Medical Gap Cover
Confused About MBF Medical Gap Cover?
With MBF, you don't need to be. If you have MBF Hospital Cover, and your doctors participate, you're covered when:
- Medicare pays a benefit for your in-patient hospital treatment; and
- Membership conditions are met (including waiting periods)
The medical gap is the amount you pay above the Medicare Benefits Schedule Fee that some doctors charge for in-patient hospital medical services. We know that you want the certainty of 'no gaps' on your doctors' fees for these services. As an MBF member, you can help make medical gap cover even more widely available.
We also recommend that you speak with your general practitioner. They are in the best position to refer you a specialist that will meet your clinical needs.
Remember, MBF Medical Gap Cover is available:
- When your MBF membership includes hospital cover
- Where normal membership conditions are met. E.g. Your waiting periods have been served
- Medicare pays an in-patient hospital benefit
- Your doctor agrees to participate
MBF Medical Gap Cover applies if you have hospital cover and when benefits are payable for the hospital treatment.
Doctors throughout Australia can now offer MBF members the security of MBF Medical Gap Cover. It is available to all MBF members with hospital cover when doctors charge according to the MBF Schedule of Medical Fees.
More than 5,600 doctors are registered with MBF to offer Medical Gap Cover. Approximately 1,000 of these doctors have agreed to be shown on our Find a No Gap Specialist Search Tool. We make additions regularly, if your doctor does not appear here, please ask them if they provide MBF Medical Gap Cover.
If you have an operation or other medical treatment in hospital, each doctor can choose to send accounts direct to MBF where they accept the MBF Schedule of Medical Fee as full payment.
Therefore, you will receive no bill for that doctor's services for in-patient hospital care.
Importantly - and it's worth reminding your specialist - doctors can offer you 'no gaps' without a special contract with MBF.
Radiology or Pathology (Diagnostic) Medical Gap Cover Arrangements
MBF has entered into arrangements with certain diagnostic providers for services provided in hospital. The result is no out-of-pocket expenses for diagnostic services from these providers for in-patient hospital services, where Medicare pays a benefit. MBF and the diagnostic group concerned handle the billing and payment of these services. To locate a Medical Gap Radiologist/Pathologist Provider please click here