Can I avoid the gap in cover?

If you go to hospital as a private patient, there can be unexpected gaps between the charges you incur and the benefits you get from Medicare and from your private health insurance. These gaps can be very substantial.

Gaps of this kind can arise from the policies of the hospital itself and of the medical practitioners that use that hospital.

If you ask, your insurer will provide you with details of hospitals where they have arrangements to avoid or restrict gap charges. Before you go to any particular hospital, it is a good idea to contact your insurer and double check the situation. You may choose to exercise your rights as a consumer to choose another hospital.

Of course, if you have a deductible or copayments on your health cover, you will have to pay those costs even if there is an agreement between your insurer and the hospital. However some hospitals will waive these too, so it is at least worth asking the question.

Doctors in Australia are free to charge whatever fees they believe are appropriate for their private services. However, many doctors also have arrangements with hospitals and with health insurance companies to limit the gaps between their fees and the amounts recoverable from Medicare and from private insurance.

Again, it is prudent to ask your doctor about charges, for the doctor’s
own services and also for those of any specialists (such as surgeons, anaesthetists and radiologists) that may be involved in your care.

You will not be charged more if you ask, and you may be charged less.

To compare health insurance and find the best and cheapest option for health cover you and your family you can go to www.ozecover.com.au. The service costs you nothing and its the only one that compares every health insurance company and every product in Australia. Your quote is personalised, based on your answers to some simple questions.