Ramsay Health Care and health insurer Bupa have not reached agreement on a new contract, resulting in the termination of the existing agreement.
This will unfortunately impact Bupa members wishing to access Ramsay Health Care facilities after 2 August 2022.
After this date, benefits paid by Bupa will reduce for policy-holders accessing treatment at Ramsay Health Care facilities, unless transitional arrangements apply.
Where transitional arrangements do not apply, Bupa policy-holders will be required to pay increased out-of-pocket costs for admission at Ramsay hospitals. Ramsay is unable to absorb these out-of-pocket costs.
Communications regarding transitional arrangements is planned after 3 June 2022, once those communications have been agreed with Bupa.
We understand this may create stress and inconvenience for you and we apologise for this. Given the challenges facing the health sector, it is not a decision we have taken lightly.
Why have Ramsay Health Care and Bupa not reached agreement?
Maintaining high quality levels of care for our patients is of utmost importance. Ramsay hospitals have played an important and active role Australia’s COVID-19 pandemic response, while also ensuring our patients and health care workers have remained safe with appropriate PPE, social distancing, cleaning and training.
Costs of providing care have significantly increased for private hospitals over the past two years. On the other hand, health insurers have accumulated profits of $1.8 billion in the calendar year to 31 December 2021.
Ramsay considers higher benefits are necessary to cover the cost increases private hospitals are now faced with, when providing quality care to patients.
Ramsay will work with Bupa over the coming weeks to agree the communications to patients regarding:
- Ramsay no longer having an agreement with Bupa;
- Ramsay continuing to have agreements with all other Australian health insurers;
- Bupa policy-holders paying an additional out-of-pocket cost; and
- Bupa policy-holder options to minimise these additional out-of-pocket costs, including by discussing the timing of treatment with their doctor or reviewing their cover.
Questions about changing cover?
The law includes special ‘portability’ rules that mean consumers changing cover (or insurer) won’t have to re-serve the normal waiting periods again before benefits can be paid (they may have to serve waiting periods for any better benefits or conditions under the new cover). For further information, please access a copy of the Government brochure “Right to Change” or download it here.
Maternity patients booked in after August 2
Thank you for entrusting Ramsay to be your birthing hospital. We promise to look after you.
We know the recent news regarding our terminated agreement with BUPA may disrupt your plans and be a cause for concern.
We will follow the recommendations of the Ombudsman, regarding what benefits, fees and out-of-pockets should apply after 2 August 2022.
Disappointingly, BUPA unilaterally issued a media release regarding how it intends to pay benefits after 2 August 2022. They haven’t discussed how this works with hospitals or doctors.
We promise you, if the benefits paid by BUPA don’t reduce after 2 August 2022 we will accept these as payment of our fees.
If the benefits paid by BUPA do reduce, this will be your additional out-of-pocket cost.
You should contact BUPA to receive, in writing, confirmation BUPA will pay you benefits in accordance with their media release and also seek confirmation about how much they will pay your doctors.
Frequently Asked Questions
No. These arrangements will not affect members of any other health fund.
Ramsay Health Care has contracts with all other Australian private health insurers.
The amount patients need to pay will depend on your treatment, level of cover and the amount of Bupa’s reduced benefits. Once Bupa supplies Ramsay the non-contracted schedules of benefits we can inform Bupa customers of their anticipated out-of-pocket costs.
The law includes special ‘portability’ rules that mean consumers changing cover (or insurer) won’t have to re-serve the normal waiting periods again before benefits can be paid (you may have to serve waiting periods for any better benefits or conditions under the new cover). For further information, please access a copy of the Government brochure “Right to Change” or download it here.
With the benefit paid by Bupa reducing for policy-holders accessing treatment at Ramsay Health Care facilities after 2 August 2022 (unless transitional arrangements apply), Bupa policy-holders will be required to pay increased out-of-pocket costs for admission at Ramsay hospitals.
Once Bupa supplies Ramsay the non-agreement schedules of benefits, our admissions team will inform Bupa policyholders of their anticipated out-of-pocket costs as part of the Informed Financial Consent process.