BUPA Members May Need to Pay More at Ramsay Private Hospitals

Updated 31 August 2022

BUPA released the following statement:

Bupa and Ramsay Health Care (Ramsay) are pleased to announce they have signed a new three-year agreement that will ensure Bupa members continue to be covered, without additional out-of-pocket costs, when they receive treatment at a Ramsay facility in Australia.

We acknowledge the uncertainty that these changes may have brought, and we have worked tirelessly to advocate for our members and minimise any impacts. This agreement comes prior to any changes that were due to come into effect for Bupa members.

Bupa and Ramsay’s new agreement continues our long-standing partnership. The agreement provides our members with continued access to the high-quality healthcare they have come to expect when treated in a Ramsay hospital, while helping to keep care affordable for our members.

Bupa maintains its extensive hospital network in Australia

This new agreement is a great outcome for our members, as they will continue to have access to Bupa’s extensive hospital network – one of the largest in Australia – with no additional out-of-pocket costs. The continuity of Ramsay hospitals as part of our hospital network will support our member’s choice and flexibility over how and where they can receive treatment.

As part of the agreement, Ramsay and Bupa will establish a new committee to develop initiatives which further expand the value of private health service offerings for patients.

Ramsay Health Care has several hospitals located on the lower north shore.  Ramsay owns the following health care centres on the North Shore:

Hunters Hill Private Hospital
Castlecrag Private Hospital
North Shore Private Hospital
Ramsay Clinic Northside

All private health insurers and private hospitals have agreements that set out the insurer’s reimbursement rates to hospitals after a client has a hospital stay or procedure.

The contracts include an annual indexation rate. This indexation, paid by the insurer, helps the hospital cover yearly increases in wage and supply costs.

In 2022 Bupa and Ramsay Health Care have not been able to agree on the new annual indexation rate, so that the current contract will terminate on 2 August 2022.

This means Bupa patients with Ramsay Health Care will be required to cover the shortfall as an additional out-of-pocket cost.

Update Statement from BUPA

As of 2 August 2022, Bupa and Ramsay Health Care  are no longer in contract. From 2 October 2022, this could mean you may incur out-of-pocket costs when attending Ramsay facilities.  Further info here.

Only Bupa patients face this out-of-pocket expense; all other health insurers have agreed on terms with Ramsay Hospitals.

Why Have the Parties Failed to Reach an Agreement?

Ramsay Health Care argues that during the COVID-19 pandemic, private hospitals put in place measures to protect patients and staff—such as increasing PPE equipment, cleaning protocols and infection prevention training for staff. They argue each of these measures has involved high costs, and Bupa’s offered indexation rate is well below inflation and fails to cover these cost increases.

Bupa argues that the increase Ramsay is seeking would potentially result in a sizeable premium increase for customers at a time when the cost of living pressures is having a significant impact. Despite their attempt to negotiate a fair agreement for both Ramsay and their customers, Ramsay has notified Bupa that it will terminate their agreement, effective 2 August 2022.

What Happens If the Parties Fail to Reach an Agreement?

Nothing will change if you are booked into a Ramsay Health Care centre between now and 2 August 2022

For all other admissions, the below transitional arrangements apply:

All admissions meeting the below criteria will face no additional-out of pocket costs AND will be entitled to full network hospital benefits.

If you are a Bupa member, double-check your out-of-pocket expenses after 2 August 2022.

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