Terms and Conditions
No Out-of-Pocket Expenses*
No Out-of-Pocket Expenses is valid for Bupa, HCF and Westfund members on eligible extras covers, subject to yearly limits, waiting period, policy and fund rules.
If your Health Insurance does not cover for the full amount of your treatment, the patient will be responsible for the out-of-pocket expense.
Please check your health fund provider for detailed information prior to your visit.
Common examples where out-of-pocket expenses occur:
- You are not on eligible extras covers
- e.g. Bupa members need to have Hospital cover, combined with Extras cover that includes General Dental
- e.g. HCF members need to have Extras cover that includes General Dental
- e.g. Westfund members need to have Extras cover that includes General Dental
- Personal or family membership annual limit
- e.g. $600 per family per calendar year
- Yearly limit
- e.g. You can have maximum 1 check-up, 1 scale and clean, and 1 fluoride treatment per person, per year
- Sub limit
- e.g. You can only claim scale and clean once every 183 days (i.e. 6 months)
- Service limit
- e.g. Your maximum benefit for the particular service / item is below the Preferred Provider fee schedule
- Lifetime limit
- e.g. You have a lifetime limit for orthodontics
- Waiting period
- e.g. The waiting period for General Dental is generally 2 months
- You are not covered for dental procedures on the day
- e.g. You have outstanding insurance premium
