Table of benefits
BUPA Secure Care Bupa Essential Care Bupa Diamond Care   Bupa Critical Care Bupa Complete Care Bupa Advantage Care  
Coverage in the Bupa Secure Provider Network only (except as specified under the Emergency Medical Treatment Provision) Coverage in the Bupa Secure Provider Network only (except as specified under the Emergency Medical Treatment Provision) Insureds are not required to obtain treatment from the Bupa Provider Network Coverage in the Bupa Critical Provider Network only (except as specified under the Emergency Medical Treatment Provision) Insureds are not required to obtain treatment from the Bupa Provider Network Coverage in the Bupa Advantage Provider Network only (except as specified under the Emergency Medical Treatment Provision)  
$2 million max coverage per Insured per policy year $1 million max coverage per Insured per policy year Maximum coverage per Insured per policy year ... No limit $1 million max coverage per Insured per policy year Maximum coverage per Insured per policy year ... No limit $2.5 million max coverage per Insured per policy year  
    This policy only pays benefits for the following medical conditions and treatments;

$150,000 Neurological illnesses, including cerebral vascular accidents
$150,000 cardiac surgery and angioplasty
$200,000 cancer treatment, including chemotherapy, radiotherapy and reconstructive surgery
$150,000 severe trauma (polytrauma) including rehabilitation
$100,000 chronic renal insufficiency (dialysis)
$300,000 severe burns, including reconstructive surgery
$150,000 septicemia (severe infectious disorder)
Organ transplant (per insured, per lifetime):
Heart $300,000 ... Heart / lung $300,000 ... lung $250,000 ... Pancreas $250,000 ... Pancreas / kidney $300,000 ... Kidney $200,000 ... Liver $200,000 ... Bone marrow $ 250,000		      
   

 

      
In-patient benefits (for a maximum of 240 days) In-patient benefits (for a maximum of 240 days) In-patient benefits In-patient benefits In-patient benefits In-patient benefits  
    100% Hospital services -      
100% Hospital room and board (private, semi-private) 100% Hospital room and board (semi-private) 100% in a Bupa Hospital Network... Hospital room and board (semi-private)
$2000 per day in other hospitals		 100% Hospital room and board (semi-private) ... 100% (in a Bupa Hospital Network) Hospital room and board (private, semi-private)
... $1000 per day in other hospitals		 100% Hospital room and board (semi-private)  
100% intensive care unit 100% intensive care unit 100% in a Bupa Hospital Network ... intensive care unit
$4000 per day in other hospitals		 100% intensive care unit 100% in a Bupa Hospital Network ... intensive care unit
$3000 per day in other hospitals		 100% intensive care unit  
    Guest meals $50 per day - 100% surgeon and anesthetists fees    
100% surgeon and anesthetists fees 100% surgeon and anesthetists fees 100% surgeon and anesthetists fees 100% surgeon and anesthetists fees   100% surgeon and anesthetists fees  
100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology, X rays, MRI CT/PET scan, ultrasound and endoscopies)  
100% drugs prescribed while in-patient 100% drugs prescribed while in-patient 100% drugs prescribed while in-patient 100% drugs prescribed while in-patient 100% drugs prescribed while in-patient 100% drugs prescribed while in-patient
100% cancer treatment (chemotherapy, radiotherapy) 100% cancer treatment (chemotherapy, radiotherapy) 100% cancer treatment (chemotherapy, radiotherapy) 100% cancer treatment (chemotherapy, radiotherapy) 100% cancer treatment (chemotherapy, radiotherapy)
100% prostheses and applicances implanted during surgery 100% prostheses and applicances implanted during surgery  100% prostheses and applicances implanted during surgery    100% prostheses and applicances implanted during surgery  100% prostheses and applicances implanted during surgery  
$100 per day (maximum of $1000 per admission). Accommodation for companion of a hospitalised child -  $400 per day (maximum of $1000 per admission). Accommodation for companion of a hospitalised child   $300 per day (maximum of $1000 per admission). Accommodation for companion of a hospitalised child $300 per day (maximum of $1000 per admission). Accommodation for companion of a hospitalised child  
           
Out-patient benefits Out-patient benefits Out-patient benefits Out-patient benefits Out-patient benefits Out-patient benefits  
100% Physicians and specialists visits 100% Physicians and specialists visits 100% Physicians and specialists visits 100% Physicians and specialists visits 100% Physicians and specialists visits 100% Physicians and specialists visits  
             
100% (for a maximum of 6 months) prescribed drugs (following hospitalisation or out-patient surgery) $10,000 (for a maximum of 6 months) prescribed drugs (following hospitalisation or out-patient surgery) Prescribed drugs:
... 100% (for a maximum of 6 months), $3000 per year thereafter Following hospitalisation or out-patient surgery
... $700 outpatient or non-hospitalisation		 100% (for a maximum of 6 months) prescribed drugs (following hospitalisation or out-patient surgery) Prescribed drugs:
... 100% (for a maximum of 6 months), $2000 per year thereafter Following hospitalisation or out-patient surgery		 Prescribed drugs:
... 100% (for a maximum of 6 months), $2000 per year thereafter Following hospitalisation or out-patient surgery		  
100% Cancer treatment (chemotherapy / radiotherapy) 100% Cancer treatment (chemotherapy / radiotherapy) 100% Cancer treatment (chemotherapy / radiotherapy)   100% Cancer treatment (chemotherapy / radiotherapy) 100% Cancer treatment (chemotherapy / radiotherapy)  
100% (maximum of 60 sessions per year) physical therapy rehabilitation (must be pre-approved) 100% (maximum of 40 sessions per year) physical therapy rehabilitation (must be pre-approved) 100% Physical therapy / rehabilitation (must be pre-approved) 100% physical therapy/ rehabilitation (must be pre-approved) 100% Physical therapy / rehabilitation (must be pre-approved) 100% Physical therapy / rehabilitation (must be pre-approved)  
100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies) 100% diagnostic services (pathology: X rays, MRI / CT / PET scan, ultrasound and endoscopies)
100% dialysis 100% dialysis 100% dialysis   100% dialysis 100% dialysis  
$300 per day (maximum of 90 days per year per incident) Home health care (must be pre-approved) $200 per day (maximum of 60 days per year per incident) Home health care (must be pre-approved) 100% ... Home health care (must be pre-approved) 100% ... Home health care (must be pre-approved) 100% ... Home health care (must be pre-approved) 100% ... Home health care (must be pre-approved)  
 

 

 

 

 

      
Other benefits Other benefits Other benefits Other benefits Other benefits Other benefits  
$50,000 air ambulance (must be pre-approved) $25,000 air ambulance (must be pre-approved) 100% ... air ambulance (must be pre-approved) $25,000 air ambulance (must be pre-approved) $125,000 air ambulance (must be pre-approved) $100,000 air ambulance (must be pre-approved)  
100% ground ambulance 100% ground ambulance 100% ground ambulance 100% ground ambulance 100% ground ambulance 100% ground ambulance  
$3000 (per pregnancy) Maternity (includes normal maternity, complicated delivery, cesarean delivery, and all pre- and post-natal treatment)
... 10 month waiting period
... no deductible applies
... Plans 1, 2 and 3 only		 $1500 (per pregnancy) Maternity (includes normal maternity, complicated delivery, cesarean delivery, and all pre- and post-natal treatment)
... 10 month waiting period
... no deductible applies
... Plans 1, 2 and 3 only		 $8500 (per pregnancy) Maternity (includes normal maternity, cesarean delivery, and all pre- and post-natal treatment)
... 10 month waiting period
... no deductible applies
... Plans 1, 2 and 3 only

 

 $6000 (per pregnancy) Maternity (includes normal maternity, cesarean delivery, and all pre- and post-natal treatment)
... 10 month waiting period
... no deductible applies
... Plans 1, 2 and 3 only		 $4500 (per pregnancy) Maternity (includes normal maternity, complicated delivery, cesarean delivery, and all pre- and post-natal treatment)
... 10 month waiting period
... no deductible applies
... Plans 1, 2 and 3 only		  
    100% ... Complications of maternity and newborn
... 10 month waiting period		   $1,000,000 (per lifetime, per policy) ... Complications of maternity and newborn
... 10 month waiting period		    
  Well baby care ... 5 visits (within 6 months of delivery)        
    $50,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children        
$150,000 (per lifetime) Congenital and hereditary disorders diagnosed before the age of 18 $100,000 (per lifetime) Congenital and hereditary disorders diagnosed before the age of 18 100% ... Congenital and hereditary disorders   $1,000,000 (per lifetime) Congenital and hereditary disorders diagnosed before the age of 18 $300,000 (per lifetime) Congenital and hereditary disorders diagnosed before the age of 18  
100% congenital and hereditary disorders diagnosed on or after the age of 18 100% congenital and hereditary disorders diagnosed on or after the age of 18 100% ... Congenital and hereditary disorders   100% congenital and hereditary disorders diagnosed on or after the age of 18 100% congenital and hereditary disorders diagnosed on or after the age of 18  
    $750,000 (per diagnosis). Transplant procedures (per lifetime)   $600,000 (per diagnosis). Transplant procedures (per lifetime) $300,000 (per diagnosis). Transplant procedures (per lifetime)  
$15,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children $10,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children $50,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children   $30,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children $30,000 (for a maximum of 90 days after delivery) Provisional coverage for newborn children  
100% emergency dental coverage 100% emergency dental coverage 100% emergency dental coverage 100% emergency dental coverage 100% emergency dental coverage 100% emergency dental coverage  
$10,000 repatriation of mortal remains $5,000 repatriation of mortal remains 100% ... repatriation of mortal remains   100% ... repatriation of mortal remains 100% ... repatriation of mortal remains  
100% Hospice terminal care 100% Hospice terminal care 100% Hospice terminal care 100% Hospice terminal care 100% Hospice terminal care 100% Hospice terminal care  
 

 

 100% ... Complementary therapist (maximum of 80 visits / sessions   100% ... Complementary therapist (maximum of 20 visits / sessions    
    $600 ... Health checkup (all inclusive) No deductible applies   $300 ... Health checkup (all inclusive) No deductible applies $150 ... Health checkup (all inclusive) No deductible applies  
    4 visits ... Prescribed dietician guidance        
   

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Notes on benefits Notes on benefits Notes on benefits Notes on benefits Notes on benefits    
All in-patient and day-patient treatment must take place in a Bupa Secure Network hospital All in-patient and day-patient treatment must take place in a Bupa Essential Network hospital - All in-patient and day-patient treatment must take place in a Bupa Critical Network hospital All in-patient and day-patient treatment must take place in a Bupa Advantage Network  
Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this Membership Guide. The Table of benefits is only a summary of coverage. Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this Membership Guide. The Table of benefits is only a summary of coverage. Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this Membership Guide. The Table of benefits is only a summary of coverage. Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this  Membership Guide. The Table of benefits is only a summary of coverage. Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this Membership Guide. The Table of benefits is only a summary of coverage. Full details of the policy terms and conditions are in the Policy Provisions, Administration, and Exclusions and Limitations sections of  this Membership Guide. The Table of benefits is only a summary of coverage.  
All costs are subject to the usual, customary and reasonable fees for the procedure and territory All costs are subject to the usual, customary and reasonable fees for the procedure and territory All costs are subject to the usual, customary and reasonable fees for the procedure and territory All costs are subject to the usual, customary and reasonable fees for the procedure and territory All costs are subject to the usual, customary and reasonable fees for the procedure and territory All costs are subject to the usual, customary and reasonable fees for the procedure and territory  
Members are required to notify USA Medical Services  prior to beginning any treatment Members are required to notify USA Medical Services  prior to beginning any treatment Members are required to notify USA Medical Services  prior to beginning any treatment Members are required to notify USA Medical Services  prior to beginning any treatment Members are required to notify USA Medical Services  prior to beginning any treatment Members are required to notify USA Medical Services  prior to beginning any treatment  
All benefits are subject to any applicable deductible, unless otherwise stated. All benefits are subject to any applicable deductible, unless otherwise stated. All benefits are subject to any applicable deductible, unless otherwise stated. All benefits are subject to any applicable deductible, unless otherwise stated. All benefits are subject to any applicable deductible, unless otherwise stated. All benefits are subject to any applicable deductible, unless otherwise stated.  
Unless otherwise stated, all benefits are per Insured, per policy year. Unless otherwise stated, all benefits are per Insured, per policy year.          


 

 

 

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