NO GAP

A ‘medical gap’ is any out-of-pocket expense incurred by a patient for their medical treatment during their stay in hospital. This reflects the difference between the total fee charged by the doctor and any Medicare rebate plus health fund benefit. Our surgeons have a gap cover arrangement with the following health funds in place which will cover all of your surgeon’s charge*, you will not have to contribute towards the surgeon’s bill out of your own pocket.

Unfortunately Latrobe Health services does not have a No Gap scheme. As such there will be a gap charged to equalise the amount to that paid by Most  other health funds.

Unfortunately HCF has chosen to significantly CUT their payments made for item numbers 30648 30651 30652 30655 (inguinal and ventral hernias) which replaced item numbers 30614 30609 and 30403, as such from November 1 2021 they are NO LONGER A NO GAP FUND. There will be an out of pocket cost for procedures. 

Please see the list below which provides more details on gap cover by each health fund

Fund	Link
ACA Health Benefits Fund	http://www.acahealth.com.au/
ahm Health Insurance	https://ahm.com.au/
Australian Unity Health Limited	http://www.australianunity.com.au/
Bupa Australia Pty Ltd	http://www.bupa.com.au/
CBHS Health Fund Limited	http://www.cbhs.com.au/
CDH Benefits Fund	http://www.cdhbf.com.au
Central West Health Cover	http://centralwesthealth.com.au
CUA Health Limited	https://www.ahsa.com.au/GapCover/
Defence Health Limited	http://www.defencehealth.com.au/
Doctors’ Health Fund	http://www.doctorshealthfund.com.au/
GMF Health	http://www.gmfhealth.com.au
GMHBA Limited	http://www.gmhba.com.au
Grand United Corporate Health	http://www.ahsa.com.au/GapCover/
HBF Health Limited	http://www.hbf.com.au/health-insurance/
HCF	http://www.hcf.com.au
Health Care Insurance Limited	http://www.hciltd.com.au
Health Insurance Fund of Australia Limited	http://www.hif.com.au/
Health Partners	http://www.healthpartners.com.au/HospitalCover/
health.com.au	http://www.health.com.au
Latrobe Health Services	http://www.latrobehealth.com.au
Medibank Private Limited	http://www.medibank.com.au/
Mildura District Hospital Fund Ltd	http://www.mdhf.com.au
National Health Benefits Australia Pty Ltd (onemedifund)	http://www.onemedifund.com.au
Navy Health Ltd	http://navyhealth.com.au/
NIB Health Funds Ltd.	http://www.nib.com.au/
Peoplecare Health Insurance	http://www.peoplecare.com.au/
Phoenix Health Fund Limited	http://www.phoenixhealthfund.com.au/
Police Health	http://www.policehealth.com.au/
Queensland Country Health Fund Ltd	http://www.qldcountryhealth.com.au
Railway and Transport Health Fund Limited	http://www.ahsa.com.au/search/
Reserve Bank Health Society Ltd	http://www.myrbhs.com.au
St.Lukes Health	http://www.stlukes.com.au/
Teachers Health Fund	http://www.teachershealth.com.au/
Transport Health Pty Ltd	http://www.transporthealth.com.au/
TUH	http://www.tuh.com.au/
Westfund Limited	http://www.westfund.com.au/health-services/

Terms and conditions:

*Some anaesthetists do charge a gap.
*Australian Unity Has no gap cover scheme for Members on Basic Hospital (B1, YB2), Smart Start (LB), Care ‘N Share (BA), Budget Hospital (B2), Basic Starter (YCA) and Basic Saver (YCB)
*Frank Health insurance without extra gap cover will have a gap payment charged.
*Combined Cases (involving multiple surgeons eg plastic surgeons) may incur a co-payment. This will be discussed with you and full financial consent obtained before your procedure.
*You may have a health fund excess depending on your policy.
*Some anaesthetists do charge a gap.
*From 1 July 2021 there may be a gap payment required for incisional, ventral, umbilical or recurrent hernias. (Not including inguinal)