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Access Gap Cover Doctors Search

Access Gap Cover (AGC) is a billing scheme that aims to reduce or eliminate out-of-pocket expenses to members for doctor and specialist services received in hospital. AGC allows us to pay above the scheduled fee for doctors’ services provided to you as an inpatient, covering the entire doctors’ fee or leaving you with significantly reduced out-of-pocket expenses.

Doctors may choose to participate in AGC on a patient-by-patient basis, so you should discuss this with your doctor. If your doctor charges the AGC fee, you may have nothing to pay. Even if the charge is above the AGC fee, you will be able to establish the ‘known gap’ you will have to pay before you receive treatment.

Ensure your doctor provides you with an Informed Financial Consent document. This will provide you with the estimate of fees for the cost of the treatment and usually indicates any out-of pocket expenses you may occur.

Find an Access Gap Doctor/Specialist who has previously participated in AGC with Teachers Health Fund.

For more information about Access Gap Cover visit ahsa.com.au/web/doctors

Join NowX

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You

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Your Cover

Select your desired level of cover:

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Your Rebate

All Australian residents, who are entitled to Medicare, are able to claim an income tested rebate on their private health insurance; would you like to apply your rebate?

For individuals earning between $88,001 - $102,000 (or $176,001 - $204,000 for families*).
*For families with children, the thresholds are increased by $1,500 for each child after the first.

How rebate tiers workX

Most Australians with private health insurance currently receive a rebate from the Australian Government to help cover the cost of their premiums. The private health insurance rebate is income tested. The table below details the different rebate amounts and Medicare Levy Surcharge levels.

The rebate applies to hospital, general treatment and ambulance policies. It does not apply to overseas visitors cover. The rebate levels applicable for 1 July 2013 to 30 June 2014 are:

Singles
Families
≤$88,000
≤$176,000
≤$88,001-102,000
≤$176,001-204,000
≤$102,001-136,000
≤$204,001-272,000
≤$136,001
≤$272,001
Rebate
< Age 6530%20%10%0%
Age 65-6935%25%15%0%
Age 70+40%30%20%0%

Single parents and couples (including de facto couples) are subject to family tiers. For families with children, the thresholds are increased by $1,500 for each child after the first. http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/insurancerebate.htm