Welcome to Bupa

1 Welcome to BupaYour important information GuideHealth Insurance1In everything we do, our focus is to make your life longer, healthier and s why we offer a broad range of services and support to take care of your health and wellbeing. From the protection of health, travel, car, home and pet insurance to the reassurance of access to aged care and accredited healthcare providers. Plus, a range of projects, tools and programs to promote health, wellbeing and sustainability in the community. We believe that life is a giftOther Insurance We support you when you need it most, through a range of other insurances, including pet, car, travel and home and contents Insurance As one of Australia s leading health insurers, we have agreements with most private overnight and day hospitals, plus a huge Extras network so you ll know you always have lots of affordable choices.

2 Villages & Aged CareWe are one of Australia s largest residential Aged Care providers, offering a range of respite, residential and specialised dementia care. We help ensure your older family members continue to enjoy life, while having access to support when they need re also taking care of our community with projects, tools and programs to promote health, wellbeing and sustainability. We re sharing our wealth of knowledge through our online health resource Bupa Health Link, and innovative health tools like mummatters and the Stroke Foundation s enableme. We re also helping to fund breakthrough medical research that enables real health and care improvements for all Australians through our Bupa Health ServicesWhether you re after dental care, an eye or hearing check, we re all about giving you the personalised help and advice you need quickly and easily.

3 That s why we have accredited healthcare providers, who focus on preventative health, and are always there when you need them. up to date Click the links below to visit Bupa FacebookB upa Twit terBupa YouTubeEfiective 1 July 201932We get it. Health insurance can be confusing. That s why we ve designed this guide to explain how it works generally. It applies to anyone with full access to public healthcare (from Medicare). This includes Australian citizens, permanent residents and some of those in the process of applying for permanent you need more specific information , like the services you re covered for on your policy, please check your policy you d prefer to speak to us in person, call 134 135 (or +613 9487 6400 if you are overseas).

4 This guide does not replace the Bupa Fund Rules, which outline the terms and conditions of your cover and are available read this guide carefully and keep it available for membership 6 Health insurance explained 7 Private health insurance reforms 8 Switching from another insurer 9 Changing your existing Bupa cover 10 Your toolbox 11 Going to hospital 12 Hospital waiting periods 13 Costs of going to hospital 14 Deciding whether to go to hospital 24 Choosing a hospital 25 Choosing a private hospital 26 Choosing a public hospital 28 Choosing a specialist 30 Reducing your medical costs 32 Potential out of pocket costs 34 Paying your hospital expenses 36 Your Extras cover 38

5 Understanding Extras cover 39 Choosing your provider 40 Members First providers 41 Extras waiting periods 42 Claiming for Extras 42 Knowing your claim limits 44 Restrictions on making claims 45 Special types of Extras services 47 Making an Extras claim 50 Accident cover 52 Health cover and accidental injuries 52 Paying for your health cover 54 Community rating 55 Why your premium goes up every year 55 Late and overdue payments 56 Government policies and tax considerations 58 Things to note 62 Privacy and personal data 63 Health cover and overseas travel 64 Suspending your membership when you go overseas 65 Complaints and feedback 66 Effective 1 July 201954 Your membershipWhether you re new to Bupa, have switched from another insurer or want to change your cover with us, read on to find out what your next steps More control if you need to go to hospital for a non-emergency procedure.

6 You ll have more choice when it comes to your hospital, your specialist and when you d like your procedure to take place. You might also be able to request a private Reduced wait times for non-emergency hospital procedures (like having your tonsils out) at a private hospital. If you re not privately insured, you might have to choose between being on a public hospital waiting list for months (sometimes over a year)+ or paying a hefty fee to go to a private The ability to claim money back on some everyday health services that may not be covered by Medicare, such as dental and physio. Depending on your cover, you may even be able to claim money back for services like remedial massage and You could avoid or minimise the Lifetime Health Cover (LHC) loading if you re 31 or over and don t have hospital cover.

7 The LHC loading is a Government initiative designed to encourage Australians to take out hospital insurance earlier in life. If you don t have hospital cover by July 1 following your 31st birthday, but then decide to take it out later in life, you ll pay a 2% loading on top of your premium for every year delayed (up to a maximum of 70%). This extra loading remains in place for 10 years. For example, if you delayed getting hospital cover for 3 years after you turned 31, you ll pay an additional 6% on top of your premium for the next 10 years. 5. Tax time savings Depending on your income, you may have to pay an extra tax (on top of the Australian Government s Medicare Levy) if you don t have appropriate hospital cover for you and all your dependants over the whole year.

8 That s similar to the cost of some of our hospital covers. The Government will also contribute to the cost of your premium this is known as a rebate . The amount is based on your age and income and you can choose to get it as a reduced premium or offset in your tax return.*Health insurance explained+ Source: Australian Government Institute of Health and Welfare Report: Elective surgery waiting times 2017-18. * Current rebate percentages are effective for payments made from 1 April 2019 and are indexed annually. The income thresholds will remain the same from 1 July 2015 until 30 June 2021. On a family or single-parent membership, income thresholds increase by $1,500 per child after the first.

9 The family thresholds also apply to single parent families and de facto couples. For more information go to Australians, we re lucky enough to have access to a quality, public health system. But this system has its limitations. For example, it doesn t cover all treatments and services, and limits things like where and when you re treated. Private health insurance means:Efiective 1 July 201976 Here s a quick guide on the changes Age-Based DiscountIf you re aged 18-29, you are entitled to receive an Age-Based Discount on your Bupa Hospital cover. This is an optional reform that Bupa chose to adopt. The discount is calculated at 2% for each year you re aged under 30.

10 The maximum discount is 10% for 18 to 25 year you ve received your Age-Based Discount, you ll retain that discount until you turn 41, if you hold Hospital cover with us. From 41 years of the age the discount will reduce 2% each year until it reaches 0%.Gold, silver, bronze and basic tiers, and standard clinical definitionsYou may notice that from 1 July the name of your Hospital cover includes the words gold, silver, bronze, or basic. This refers to the Hospital product tier your cover falls into. There are set minimum hospital services which need to be covered within each product tier. Where an insurer has chosen to provide more than the minimum requirement, you ll see the word Plus in your addition, all health funds are required to use the same standard clinical definitions when referring to in-hospital treatments for your health cover.