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Choosing a specialist that participates in GapCover

Medibank has partnered with leading digital health platform Healthshare to empower its 3.8 million members to make more informed decisions about their healthcare.

Lung cancer

GPs and their patients will be able to look up specialists who have participated in Medibank’s GapCover arrangements, which were introduced to help reduce out-of-pocket costs for members.

The Healthshare platform will show which specialists have offered known or no out-of-pocket costs for some procedures in the last 12 months.

Medibank Chief Customer Officer David Koczkar said Medibank members and their GPs will be able to have a discussion about the potential for out-of-pocket costs from specialists before being referred.

“This partnership with Healthshare will give our customers better information to help them choose who treats them and how much they will pay, keeping their potential out-of-pocket costs in check,” he said.

Medibank Chief Medical Officer Dr Linda Swan said specialist referrals are a crucial part of the care that GPs provide, and it is important to give GPs access to the most up-to-date information.

“Information about specialists who have participated in Medibank’s GapCover scheme will be available on practice management software, making it easier for GPs to look for this when discussing a potential referral with a patient who is concerned about out-of-pocket costs,” she said.

Specialists can still decide on a case by case basis whether they will participate in Medibank’s GapCover scheme. The Healthshare platform simply reveals those who have been open to participation in the past and may well be open to participating again in the future.

Mr Koczkar said Medibank is working hard to ensure every interaction is better and clearer for Medibank members.

“Our commitment to transparency will give our members a better experience and greater value.  We want them to know they have the right cover, know what value is available to them and understand how we will support them to live a healthier life,” Mr Koczkar said.

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