OSHC covers you for your hospital treatment and medical expenses, if you’re admitted to any hospital within our network of Members First or Participating hospitals, or public hospitals in Australia. You’re covered for:
Service
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Details
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| Out-of-hospital medical services (outpatient services) Includes doctor’s fees, pathology services and x-rays |
Bupa Australia pays 100% of the Medicare Benefit Schedule (MBS) fee where those services are provided in accordance with the MBS schedule |
| Emergency Ambulance transportation |
100% of the charge of transport by or under arrangement with an approved ambulance service when medically necessary for admission to hospital for emergency treatment. It does not cover general ambulance, including transport between hospitals
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| Public Hospital |
Bupa Australia fully covers shared ward hospital accommodation, same day services, accident and emergency and outpatient medical and post-operative services. You’ll be required to pay the difference (if any) between the OSHC benefit and the actual fee charged for medical services |
| Participating Private hospitals including licensed day hospital facilities |
If you choose to be treated in a participating private hospital, you’ll be fully covered for hospital accommodation and theatre fees. If medical services are provided through Bupa Australia’s Ezyclaim system there will be no or a known gap to for medical services, otherwise you’ll be required to pay the difference (if any) between the OSHC benefit and the actual fee charged for medical services. You’ll also be covered for any prescribed medicines or ancillary services covered by the hospital agreement with Bupa Australia that relate to your hospital admission. |
| Members First hospitals |
Certainty of a single room or money back
To receive a single room for an overnight stay at any of our Members First hospitals, book at least 24 hours before your admission and ensure you request a single room. If there’s no single room available, you’ll receive $50 a day from the hospital for every day you’re not in one. This applies to any overnight admission - excluding nursing home type patients, emergencies or where a single room is medically inappropriate.
Click here for a list of Members First hospitals
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| Non Participating Private Hospitals |
If you choose to be treated in a non participating private hospital you'll be required to pay any difference between the OSHC benefit and the hospital charge.
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| Surgically Implanted Prosthesis |
Prostheses listed in the Department of Health and Ageing Prosthesis list and implanted as part of hospital treatment provided that the hospital treatment is included as part of the students cover are covered. If the prosthesis used is listed as a gap prostheses you’ll be required to pay any gap charged by the hospital. |
| Pharmaceutical prescription items |
You're required to pay an amount equal to the current highest government pharmaceutical scheme (PBS) fee and Bupa Australia will refund the difference between the item cost and the government PBS fee up to $50 per script item prescribed and dispensed by a Bupa Australia registered practitioner to a maximum of:
- $300 per calendar year for a single membership
- $600 per calendar year for a family membership
If there are several items listed on the same prescription, each item will count as a separate claim. Medicines provided during a hospital stay are covered as part of the in-patient costs. Medicines prescribed when the policy holder is an out-patient can be claimed up to the annual limit available for prescribed medicines. This covers most prescriptive medicines.
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What's not covered?
While your OSHC helps to pay for a wide range of services, it's important you know there are occasions when you will not be fully covered. You're not covered for:
Service
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Details
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| Pregnancy Related Services |
Pregnancy related services, including premature births, miscarriages, and terminations, are not covered if the student visa is for less than 3 months. This applies whether or not you were pregnant at the time of joining. |
| Assisted Reproductive Services |
Assisted reproductive services such as but not limited to in-vitro fertilisation (IVF) are not covered. |
| Some Prescriptions |
You’re not covered for some prescriptions such as oral contraceptives and weight loss medications and any pharmaceutical items purchased before your arrival in Australia. |
| Medical check ups relating to visa applications or employment |
The policy holder will not be covered for medical check ups relating to visa applications or employment. |
| Specified Treatments |
- Treatment during the first 12 months after your arrival in Australia for a medical condition that was in existence before you arrived, except in cases where a medical practitioner certifies and Bupa Australia agrees that you need emergency treatment or treatment for a life threatening condition in Australia. This also applies if you were an onshore applicant who previously did not hold a Student Visa
- Treatment before you arrived in Australia
- Treatment is not covered for services where compensation or damages can be claimed either in Australia or overseas (unless the services, treatment or transportation is covered by extras)
- Treatment is not covered for a student’s child who is over 18 years of age
- Treatment is not covered for services not covered under the Medicare Benefits Schedules, for example health screening services
- Treatment is not covered for secondary conditions or disabilities related to a pre-existing condition
- Treatment is not covered while travelling to or from Australia
- Treatment for elective cosmetic surgery
- Treatment given outside Australia or treatment on your way to or from Australia
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| Additional Charges |
Additional charges will be applied for single room accommodation in a public hospital |
| Gap Payment |
The gap payment is the difference between what the doctor charges and what is paid under the Medicare Benefits Schedule (MBS). You will need to pay for any difference between the MBS and the doctor's fee. |