Silver Plus Prime $750 Excess

Hospital: what is covered

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 - Silver Plus
• Hospital - Private or public hospital
• Excess - Capped per person and per policy per year. $750 per admission. $750 per person a year. $1,500 per policy a year.
• Co-payments - None.
• Known gap - Yes, with the fund's doctors
• Age-based discount - Offered for 18 to 29 year olds
• Accident cover - No
• Travel and accommodation benefits - Yes

Waiting periods

• Most treatments - 2 months
• Existing conditions - 12 months
• Rehabilitation, psychiatric and palliative care - 2 months

As filed by the insurer: Hospital and Extras for people who no longer need cover for Pregnancy and birth or Assisted reproductive services. For more details on the product contact Bupa.

For accommodation we pay up to $50 per night to a limit of $150 per person per trip. Benefits are payable per return trip. Eligibility criteria apply. Contact Bupa for more information.

Extras: what you get back

Not covered: Braces, Audiology, Antenatal and postnatal, Eye therapy (orthoptics), Speech therapy, Vaccinations.

* Home nursing covers selected services. Dietary covers consultations only. Step down benefits apply after first 10 total services across Chiropractic and Osteopathy. 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. 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.

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. Mental health includes Psychology, Digital Mental Health, Social Work (psychological therapies), and Counselling (including Indigenous Counselling). Sub-limits apply for Digital Mental Health. Blood glucose monitors, hearing aids, and other health aids, are payable under the Health Appliances category up to $800 per year. Sub-limits and restrictions apply.

Enjoy a Top-up Bonus of $50-$100 every year to help pay out-of-pocket extras expenses payable on your cover.

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 Queensland

Bupa has agreements with 108 private hospitals here, as filed with the Ombudsman.

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 J21D/WJKI20, filed by Bupa HI Pty Ltd, issued 13 July 2026.