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Bupa is making changes, from reading this if my implant breaks again would I not be covered anymore?

On your cover we pay benefits towards breast augmentation (when clinically necessary). From 1 July 2018, we will continue to cover you for reconstructive surgery. We will not cover you for any breast procedures except when they are post breast cancer. We are also updating our Fund Rules to clarify the definition of Cosmetic Surgery so you have a better idea of what is excluded and deemed as Cosmetic Surgery. Reconstructive Surgery is to restore function or typical appearance by reconstructing defective organs or parts. It would usually follow a previous medically necessary surgery, an event that caused a change in the appearance and/or function of a part of the body or a significant congenital problem (something you were born with), that created problems with how your body works. For example, after a mastectomy for breast cancer, there may be a desire to reconstruct the breast back to an acceptable appearance, whereas changing the appearance of the breast for most other reasons would be cosmetic in nature and intent. Unless it is for the purpose of restoring the body, it may not be covered

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13 minutes ago, henleybeachgirl said:

Bupa is making changes, from reading this if my implant breaks again would I not be covered anymore?

On your cover we pay benefits towards breast augmentation (when clinically necessary). From 1 July 2018, we will continue to cover you for reconstructive surgery. We will not cover you for any breast procedures except when they are post breast cancer. We are also updating our Fund Rules to clarify the definition of Cosmetic Surgery so you have a better idea of what is excluded and deemed as Cosmetic Surgery. Reconstructive Surgery is to restore function or typical appearance by reconstructing defective organs or parts. It would usually follow a previous medically necessary surgery, an event that caused a change in the appearance and/or function of a part of the body or a significant congenital problem (something you were born with), that created problems with how your body works. For example, after a mastectomy for breast cancer, there may be a desire to reconstruct the breast back to an acceptable appearance, whereas changing the appearance of the breast for most other reasons would be cosmetic in nature and intent. Unless it is for the purpose of restoring the body, it may not be covered

Hey @henleybeachgirlthat does appear to be what the clause is stating. However, for complete clarification I would suggest you call them. I also found this when I did a search and it seems to confirm your concerns. https://plasticsurgery.org.au/media-release/bupa-patients-to-benefit-from-landmark-agreement/

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9 minutes ago, sabP said:

Hey @henleybeachgirlthat does appear to be what the clause is stating. However, for complete clarification I would suggest you call them. I also found this when I did a search and it seems to confirm your concerns. https://plasticsurgery.org.au/media-release/bupa-patients-to-benefit-from-landmark-agreement/

Who else covers implants,? I’ve had a rupture once, so I defiantly would like to be covered. 

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1 hour ago, henleybeachgirl said:

Who else covers implants,? I’ve had a rupture once, so I defiantly would like to be covered. 

I think you would need to call some health insurers and ask if they would cover you. Each health insurer is different and what and how much they will cover differs from fund to fund as well. You also need to be mindful of any waiting periods for coverage. Maybe someone else on this forum can advise about their insurance coverage. I'm with HBF in Perth and I believe if my surgeon advised I needed corrective surgery and they allocate a medicare rebate number then there would be some coverage, but I have no idea how much.

My concern is that if BUPA have struck this arrangement, other health funds may follow suit.

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5 minutes ago, sabP said:

I think you would need to call some health insurers and ask if they would cover you. Each health insurer is different and what and how much they will cover differs from fund to fund as well. You also need to be mindful of any waiting periods for coverage. Maybe someone else on this forum can advise about their insurance coverage. I'm with HBF in Perth and I believe if my surgeon advised I needed corrective surgery and they allocate a medicare rebate number then there would be some coverage, but I have no idea how much.

My concern is that if BUPA have struck this arrangement, other health funds may follow suit.

thanks

 

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