When you are admitted to hospital as a private patient, your specialist’s bills will be covered up to the Medicare Benefits Schedule (MBS) fee. Medicare will cover 75% of the MBS fee, while we will cover the remaining 25%. However, you may still incur an out-of-pocket cost if there’s a difference between your specialist’s fees and the combined benefit provided from Medicare and HBF.
That’s where Medical Gap Agreements come in. Our Medical Gap Agreements can help reduce these out-of-pocket costs for you.