A Difficult Decision
Understanding Your Concerns
Ensuring a Sustainable Future
Patient-Centric Approach
Bridging the Funding Gap
ACHA has advised Bupa and the Australian Health Services Alliance (AHSA) funds that it has been left with no choice with to terminate its contracts with the funds. This follows their refusal to acknowledge the viability crisis impacting private hospitals, and provide sustainable funding for their members’ care.
The terminations will come into effect from 20 February for Bupa, and from 4 March 2025 for the AHSA funds. The termination will impact all Bupa customers as well as the customers in the Alliance Group, which includes:
- Bupa
- Bupa International
- ACA Health
- AIA Health Insurance
- Australian Unity
- CBHS Corporate
- CBHS Health
- Defence Health
- Doctors Health
- Emergency Services Health
- Frank Health Insurance
- GMHBA
- HBF (only for treatment outside of WA)
- HCI
- HIF
- Health Partners
- Navy Health
- Nurses & Midwives Health
- Onemedifund
- Peoplecare
- Phoenix Health Fund
- Police Health
- Queensland Country Health Fund
- RBHS (Reserve Bank Health Society)
- see-u by HBF
- Teachers Health
- Territory Health Fund
- TUH
- UniHealth
- Union Health
- Westfund
After these dates, while Bupa and AHSA members can still be treated in Healthscope hospitals, they may face additional out-of-pocket expenses.
We will continue to negotiate with both Bupa and AHSA funds in the hope of reaching an acceptable agreement that fairly funds our hospitals and removes the need for additional out-of-pocket costs.
This website contains important information for impacted patients and their doctors, including options for Bupa and AHSA members can avoid any additional out of pocket fees by switching to a comparable product with another private health insurer.
Patient Information
Healthscope, Bupa and AHSA funds have been unable to reach an agreement that fairly funds our hospitals, impacting Bupa and AHSA insured-members accessing a Healthscope facility. The current agreement will end on 20 February for Bupa, and 4 March for AHSA funds.
How are Bupa and AHSA insured patients impacted if accessing a Healthscope facility?
- Healthscope will absorb the gap between its increased costs of delivering care and the benefits paid by HCF for a short time.
- Unless benefits paid by Bupa and AHSA funds increase to cover Healthscope’s increased costs of delivering care, additional out-of-pocket costs will apply according to the dates below:
Bupa
| Treatment Type (irrespective of when booked) |
|---|
| Emergency admissions |
| Rehabilitation and mental health treatment started on or before Thursday 20 February 2025 |
| Oncology, renal dialysis and other planned treatment started on or before Thursday 20 February 2025 |
| No additional out-of-pocket for patients until: |
|---|
| Tuesday 20 May 2025 |
| Wednesday 20 August 2025 |
| Wednesday 20 August 2025 |
| Other Treatments (including elective surgery) |
|---|
| Pregnancy and birth pre-booked on or before Thursday 20 February 2025 |
| Other procedures/services pre-booked on or before Thursday 20 February 2025 |
| No additional out-of-pocket costs if you are admitted: |
|---|
| Thursday 20 November 2025 |
| Wednesday 20 August 2025 |
AHSA
| Treatment Type (irrespective of when booked) |
|---|
| Emergency admissions |
| Rehabilitation and mental health treatment started on or before Tuesday 4 March 2025 |
| Oncology, renal dialysis and other planned treatment started on or before Tuesday 4 March 2025 |
| No additional out-of-pocket for patients until: |
|---|
| Wednesday 4 June 2025 |
| Thursday 4 September 2025 |
| Thursday 4 September 2025 |
| Other Treatments (including elective surgery) |
|---|
| Pregnancy and birth pre-booked on or before Tuesday 4 March 2025 |
| Other procedures/services pre-booked on or before 4 March 2025 |
| No additional out-of-pocket costs if you are admitted: |
|---|
| Thursday 4 December, 2025 |
| Thursday 4 September, 2025 |
The Fee will apply to all admitted patients who are members of Bupa and the AHSA health funds who do not meet any of the exclusion criteria. These are:
- Members of all other health funds
- Chronic Admitted Same Day Patients (e.g. Chemotherapy patients)
- Rehabilitation Day Program Patients
- Patients transferred from another ACHA site
- Related readmissions within 28 Days
- Palliative Care patients
- Babies born in a ACHA hospital
- Same day maternity patients
How can I avoid the fee?
Patients who are members of Bupa, Bupa International or one of the 29 AHSA insurers can avoid the ACHA Hospital Facility Fee by switching their cover to a comparable product with another fund. Australia's private health insurance laws allow members to move their cover to another health fund without re-serving waiting periods*.
*Before switching, make sure you understand whether you will have any additional costs and confirm the new product is comparable so that you do not have to re-serve any waiting periods. Make sure you discuss all your health insurance needs with the new fund.
To check if your insurer will incur the Fee
See the full list here:
To find out more about switching insurer
Please read the following guide by the Commonwealth Ombudsman.
ACHA has taken the difficult decision to introduce a new Hospital Facility Fee for members of Bupa, Bupa International and 29 health funds who are members of the Australian Health Service Alliance (AHSA) to sustainably cover the cost of their care.
ACHA is acutely aware that amid a cost-of-living crisis in this country, the last thing that some of our patients need is another fee when accessing the care in our hospitals – but Bupa, Bupa International and the 29 Alliance insurers have led us to believe we have no choice.
The Fee will sit alongside other hospital out of pocket fees patients are already required to pay, which may include insurer excesses and co-payments.
ACHA wanted to avoid this outcome, however lengthy negotiations with these insurers have not resulted in sustainable funding from these insurers. We will not compromise on patient care.
The fee is $100 for overnight patients per admission and $50 for same day patients per admission.
It is a one-off fee per procedure that will be charged upon admission to the hospital.
Patients who are members of these funds should consider switching their cover to a comparable product with another fund. They should ensure they discuss all their health insurance needs with the fund.
The fee will be charged from 26th November.
It is a one-off fee per procedure that will be charged upon admission to the hospital.
ACHA will introduce a Hospital Facility Fee of $100 per admission (overnight patients) and $50 per admission (same day patients) for members of the following funds:
· Members of Bupa and Bupa International
· Members of ACA Health Benefits Fund, AIA Health Insurance, Australian Unity, CBHS Corporate, CBHS Health, Defence Health, Doctors Health, Emergency Services Health, Frank Health Insurance, GMHBA, HBF (only for treatment outside of WA), HCI, HIF, Health Partners, Navy Health, Nurses & Midwives Health, Onemedifund, Peoplecare, Phoenix Health Fund, Police Health, Queensland Country Health Fund, RBHS (Reserve Bank Health Society), see-u by HBF, Teachers Health, Territory Health Fund, TUH, UniHealth, Union Health, Westfund
Not included under the Fee: Latrobe Health Services
Members of all other health funds (except Bupa, Bupa International and 29 health funds who are members of the Australian Health Service Alliance (AHSA)).
The fee will also not apply to patients who are members of these funds under the following circumstances:
- Chronic Admitted Same Day Patients (e.g. Chemotherapy patients)
- Rehabilitation Day Program Patients
- Patients transferred from another ACHA site
- Related readmissions within 28 Days
- Palliative Care patients
- Babies born at ACHA hospitals
In special cases hospital General Managers will have the ability to waive the fee on an individual patient basis based on discussions with the relevant VMO and/or patient
Patients who are members of these funds should consider switching their cover to a comparable product with another fund. Ensure you discuss all your health insurance needs with the fund.
If you wish to avoid the fee, members of these funds should consider switching their cover to a comparable product with another fund. They should ensure they discuss all their health insurance needs with the fund. ACHA will apply these fees in the most compassionate way possible, and so there is some hospital-level discretion that will be applied on a case-by-case basis subject to the approval of the hospital General Manager.
At this stage we have no plans to introduce any further fees. We have not taken the decision to introduce this fee lightly, however we have been left with no choice because Bupa and the 29 health funds who are members of the Australian Health Service Alliance (AHSA) are not sustainably covering the cost of hospital care.
