How over 50s with hospital cover are using this tactic to avoid gap fees

Taking out health insurance should mean you avoid forking out large amounts of money when you need treatment, right?

But in 2020 the average out-of-pocket fee for hospital treatment rose by $319*. That’s over five percent in just one year. Here’s how to avoid pricey gap payments

But I’m paying for top tier coverage so why am I getting a gap fee?

If you’re already paying for the highest level of hospital cover, it’s not unreasonable to assume there should be little or no gap fees to pay when you need treatment.

Sadly, higher premiums don’t always lead to lower gap fees. 

Out-of-pocket costs often exist regardless of your level of cover and depends on if your doctor or specialist charges over the Medicare Benefits Schedule fee and whether your fund runs a no or known gap scheme (if you want to know more about these schemes, have a look at our gap fees guide).

This means people who are more likely to access common hospital and specialist services – often Australians aged 50 and above – are most affected by these gap charges. 


Do I now have to sell a non-vital organ to cover common treatments?

Health funds aren’t always great at communicating no gap schemes, or when or where their members may be hit by gap fees. 

You often have to do a bit of legwork to work out if you’re likely to be hit with a big medical bill, but the good news is there is a way to cut the uncertainty of a nasty gap fee

Our team of experts will dive into the details to make sure we’re recommending a fund that has an appropriate medical gap scheme and an agreement with your local hospital.

It can be hard enough to understand known gaps and gap-free services, when and where these take place and which hoops you have to jump through in order to qualify. 

So get in touch with Health Insurance Comparison today and let us find a way to cut down the pain of out-of-pocket hospital expenses.

This article is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

*APRA, Quarterly Private Health statistics, Feb 2021