Lowering your out-of-pocket expenses

The Doctors’ Health Fund pays medical benefits up to the Australian Medical Association (AMA) list of services and fees on Top Cover Gold.
 
These benefits are above the Medicare Benefits Schedule (MBS) and other medical gap schemes and doctors do not need to ‘opt in’ to charge AMA fees and for benefits to be paid, offering flexibility and freedom of choice
 
Medical benefits up to the AMA list of services and fees is a type of medical gap cover that provides the most extensive coverage possible for medical expenses.
 
The Doctors’ Health Fund has offered this medical gap cover for many years and is proud to offer this unique level of cover to support patients and medical professionals alike.
 
What is medical gap cover?
All private hospital policies in Australia must include gap cover for medical expenses.
 
While it is ultimately up to treating doctors how much they charge for their services, medical gap cover can help to cover the difference, in whole or in part, between 75% of the MBS and a doctors’ fees.
 
A treating doctor will choose as to whether they bill their services according to a patients’ medical gap cover or not.
 
Doctors’ Health Fund offers three levels of hospital cover, with our Top Cover Gold paying medical benefits up to the AMA list of services and fees.
 
What are the benefits?
There are benefits to having medical gap cover up to the AMA list of services and fees compared to other medical gap cover schemes:

• Minimal out-of-pocket expenses – benefits payable under this gap cover are above the MBS and other medical gap schemes. Patients are left with no out-of-pocket expenses for medical bills when doctors charge up to the AMA list of services and fees
• Less admin for doctors – unlike other medical gap covers, there’s no ‘opt in’ needed by treating doctors to charge AMA fees and for benefits to be paid. If you charge up to the AMA fees, the Doctors’ Health Fund will pay them, and your patient will be left with no out-of-pocket costs for your services. Giving more peace of mind on their and your part
• Focus on the appropriate remuneration for doctors’ services – Doctors’ Health Fund believes the AMA list of services and fees provide reasonable remuneration to doctors for their years of training, expertise, and experience

Doctors’ Health Fund insurance MBS Medicare Benefits Schedule