Access Gap Cover is the Health Fund's known scheme. It is designed to cut down the out of pocket expenses members may incur on inpatient medical services. All health fund members who have hospital insurance are eligible for Access Gap Cover providing their doctor is willing to participate.

To take advantage of Access Gap, you must ask each doctor or specialist who will be providing you with inpatient services if they are participating in the scheme. If they are, you must then ask if they will do so in your case as practitioners participate in the Access Gap scheme on a case by case basis.

If your doctor or specialist participates in Access Gap and is willing to charge you under that scheme, they will provide you with a written ‘quote' to advise you of any expenses you may still have, if any. Many practitioners will then submit their account to the Fund on your behalf. If your specialist prefers to send the account to you personally, it is important that you submit this account to the Fund directly and NOT to Medicare. The account should bear a sticker or other message to advise you to do this.

A list of doctors who have participated in Access Gap, is available by clicking here.

Some professionals do not want their name advertised in this way. If your doctor or specialist has not participated in Access Gap but is willing to do so for you, please ask them to contact the Fund for directions on how to register.

Professionals who participate in Access Gap Cover typically may include specialists, doctors, radiographers, anaesthetists and pathologists.