A gap payment is the difference between what a doctor charges you and how much Medicare or your health fund will give you back. If you have private health insurance, contact your health fund to check that your treatment in hospital is covered and to ask about your gap cover.
Gap cover is the arrangement some health funds make with individual doctors about gap payments. It can insure you against some of the difference between what a specialist charges you and what Medicare will give you back. Choosing to use the doctors and hospitals that take part in your health insurer’s medical gap scheme can help reduce out-of-pocket costs.
Out-of-pocket costs are those additional costs that are not covered by Medicare or your health fund. Examples are listed here. You will have to pay these costs yourself.
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Rania Tannous, Head of Legal, Corporate, Legal and Governance, AMP; Patricia Troll, Senior Legal Counsel, AMP Financial Services Legal, Legal and Governance, AMP; Lynette Brailey, Program Coordinator, Financial Assistance Service, Cancer Council NSW; Stephen Bray, Financial Planner, FM Financial, TAS; Angela Daly, Senior Social Worker, Cancer Services, The Adem Crosby Centre, Sunshine Coast Hospital and Health Service, QLD; Sandra Hodge, Consumer; Sandi Johnson, Consumer; Antony Mitchell, Financial Counsellor, Financial Counselling Program, Cancer Council VIC; Lucy Pollerd, Social Worker, Peter MacCallum Cancer Centre, VIC; Heather Richards, Consumer; Deb Roffe, 13 11 20 Consultant, Cancer Council SA.
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