We're here to help you get the most out of your hospital cover.
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How to make a hospital claim online
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Want to know where to find your limits?
Save time by getting all the information you need to check your coverage for a hospital stay. We’ll help you get financially ready by knowing what to ask your specialist or treating doctor before your admission.
Questions for your specialist
Here are some questions that you should ask your specialist or treating doctor, so you know what to expect with any potential out-of-pocket costs.
- What are the Medicare Benefits Schedule (MBS) item numbers you’ll be using?
- Can you provide a written estimate of any costs and out-of-pocket costs (also known as Informed Financial Consent)?
- Will you participate in the Bupa Medical Gap Scheme?
- Do you know if other treating doctors (i.e. anaesthetist, assistant surgeon) will also participate in the Bupa Medical Gap Scheme?
- Which hospital will I be treated in? How long is the estimated stay?
- Will there be additional costs for radiology, pathology, or prostheses?
For more information, read our Five tips to reduce your out-of-pocket costs.
Before you contact us
So that we can personalise our conversation, it's best to have the following information from your specialist or treating doctor before you chat with us:
Date (or estimated date) for when are you’ll be admitted into hospital expand_more expand_less
We'll use the date to check you’ve served any waiting periods. We'll also check if you need to pay an excess or co-payment.
Medicare Benefits Schedule (MBS) item number(s) expand_more expand_less
We use the MBS item numbers to check that the procedure is included in your policy, so that you can be covered as a private patient.
The MBS fee is an amount set by the Federal Government for each medical service covered by Medicare. The fees charged by a specialist, surgeon, anaesthetist, or another specialist for any treatment given when you’re in hospital could be equal to, or more than the MBS fee. It’s best to talk to your doctor or specialist to understand if you might have any out-of-pocket costs for these item numbers, or ask them if they participate in the Bupa Medical Gap Scheme.
Which hospital you are (or might be) going to expand_more expand_less
We can check if the hospital is one of our Members First or Network hospitals. If you're not sure which hospital you're going to, get help to find the right hospital or find out more about our hospital agreements.
Your doctor's/specialist's details expand_more expand_less
We can check if they've participated in the Bupa Medical Gap Scheme before. This could mean no or reduced out-of-pocket costs for your doctor's/specialist's fees. It's important to note that each doctor involved in your treatment could choose to use the Bupa Medical Gap Scheme or not.
When you contact us
When you know more about your admission, contact us and we'll confirm:
- if you're covered for the procedure.
- if you need to pay an excess or co-payment.
- if you've served all your waiting periods.
- if the hospital is part of our network, and what that means for you.
- other questions to ask your treating doctor.
- How to claim after your procedure.
There can be a lot of new information when going to hospital. Find it all in our simple guide that's ready when you are.
file_download Going to Hospital Guide
(PDF, 3MB)
Quick answers to common questions
What is Informed Financial Consent? expand_more expand_less
Informed Financial Consent is written confirmation from your doctor or hospital about how much your treatment will cost, including any extra money you may have to pay out of your own pocket, commonly known as a "gap" payment.
You're entitled to ask your doctor and hospital for Informed Financial Consent before you receive any treatment.
This is different to a clinical consent form. The clinical consent form (for your consent to the procedure itself) comes with the hospital's Admission Information pack. In your hospital's Admission Information pack, you’ll have to fill out the clinical consent form. It'll mean you've been given accurate information that you clearly understand and that you agree to the procedure itself.
