How to use your Bupa Malta Plan

Step 5: Guide to benefits - physicians' fees

We reimburse physicians’ fees to the value of not more than the amounts shown below for treatments in Malta or in line with Bupa's equivalent schedules in the country of treatment and or reasonable and customary charges whichever is the lower.

Physicians
Attending to a client whilst being hospitalised 103.00 daily
Supplementary benefit for major illnesses listed below 47.00 daily

 

Supplementary benefit payable to physicians

The Bupa Malta table of benefits makes provision for a supplementary benefit to be paid to physicians for a maximum of 14 days a year during the acute phase of certain medical conditions.

The following are some examples of possible signs and symptoms of a patient fulfilling Bupa’s interpretation of the ‘acute’ phase of a major medical illness.

It is not expected that the patient should present with the following clinical signs and symptoms these are just examples.

Body system

Example signs and symptoms

Cardiovascular

The patient may have one or more of the following
Acute cardiac failure Vasoactive drugs used to support arterial pressure
Acute myocardial infarction Occurrence of atrial or ventricular tachycardia/fibrillation
Acute circulatory failure Acute complete heart block
Mean arterial BP = <60

 

Respiratory

The patient may have one or more of the following
Pneumonia Respiratory rate >40 per minute
Respiratory distress syndrome PaCO2 >6-7KPa (50 mmHg) in the absence of opioid or metabolic alkalosis
Other respiratory conditions of the new-born Some form of assisted ventilation

 

Renal

The patient may have one or more of the following
Acute Renal failure Oliguria = <0.5ml / kg/ hr with a rising creatinine, despite adequate fluids
Serum urea = >35mMol/L
Serum creatinine = 300 u Mol / L

 

Neurological

The patient may have one or more of the following
Meningitis Best GCS =<10 in the absence of sedative drugs
CVA Haemorrhage/Thrombosis or metabolic cause
Intra cerebral haemorrhage Neuropathy/myopathy/cord lesion limiting
Serious brain injury Serious brain injury (paraplegia, respiratory reserve or mobility brain damage)
Raised ICP

 

Metabolic / Hepatic

The patient may have one or more of the following
Septicaemia Blood levels outside the normal limits over a 24 hour period (U&Es + FBC)
Acute – subacute necrosis of liver Clinical hepatic failure causing other OSFs / Diabetic coma
complications, or PT prolonged 3 sees > control and
Diseases of the pancreas LFTs twice the upper limit of normal

 

Gastrointestinal

The patient may have one or more of the following
Gastrointestinal haemorrhage Prolonged ileus/uncontrollable diarrhoea requiring
intervention
Haemorrhage requiring acute blood transfusion
Dependant on Parenteral Nutrition

 

Others / Cancers
Malignant neoplasm
Leukaemia
Aplastic anaemias
Acute lymphadenitis

 

 
N.B. The above lists the most common conditions for which the supplementary benefit will be automatically available. Considerations will be given to the allocation of this supplement to other conditions on a case by case basis. Consultants are requested to provide details in the form of a medical report where appropriate.

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GLOBALCAPITAL HEALTH INSURANCE AGENCY

GlobalCapital Health Insurance Agency Limited acts as an insurance agent and is regulated by the Malta Financial Services Authority (MFSA). Registered address: GlobalCapital Health Insurance Agency Limited, Testaferrata Street, Ta’ Xbiex XBX 1403, Malta.

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