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BUPA MEMBERSHIP GUIDE | BUPA PROVIDERS ONLINE


THE AGREEMENT BETWEEN THE SPONSOR AND BUPA PROVIDER

Your cover is provided under an agreement between the sponsor and Bupa provider. There is no legal contract between you and Bupa provider for your cover under the agreement. Only the sponsor and Bupa have legal rights under the agreement and are the only ones who can enforce the agreement, although bupa will allow anyone who is covered under the agreement complete access to complaints process.

THE DOCUMENTS THAT SET OUT YOUR COVER

The following documents set out the details of the cover bupa will provide for you under the agreement. These documents must be read together as a whole, they should not be read as separate documents.

THE BUPA SELECT MEMBERSHIP GUIDE

This sets out the general terms and conditions of membership (including exclusions) and all the elements of cover that can be provided under Bupa Select.

Bupa Providers Online Guide Book


YOUR MEMBERSHIP CERTIFICATE

This shows the cover that is specific to your benefits, including the underwriting method applied, the limits that apply, any variations to the benefits, terms or conditions explained in this membership guide and whether an excess or co-insurance applies to your cover and if it does, the amount and how it applies.

And for underwritten members | Bupa Providers Online

YOUR APPLICATION FOR COVER:

This includes any applications for cover for underwritten members and the declarations that you made during the application process.

PAYMENT OF BENEFITS

Bupa only pay for treatment that you receive, or the benefits that you are entitled to, while you are covered under the agreement and we only pay in accordance with the agreement. We also only pay the benefits that applied to you on the date you received your treatment or the date that you became entitled to those benefits. When you receive private medical treatment you have a contract with the providers of your treatment. You are responsible for the costs you incur in having private treatment. However, if your treatment is eligible treatment bupa pay the costs that are covered under your benefits. Any costs, including eligible treatment costs, that are not covered under your benefits are your sole responsibility. The provider might, for example, be a consultant, a recognised facility or both. Sometimes one provider may have arrangements with other providers involved in your care and, therefore, be entitled to receive all the costs associated with your treatment. For example a recognised facility may charge for recognised facility charges, consultants’ fees and diagnostic tests all together. In many cases bupa have arrangements with providers about how much they charge our members for treatment and how we pay them. For treatment costs covered under your benefits bupa will, in most cases, pay the provider of your treatment direct – such as the recognised facility or consultant – or whichever other person or facility is entitled to receive the payment. Otherwise bupa will pay the main member. Bupa will write to tell the main member how bupa have dealt with any claim. Please also see the section ‘Claiming’.
You may download whole membership guide from official website.

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