and contractual obligations to maintain the
Government’s Private Health Insurance
security of the data. If you are on a corporate
Industry Code of Conduct, you can find this
health plan, we may disclose your information
information on our website.
to your employer to verify your eligibility to
be on that corporate plan. The policy holder The Australian Government’s Private
is responsible for ensuring that each person Patient’s Hospital Charter is available at
on their policy is aware that we handle their privatehealth.gov.au
For more student resources visit
our overseas student hub at
bupa.com.au/students
20 21Bupa health
cover made easy
Unsure of any words? Visit: bupa.com.au/glossary
This guide is in addition to our Fund Rules available online or
by contacting us.
Go to bupa.com.au/fundrules/oshc
to see our Overseas Student rules.
For more information
bupa.com.au/students
Visit a Bupa Health Insurance store Bupa HI Pty Ltd
ABN 81 000 057 590
1800 888 942 from within Australia
+61 3 9937 4223 from outside Australia Effective 24 November 2021
11542-11-21You can also read
