Bupa customers to lose cover at dozens of private hospitals

Millions of Australians are expected to be impacted as Healthscope, Australia’s second-largest private hospital operator, terminates its agreements with two major health insurers, Bupa and the Australian Health Services Alliance.    

Healthscope CEO Greg Horan said Bupa and the AHSA’s ‘refusal’ to maintain funding for its hospitals at sustainable levels had forced it to end the contract.

‘Healthscope cares for over 650,000 patients every year and we are absolutely committed to providing the best possible care. But we can only do this if we are adequately funded,’ Mr Horan said. 

‘In an environment of rising costs and private hospital closures, it is unacceptable for insurers to fail their core purpose – funding the care of their members, particularly those like Bupa who are boasting of record profits.’

Horan claimed that while private hospitals were losing money, health insurers were ‘banking record profits’. 

The changes will take effect on February 20, 2025, for Bupa, and on March 4, 2025, for AHSA funds. 

These terminations will impact all Bupa customers and those insured by AHSA members, including Australian Unity, GMHBA, Health Partners, Westfund, and HIF. 

Bupa has 4.1 million health insurance members and the AHSA collectively covers more than 2.5 million people. 

Australian Health Services Alliance CEO Andrew Sando accused Healthscope of ‘gouging’ the public.

‘Healthscope is driven by one thing – maximising returns for their investors, regardless of the impact upon the Australian private health care system,’ he said.

‘If the member-owned and not-for-profit insurers are forced to pay more to Healthscope to improve the profit of its Canadian private equity owners, then it inevitably stands that premium prices will be impacted, further compounding the cost of living pressures facing ordinary Australians.

‘Higher premiums create greater affordability challenges for ordinary Australians, fewer private health insurance memberships and participation, more reliance and pressure on public services and longer waiting lists.’ 

Bupa APAC CEO Nick Stone said customers would be covered at Healthscope hospitals until February.  

‘We are shocked and deeply disappointed by Healthscope’s action.

‘They appear to be disregarding the interests of our shared patients and customers by seeking to impact their access to healthcare.

‘Insurers and hospitals need to put aside their individual interests and work productively together, along with government, to ensure our joint customers and patients continue to have choice and access and our private health sector remains affordable and sustainable.’