What is Covered?

Notes to the table of benefits: 2. In-patient and day-case treatment

Important - for all in-patient and day-case treatment costs:

  • it must be medically essential for you to occupy a hospital bed to receive the treatment
  • your treatment must be provided, or overseen, by a consultant
  • we pay for accommodation in a room that is no more expensive than the hospital’s standard single room with a private bathroom. This means that we will not pay the extra costs of a deluxe, executive or VIP suite etc.
  • if the cost of treatment is linked to the type of room, we pay the cost of treatment at the rate which would be charged if you occupied a standard single room with a private bathroom
  • the hospital where you have your treatment must be recognised.


Long in-patient stays: 5 days or longer
In order for us to cover an in-patient stay lasting 5 days or more, you must send us a medical report from your consultant before the third night, confirming:

  • your diagnosis
  • treatment already given
  • treatment planned
  • discharge date.


2a: Consultants’ fees for surgical procedures and medical treatment including pre- and post-operative care

We pay consultants’ fees for day-case and in-patient treatment you receive in a participating hospital

  • Surgeons’ and anaesthetists’ fees
    We pay surgeons’ and anaesthetists’ fees for a surgical operation, including all pre- and post-operative care.

    Note: This benefit does not include follow-up consultations with your consultant, as these are paid under benefit 1a. This means that members with Essential Option do not have cover for follow-up consultations.

  • Physicians’ fees
    We pay physicians’ fees for treatment you receive in hospital if this does not include a surgical operation, for example if you are in hospital for treatment of a medical condition such as pneumonia. If your treatment includes a surgical operation we will only pay physicians’ fees if the attendance of a physician is medically necessary, for example, in the rare event of a heart attack following a surgical operation.

  • Consultants’ fees for minor procedures carried out under local anaesthestic (applicable only for the Bupa Malta Standard Cover)
    If you need a minor surgical operation performed as out-patient treatment under local anaesthetic (such as the removal of a small cyst) we will pay up to the eligible benefit for consultant surgeons’ fees for each surgical operation.


2b: Hospital accommodation & nursing services

  • Hospital accommodation
    We pay for hospital accommodation and nursing services in a participating hospital required as part of your day-case or in-patient treatment.

    We pay charges for your hospital accommodation, including all your own meals and refreshments. We do not pay for personal items such as telephone calls, newspapers, guest meals or cosmetics.

    We pay for accommodation in a room that is no more expensive than the hospital’s standard single room with a private bathroom.

    We pay for the length of stay that is medically appropriate for the procedure that you are admitted for.

    Example: unless medically essential, we do not pay for day-case accommodation for out-patient treatment (such as an MRI scan), and we do not pay for in-patient accommodation for day-case treatment (such as a biopsy).

  • Nursing Services
    We pay for nursing services you need as part of your treatment in hospital. We do not pay for nurses hired in addition to the hospital’s own staff. In the rare case where a hospital does not provide nursing staff, we will pay for the reasonable cost of hiring a qualified nurse for your treatment.


2c: Parent accommodation

We pay for hospital accommodation for each night you need to stay with your child in the same hospital. This is limited to only one parent each night.

Your child must be:

  • aged under 13
  • a Bupa Malta member receiving treatment for which he or she is covered under their plan.


2d: Theatre charges, intensive care, drugs and surgical dressings

  • Theatre charges and intensive care
    We pay for use of an operating theatre. We pay for intensive care in an intensive care unit, intensive therapy unit, high dependency unit or cardiac care unit if:
    • intensive care is routinely required after the treatment, such as after heart or brain surgery, or
    • intensive care is medically essential due to unexpected circumstances, in which case your consultant should contact us at the earliest opportunity.

  • Drugs and surgical dressings
    We pay for drugs and surgical dressings you need as part of your treatment in hospital.


2e: Drugs and Dressing prescribed to take home following day-case or in-patient treatment (applicable only for the Bupa Malta Private Hospital Cover - Premier Option)

We pay for the cost of drugs and dressings following hospitalisation if it is prescribed on date of discharge from hospital. We only pay for items which need a prescription.

2f: Consultants’ fees for pathology, radiology, diagnostic tests and treatment by therapists

  • Consultants’ fees for consultations
    We pay consultants’ fees for consultations carried out as in-patient treatment. This means a meeting with a consultant during your in–patient stay and not acting as the physician.

  • Pathology, radiology and diagnostic tests
    We pay for pathology such as checking blood and urine samples for specific abnormalities, radiology such as X-rays and diagnostic tests such as electrocardiograms (ECGs) when recommended by your consultant to help determine or assess your condition when carried out in hospital.

  • Treatment by therapists
    We also pay for treatment provided by therapists such as physiotherapy if it is needed as part of your treatment in hospital.


2g: Prosthetic implants and appliances

We pay for a prosthetic implant needed as part of your treatment. By this, we mean an artificial body part or appliance which is designed to form a permanent part of your body and is surgically implanted for one or more of the following reasons:

  • to replace a joint or ligament
  • to replace one or more heart valves
  • to replace the aorta or an arterial blood vessel
  • to replace a sphincter muscle
  • to replace the lens or cornea of the eye
  • to act as a heart pacemaker
  • to remove excess fluid from the brain
  • to control urinary incontinence (bladder control)
  • to reconstruct a breast following surgery for cancer when the reconstruction is carried out as part of the original treatment for the cancer and you have obtained our written consent before receiving the treatment.
  • to restore vocal function following surgery for cancer.


We also pay for the following appliances:

  • a knee brace which is an essential part of a surgical operation for the repair to a cruciate (knee) ligament
  • a spinal support which is an essential part of a surgical operation to the spine.


2h: Advanced imaging, for example MRI, CT and PET scans (head and body scanning)

We pay for magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography (PET) when recommended by your consultant to help determine or assess your condition as part of your day-case or your in-patient treatment.

2i: Cancer treatment

Once cancer is diagnosed, we pay for consultant oncologists’ fees, chemotherapy and radiotherapy for the active phase of the cancer for day-case and in-patient treatment that are related to specifically planning and carrying out your treatment. This includes tests, scans, consultations and drugs (such as cytotoxic drugs or chemotherapy).

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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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