Gap cover doctors

A 'medical gap' is any out-of-pocket expense incurred by a patient for their medical treatment during their stay in hospital, reflecting the difference between the total fee charged by the doctor and any Medicare rebate plus health insurer benefit. Unless your health insurer has a gap cover arrangement in place with your doctor which will cover all of your doctor's charge, you will have to contribute towards the doctor's bill out of your own pocket.

It is important that you contact your health insurer before you receive hospital treatment to check whether your doctor is participating in the insurer's gap cover arrangements. You should also ask your doctor(s) how much you will have to pay over and above your insurance cover. It is up to the doctor to decide on a case-by-case basis whether he or she wishes to use an insurer's gap cover arrangement.

Some insurers have specific information on their site, or you may have to contact them to obtain details of their gap cover arrangements.

Health insurer gap cover arrangements: