What's the gap?

When you go to hospital or a day hospital facility, the benefits you’re entitled to for the in-hospital medical services you receive are based on the Federal Government’s fee schedule, known as the Commonwealth Medicare Benefits Schedule (MBS). However, specialists can set their fees above this schedule.

The ‘gap’ is the difference between the fees you’re charged by the specialists who treat you in hospital and the MBS fees for the services they provide. It can leave you with out-of-pocket expenses for your treatment, particularly if your treating specialists’ fees are higher than the MBS fees, which is often the case.

Medibank Private GapCover is helping to close that gap – by inviting specialists to participate in our GapCover arrangements. Specialists can elect to participate in GapCover on a case-by-case basis. Under GapCover, a specialist who treats you in hospital can elect to charge you either ‘no gap’ or a limited ‘known gap’ for their services. For a no gap service, you’ll have no out-of-pocket expense. For a known gap service, the specialist should notify you of any out-of-pocket expenses for their services, usually before your treatment starts.

GapCover does not eliminate amounts that you’ve agreed to pay under your policy with Medibank Private, such as any applicable excess, co-payment or other hospital charges. And it only applies to medical procedures performed by specialists in hospital or day hospital facilities.

Call Me Back

If you would like a Medibank Private consultant to call you, just let us know when is suitable to call you.

Get me a quote

Other Joining Options

Call us on:

132 331 within Australia
+61 3 8622 5780 outside Australia

8am - 8pm Monday to Friday or
8am - 4pm on Saturday,
Australian Eastern Standard Time