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 |
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 |
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 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.
© 2014 Bupa Malta / GlobalCapital Health Insurance Agency Ltd
