7 questions to ask when reviewing your health cover


If the last time you assessed your health cover was five years ago, there’s a chance it may no longer suit your needs. Just as you get regular health check-ups, it also makes sense to review your policy annually to make sure you’re covered for the things you need and aren’t paying for things you don’t.

Here are our top seven questions you should ask yourself when reviewing your cover;


  1. Does my cover suit my life stage?

It seems like an obvious question, but many people may not be on a cover suitable to their life stage. Think about what extras services you regularly use now. What might you need a year from now? For example, if you’re looking to start a family, you will have to serve a 12-month waiting period before you can claim under pregnancy cover so it might be time to change hospital policies. If you’re young and healthy, you may be after an affordable policy to avoid paying the Medical Levy Surcharge if you earn over a certain amount or minimise the Lifetime Health Cover Loading if you are 31 or older.


  1. What am I covered for again?

Some people assume that they’re covered for more than they are. Avoid this situation by digging out your cover documents and checking your inclusions and waiting periods. When reviewing hospital cover, look for the terms ‘minimum benefit’ and ‘restricted service’. If you see these words, it means you’ll only be partly covered for those services if you are treated for them a private hospital and you will be likely to have out of pocket expenses.


  1. How much can I claim back on extras?

The amount you can claim per visit and in a year (or a lifetime in some cases) will differ from cover to cover. You should also check if the limits are applied per person or per family. These things can all greatly affect the value you get from your cover.

At Bupa, we think you should know what to expect before a visit. That’s why we’ve built great relationships with thousands of providers in our Members First network, which includes dentists, physios, chiros and optical providers across Australia. By visiting one of these ‘Members First’ providers and depending on your level of cover, you can get between 60% and 100% when you make a claim (up to your yearly limits)#.


  1. Am I covered for a private room in hospital?

If privacy in hospital is important to you, make sure a private room is included in your cover. Some hospital policies only cover the full cost of a shared room, not a single room.

At our Members First hospitals you’ll receive a private room when you book and request one for an overnight stay, or if one is not available you’ll receive $50 back per night, from the hospital~.


  1. Could I reduce my premium without reducing my cover?

Some policies come with the option of reducing your premium via an excess or co-payment. With an excess, you’ll pay an amount upfront if you’re admitted to hospital. A co-payment is an amount you agree to pay each day towards your hospital stay. There can be advantages to doing it either way.


  1. What benefits are available for kids?

Some covers offer benefits specifically for kids, which can make a big difference to the cost of a hospital stay or a visit to the dentist or optometrist. For instance, Bupa family packages don’t include an excess if your kids are admitted to hospital. Plus for most kids’ visits to a Members First dentist, physio or optometrist, you’ll have nothing more to pay on the day (for most services; up to your yearly limits)^.


  1. What other benefits does your health cover provide?

Health cover can be a great support when you’re sick and need it most, but does your policy provide any value beyond that? Be sure to take a look at any extra support your insurer provides. Bupa members can access various support programs and discount partners. We’ve also teamed up with the 13SICK National Home Doctor Service to give our members complimentary access to their After Hours Plus membership. This means that when you need urgent medical care after-hours and book a bulk-billed home visit, should you require commonly prescribed medications, they will be provided on the spot at no cost.

If you’re thinking of changing your cover or moving to another insurer, the good news is that you may not have to re-serve waiting periods if you switch to an equivalent or lower level of cover.


Get in touch if you would like to find out more about Bupa health insurance. Don’t forget to mention your company name if you have access to a Bupa corporate health plan.

Call 134 135

Request a call back: bupa.com.au/callmeback

#For most items at our Members First extras providers covering dental, physio, chiro, podiatry consultations and selected optical. Fund and policy rules, waiting periods and yearly limits apply. Excludes orthodontics and hospital treatments. Set benefits apply at other providers.

~ Private room must be booked and requested at least 24hrs before admission. For included services on your cover. Applies to overnight admissions only. Excludes ‘nursing home type patients’, emergency care, same-day stays or where a private room is medically inappropriate.

^For most items covering dental, physio, chiro, podiatry consultations and selected optical packages. Available on our family packages, Ultimate Health Cover, Silver, Gold & Platinum Extras when taken with hospital cover on a family membership. Fund and policy rules and waiting periods apply. Child dependants only. Excludes orthodontics, orthotics and hospital treatments. Set benefits apply at other recognised providers. Fund and policy rules, yearly limits and waiting periods apply.