Access Gap Cover eliminates, or substantially reduces, the out-of-pocket expenses that are part of an inpatient hospital stay for people with private health insurance.
All you have to do is ask your treating specialist or surgeon if they'll bill you under Access Gap.
If they agree, the maximum you’ll pay is a known gap of up to $500 per doctor per hospital episode ($800 for obstetrics), or agree to no gap at all.
Specialists aren’t obliged to participate in the scheme, so if they won’t, you can keep looking.
It's available to Police Health members with Gold Hospital cover and Gold Combined cover*.
*All benefits may be subject to Waiting Periods, Limits and other conditions. Providers must be recognised by us. Review the cover tables on the Combined, Hospital and Extras pages, and your State Premium and Benefit Guide or contact us for more information.
You can ask to use it when you're referred to a specialist for treatment or surgery as an inpatient being admitted to hospital.
Once you've got a referral for a specialist, follow these steps;
- Use our ‘Find an Access Gap Doctor’ tool to call specialists in your area to ask about their fees before making an initial appointment. You can take a referral to any specialist, not necessarily the one named in your referral letter.
- Ask your preferred specialist the following;
- Would you treat me under Police Health's Access Gap Cover arrangements?
- Will I incur any personal out of pocket expenses for my treatment and if so, can you give me a written estimate of how much?
- Will any assisting doctors also use Access Gap Cover? This refers to other specialists including anesthetists.
- Are you prepared to send the bill to Police Health directly, so that they can claim my Medicare benefit on my behalf and send the payment back to you?
Simple, go to our Find an Access Gap Doctor search.