AMA benefits: lowering your out-of-pocket expenses

Key takeaways:

• Doctors’ Health Fund pays medical benefits up to the AMA list of services and fees on Top Cover Gold

• These benefits are above the Medicare Benefits Schedule (MBS) and other medical gap schemes

• Doctors don’t need to ‘opt in’ to charge AMA fees and for benefits to be paid, giving you flexibility and freedom of choice

Medical benefits up to the AMA list of services and fees is a type of medical gap cover that provides the most extensive coverage possible for medical expenses. At Doctors’ Health Fund, we’ve offered this medical gap cover for many years, and are proud to offer this unique level of cover to support patients and medical professionals alike.

What is medical gap cover?

All private hospital policies in Australia must include gap cover for medical expenses. While it is ultimately up to treating doctors on how much they charge for their services, medical gap cover can help to cover the difference, in whole or in part, between 75% of the Medicare Schedule Benefit and a doctors’ fees. A treating doctor will choose as to whether they bill their services according to your medical gap cover or not.

At Doctors’ Health Fund we offer three levels of hospital cover, with our Top Cover Gold paying medical benefits up to the AMA list of services and fees.

What are the benefits of having medical gap cover up to the AMA list of services and fees?

There are benefits to having medical gap cover up to the AMA list of services and fees compared to other medical gap cover schemes:

• Minimal out-of-pocket expenses – benefits payable under this gap cover are above the Medicare Benefits Schedule (MBS) and other medical gap schemes. Patients are left with no out-of-pocket expenses for medical bills when doctors charge up to the AMA list of services and fees.
• Less admin for doctors - unlike other medical gap covers, there’s no ‘opt in’ needed by treating doctors to charge AMA fees and for benefits to be paid. If you charge up to the AMA fees, we’ll pay them, and your patient will be left with no out-of-pocket costs for your services. Giving more peace of mind on their and your part.
• Benefits focus on the appropriate remuneration for doctors’ services – Doctors’ Health Fund believe the AMA list of services and fees provide reasonable remuneration to doctors for their years of training, expertise, and experience.

Interested in a quote?

See how your current cover compares today with an online quote, or contact our expert and friendly team on 1800 226 126 for a tailored and complimentary comparison report further detailing how Doctors’ Health Fund compares.