Notes to the table of benefits: 1. Outpatient Treatment

This is treatment which does not normally require a patient to occupy a hospital bed. Note 1 details the benefits payable for out-patient treatment only. If you are having treatment and you are not sure which benefit applies, please call us and we will be happy to help.

1a: Consultants’ fees for pathology, radiology, diagnostic tests and treatment by therapists (not applicable for the Bupa Malta Private Hospital Cover – Essential Option)

• Consultants’ fees for consultations
  We pay consultants’ fees for consultations carried out as out-patient treatment. This means a meeting with a consultant to assess your condition.
  
  
• 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)
  
  
• Treatment by therapists
  We pay for out-patient treatment by therapists such as physiotherapy. If your consultant refers you to a medical or health practitioner who is not a therapist we may pay the cost of treatment as if the practitioner were a therapist if all of the following apply:
  
  
  1. Your consultant refers you to the practitioner (Example: a chiropractor or acupuncturist) before the treatment takes place and remains in overall charge of your care.
     
     
  2. The treatment is an essential part of an overall course of treatment provided by that consultant, and
     
     
  3. The treatment and condition is covered under your membership.

   
1b: 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 or family doctor.

1c: Cancer treatment

Once cancer is diagnosed, we pay fees that are related specifically to planning and carrying out treatment for cancer. This includes tests, scans, consultations and drugs (such as cytotoxic drugs or chemotherapy).

When the acute phase of cancer treatment (by which we mean surgery, radiotherapy or chemotherapy) has been completed, we will continue to pay this under benefit 1a for all cancer treatment specifically related to the original diagnosis for up to a further five years.

The five years will begin on the first out-patient consultation following completion of the acute phase of treatment.. Cover during this period includes any follow-up tests, scans and consultations you may require. It also includes any drugs that may be required to keep the cancer in remission or to prevent relapse, for up to five years.

If your treatment needs to continue for more than five years, please contact us for pre-authorisation (see section entitled Pre-authorisation) before proceeding. It may be necessary for us to seek a second opinion as part of our pre-authorisation process.

1d: Mini minor procedures performed by the family doctor under local anaesthetic

We pay for surgical procedures to be performed under local anaesthetic by the family doctor.

1e: Family doctor treatment

We pay for family doctor treatment.

1f: Prescribed Drugs & Dressings

(applicable only for the Bupa Malta International Cover - Gold Option)
We pay for the cost of drugs and dressings prescribed for you by your medical practitioner for eligible treatment. We only pay for items which need a prescription.