bupa goldextras nsw act 0415

NSW/ACT

At A Glance

What's Covered?

General Dental

Major Dental

Orthodontics

Optical - Members First

Optical - Other

Physiotherapy

Chiropractic & Osteo

Ante/post natal

Natural Therapies

Pharmacy

Dietary

Psychology

Podiatry (excludes orthotics)

Speech Therapy

Eye Therapy

Occupational Therapy

Living Well

Home Nursing

Health Aids & Appliances

Travel & accommodation

No gap dental and physio for kids

Benefit Bonus

CALL US FIRST

Gold Extras 2015/4 NSW

You are covered for emergency

ambulance trips (including on-the-spot

treatment and air services) from our

recognised providers, capped at one

trip for singles and two trips for couples

or family memberships per calendar

year.

Ambulance

Our Living Well benefit helps you reach

your goals by covering some of the

costs for healthrelated programs.

These include: gym memberships,

swimming programs (child dependants

only), yoga, Pilates, nicotine

replacement therapy and weight

management programs.

Please note gym memberships, yoga,

Pilates and swimming programs require

your doctor or a Bupa recognised

provider to complete a Living Well Form

to confirm the program is medically

necessary. Visit bupa.com.au/livingwell

for details.

Living Well

Unlimited

$1100

$800

$340

$240

2 months

12 months

$500

$500

$150

$350

$1000

$500

$500

$500

6 months

$100 Travel / $150 Accom 2 months

If you're planning a treatment call us first so we can discuss your options, work out what you're covered for,

confirm your provider is registered with us, talk through any out-of-pocket costs and check that you've served

any relevant waiting periods. This can help you avoid any unnecessary out-of-pocket expenses and allow

you to make more informed choices and be confident about what to expect when using your cover.

Further information can be found in our Important Information Guide and our Fund Rules which are available

at bupa.com.au/info or by contacting us.

Call: 134 135

Visit: bupa.com.au

You'll receive the Benefit Bonus, where after your first year of membership we increase the amount you get

back each time you claim by 2% each year, up to a maximum of 10%.

If you have combined Gold Extras with a family hospital cover, well cover the cost of your kids dental and

physio up to the age of 25 if they remain on your policy, for most services when treatment is provided by a

Members First dentist or Members First physiotherapist. Excludes orthodontics and hospital treatments. Fund

and policy rules, waiting periods and yearly limits apply. Child Dependants only.

WAITING PERIOD

2 months

12 months

YEARLY LIMIT

The maximum you can claim per year per person

(unless otherwise stated)

12 months

2 months

2 months

2 months

2 months

2 months

2 months

2 months

Natural Therapies includes acupuncture, Alexander Technique, Chinese herbalism, exercise physiology, Feldenkrais, homeopathy,

iridology, massage, naturopathy and Western herbalism.

Massage includes aromatherapy, Bowen Technique, kinesiology, reflexology, shiatsu and remedial massage.

$500

$500

2 months

2 months

2 months

2 months

2 months

2 months

Additional information

With our Extras cover you can also

enjoy the advantages of our extensive

network of dental, optical,

physiotherapy and chiropractic

providers, so there are more places you

can experience great value from your

cover.

When you choose to visit a Members

First provider, in most instances you will

receive higher benefits for dental,

optical, physiotherapy and chiropractic

services ensuring you can maximise

value from your Bupa cover. On Gold

Extras you can enjoy 75% - 82.5% back

in most cases for dental, physio and

chiro.

1 April 2015

Gold Extras Members First % Level of Cover75% - 82.5% High

EXTRAS COVER

Comprehensive extras cover, providing generous benefits and high yearly limits for a wide range of services. Enjoy 75% - 82.5% back for most items at

Members First providers, selected gap free optical packages and more. Benefits listed are examples only and not a complete list.

Members First Network

$800

$600 Per Person, $1200 Per Membership

$400

$600

EXTRAS SERVICES

WE'RE HERE TO HELP

NSW/ACT

General dental

Periodic oral exam (012)

Scale & clean (114)

Fluoride application (121)

Tooth extraction (322)

Filling/tooth restoration (531)

Major Dental

Root canal (417)

Full crown (615)

Dentures complete (719)*

Orthodontics

$2,600

Optical

Frames (110)

Single vision lens (212)

Progressive lens (512)

No-gap optical packages

Kid's glasses with safety lens - any frame up to $249

Glasses with single vision lens*

Glasses with bifocal lens*

Glasses with trifocal lens*

Glasses with progressive lens*

Disposable contacts - selected 12 months' supply purchased in store

Disposable contacts - selected 12 months' supply purchased on-line

*Any frame up to $199. Conditions apply, contact us for more information.

Physiotherapy

Initial attendance

Subsequent attendance

Chiropractic / Osteopathy

Members First Initial attendance

Members First subsequent attendance

Other Initial attendance

Other subsequent attendance

Ante/post natal

Covers selected services

Psychology

Initial attendance


Dietary

Initial attendance


Call us 134 135

Visit bupa.com.au

Lifetime Limit:

0

$75.00

0$68.00

$45.00

$64.50 for the first 10 services, then $32.25




$400

$500

contact us for more details

$22.00

Benefits apply at registered providers


0

Members First Non Members First

Other optical: $240

$800

$600

Membership Limit: $1200


$51.40

Members First

$60.40

0

$500

$42.00

$35.40

$180.00

$945.00

$903.60

Non Members First

100% of cost to limit


Set benefits apply per item, please contact us with your

treatment plan for more information

$144.60

$57.90

$122.40$163.50

$88.50

$180.70

*Dentures payable once every 3 years

0

Unlimited

$1,100

$800

Limits

Members First: $340

EXTRAS COVER

$180.40

$109.15

Members First

$28.00

$54.70

$25.90

$100.00

$64.80 0

Non Members First

Gold Extras

1 April 2015

If you have any questions, our friendly team are here to help

make sure you get the most from your cover

Yearly limit per person per calendar year

Optical PartnersMembers First

Services covered & example items Members First Non Members First

Our Members First optical providers (Bupa Optical, National Pharmacies Optical, Kevin Paisley Fashion Eyewear, Prevue Eyewear, Stacey and Stacey

Optometrists and selected independent providers) and our optical partners Specsavers offer you a range of 'no gap' packages - with no out-of-pocket costs.

Any packages are subject to your yearly limits and waiting periods (contact us for more information). Refer to the list below for the no gap packages available

to you and where you can access them.


$36.75

$77.25

$187.50

$26.00

WE'RE HERE TO HELP

NSW/ACT

Podiatry (excludes orthotics)

Initial attendance


Speech therapy

Initial attendance


Eye therapy

Initial attendance


Occupational therapy

Initial attendance


Natural therapies Refer pg1 for services

Acupuncture initial attendance

Acupuncture subsequent attendance

Remedial massage initial attendance

Remedial massage standard consultation

Pharmacy

Living Well

Please refer page 1 for details

Home nursing

Covers selected services

Health Aids & Appliances

Blood glucose monitor

Asthma pump

CPAP devices

TENS machine

Blood pressure monitor

Hearing aid

Hire, repair and maintenance (6 month wait)

Travel and Accommodation

Minimum distance of 200kms travel required

Member Exclusives

Positive Health Guides Member Discount Partners

Bowel cancer screening kits Overseas Health Advice Line

Sub limit per item:

$100 sublimit

Sub limit per item:

Sub limit per item:

Sub limit per item:

Sub limit per item:

Sub limit per item:

One service up to $500 each year

One service up to $300 every 2 years


One service per family up to $150 every 3 years

One service per family up to $150 each year

Bowel cancer can generally be treated successfully if detected in its early stages. We will pay a benefit

towards selected screening kits for bowel cancer.

If the unexpected happens while youre travelling overseas, our 24-hour health advice line can provide

you with phone-based support, information and guidance. Plus, if youre planning a trip overseas, you can

get pre-departure medical information on the countries you are visiting. Just look for the number on the

back of your membership card.

If you have any questions, our friendly team are here to

make sure you get the most from your cover

Call us 134 135

Visit bupa.com.au

$1,000

0

0

Massage sub limit: $200 per person $400 per membership

0

$600

0

$500

1 April 2015

Gold Extras

$40.00

EXTRAS COVER

Services covered & example items Yearly limit per person per calendar year

$500

$500

Bupa's Positive Health Guides give you up-to-date and valuable information on how to better self manage

your chronic health condition together with your doctor or health professional. We have a range of

Positive Health Guides covering back pain, arthritis, asthma, chronic obstructive pulmonary disease,

congestive heart failure, coronary artery disease and angina, diabetes, depression and osteoporosis.


Travel: 100% of cost to yearly limit

$38.00

$32.00

$75.00

Youll enjoy savings on a range of activities, from entertainment and optical, to health and fitness. For

further information on the range of discounts available just visit bupa.com.au/memberexclusives

$27.00

Accommodation: $40/night

75% of cost up to $150.00

$32.00

$36.00

$26.00

0

$27.00

100% of cost up to $40.00 after deduction of PBS

copayment

$500

$500

0

$33.00

$28.00

$34.00

$35 per day

$150

$100

$150


75% of cost up to $150.00





$350



bupa goldextras nsw act 0415

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