Bupa
Gold Ultimate Health Cover
Bupa
How $485.99 is worked out
- Premium as filed - $640.45 a month
- Government rebate - 24.1% of the premium (never of the loading): -$154.46
- A month - $485.99
Go to insurer no commission on this policy
Hospital: what is covered
Covered (38)
- Assisted reproductive services
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Dialysis for chronic kidney failure
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Heart and vascular system
- Hernia and appendix
- Hospital psychiatric services
- Implantation of hearing devices
- Insulin pumps
- Joint reconstructions
- Joint replacements
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Pain management with device
- Palliative care
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Rehabilitation
- Skin
- Sleep studies
- Tonsils, adenoids and grommets
- Weight loss surgery
Restricted (0)
None.
Not covered (0)
None.
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Gold
- Hospital - Private or public hospital
- Excess - No excess.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Offered for 18 to 29 year olds
- Accident cover - Yes
- Travel and accommodation benefits - Yes
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Pregnancy and birth - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: You get a Gap Bonus to help pay for medical gaps when admitted to hospital. Plus, access to an advice line to help you navigate the health system. For more details on the product contact Bupa.
For accommodation we pay up to $75 per night to a limit of $300 per person per trip. Benefits are payable per return trip. Eligibility criteria apply. Contact Bupa for more information.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental * | 2 months | Check-up (item 012): $45.10; Scale and clean (item 114): $90.45; Fluoride treatment (item 121): $35.00; Tooth extraction (item 322): $132.00 | no yearly limit |
| Major dental * | 12 months | Crown (item 615): $1408.00 | $1,600 per policy a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $280.50 | $1,600 per policy a year (shared with other services) |
| Braces | 12 months | Braces, upper and lower, with a retainer (item 881): 100% back | $1,600 per policy a year, $3,200 lifetime |
| Glasses and contact lenses | 2 months | Single vision glasses: $294.55; Multifocal glasses: $416.55 | $420 per policy a year |
| Prescriptions not on the PBS * | 2 months | Prescription: $75.00 | $1,500 per policy a year |
| Physiotherapy | 2 months | First visit: $69.40; Follow-up visit: $57.75 | $1,500 per policy a year |
| Chiropractic | 2 months | First visit: $55.80; Follow-up visit: $38.50 | $1,000 per policy a year (shared with other services) |
| Podiatry | 2 months | First visit: $65.00; Follow-up visit: $45.10 | $1,000 per policy a year |
| Psychology | 2 months | First visit: $147.50; Follow-up visit: $131.00 | $1,000 per policy a year |
| Acupuncture | 2 months | First visit: $43.00; Follow-up visit: $34.00 | $1,000 per policy a year (shared with other services) |
| Remedial massage | 2 months | First visit: $62.50; Follow-up visit: $55.00 | $1,000 per policy a year (shared with other services) |
| Hearing aids * | 12 months | Hearing aid: 100% back | $850 per policy a year, 1 service every 3 years |
| Blood glucose monitors * | 12 months | Blood: 85% back | $600 per policy a year, 1 service every year |
| Antenatal and postnatal * | 2 months | First visit: $22.00; Follow-up visit: $22.00 | $500 per policy a year |
| Chinese herbal medicine | 2 months | First visit: $35.20; Follow-up visit: $26.40 | $1,000 per policy a year (shared with other services) |
| Dietitian * | 2 months | First visit: $64.00; Follow-up visit: $41.00 | $1,000 per policy a year |
| Exercise physiology | 2 months | First visit: $35.20; Follow-up visit: $26.40 | $1,000 per policy a year (shared with other services) |
| Eye therapy (orthoptics) | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $1,000 per policy a year |
| Health management programs | 6 months | Benefit: 50% back | $300 per policy a year |
| Home nursing * | 2 months | First visit: $44.00; Follow-up visit: $44.00 | $400 per policy a year |
| Occupational therapy | 2 months | First visit: $110.50; Follow-up visit: $78.00 | $1,000 per policy a year |
| Orthotics * | 12 months | Benefit: $100.00 | $1,000 per policy a year, 1 service every year |
| Osteopathy | 2 months | First visit: $69.00; Follow-up visit: $47.50 | $1,000 per policy a year (shared with other services) |
| Speech therapy | 2 months | First visit: $112.00; Follow-up visit: $74.00 | $1,000 per policy a year |
Not covered: Audiology, Vaccinations.
* Ante/Post-natal consultations and courses including lactation consultations, with a Bupa recognised provider in private practice. Home nursing covers selected services. Dietary covers consultations only. Two fully custom-made orthoses (one pair) are payable once per person per calendar year. Blood Glucose monitors are payable once per year. Hearing Aids are payable once every 3 years. Dentures payable once every 3 years. Periodic oral examination 012, Scale & Clean 114, Fluoride treatment 121 payable once every 6 months. Pharmacy benefit paid after current PBS patient contribution deducted.
Other services, as filed: Includes access to Blua Online Doctor Appointments. We pay 100% of the cost for eligible consults only, up to a yearly limit of 3 services per person. Benefits are not payable for services listed on the Medicare Benefits Schedule (MBS). 2-months waiting period, eligibility criteria, terms and conditions apply. 100% of travel expenses up to $200 per person, and $75 per night of accommodation fees up to $300 per person for essential hospital or medical treatment where the total return distance is 200km or more from home. Where applicable, benefits are paid under Hospital cover only (you cannot claim under both Hospital and Extras for the same trip). 2-months waiting period and eligibility criteria apply. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits apply for Digital Mental Health. Orthotics and other health aids are payable under the Health Appliances category up to $1000 per year. Sub-limits and restrictions apply. 100% cover for laser eye surgery by Bupa recognised providers. Excludes lens implant for eye correction and wavefront scans. A 3 year waiting period applies for new members joining this policy.
When requiring urgent hospital treatment as the result of an accident, the Accident Benefit can boost extras limits (subject to eligibility criteria).
No yearly limit on preventative dental.
Ambulance
Emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in ACT
Bupa has agreements with 14 private hospitals here, as filed with the Ombudsman.
The list
- ACT Endoscopy - Deakin (day hospital)
- Act Day Hospital - Deakin (day hospital)
- Barton Private Hospital - Barton
- Brindabella Endoscopy Centre - Garran (day hospital)
- Calvary Bruce Private Hospital - Bruce
- Calvary John James Hospital - Deakin
- Canberra Imaging Group - Deakin (day hospital)
- Canberra Microsurgery - Phillip (day hospital)
- Canberra Private Hospital - Deakin
- Canberra Surgicentre - Braddon (day hospital)
- IMH Deakin Private Hospital - Deakin
- Icon Cancer Centre Canberra - Bruce (day hospital)
- Mugga Wara Endoscopy Centre - Deakin (day hospital)
- National Capital Private Hospital - Garran
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
86.1% is the Commonwealth Ombudsman's figure for BUPA in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement J1/NAWX10, filed by Bupa HI Pty Ltd, issued 17 Sept 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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