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Doctors and their staff

Known Gap

Changes to GapCover - effective 1 June 2010

From 1 June 2010, we changed the maximum GapCover out- of-pocket to $500 per doctor, per claim.

What will this mean for Doctors using GapCover?

  • When submitting a claim, doctors must ensure that the ‘known gap’ does not exceed $500;
  • A fully itemised account must be submitted for all GapCover claims to Medibank which outlines all charges for the member per claim, including any charge not covered by Medibank;
    Where the ‘known gap’ amount exceeds $500, the claim should be submitted under the Fund Gap arrangement; and
  • As has been the case previously, doctors must obtain Informed Financial Consent from the member prior to admission explaining all out of pocket costs.

Please note, any other conditions associated with using GapCover continue to apply.