Medical gap schemes
The Doctors' Health Fund uses two medical gap schemes.Our 'Top Cover' hospital product includes our premium gap scheme, while 'Prime Choice' and 'Smart Starter' both include the Access Gap Cover scheme.
No need to ‘contract’ under our premium medical gap scheme
The Doctors’ Health Fund does not require medical practitioners to contract or register with the Fund to provide services under our premium medical gap scheme. Our scheme is different. We pay greater benefits which are based on a calculation which is applied to the doctors bill. To determine if your patient will have out-of-pocket expenses please call the Healthcare Providers hotline 1800 226 586 with the item numbers and fees which will be charged.
What to do when your patient has hospital cover with our premium medical gap cover?
To claim these benefits the patient’s aggregated bills need to be submitted to The Doctors’ Health Fund directly or to the patient. The claim needs to be accompanied by a completed Informed Financial Consent form.