Known or No Gap"No Gap" or "Known Gap" Cover
All privately insured patients undergoing surgery the public hospital will be treated under a 'No Gap" arrangement.
Depending on the procedure required and your level of health cover, you may be eligible have your surgery performed, at a private hospital, under the 'No Gap*' or 'known gap*' scheme of your private health fund depending on your level of cover.
A few insurance companies participate in a "known gap" scheme*. Under this agreement the health fund agrees to pay a higher proportion of your costs and your surgeon limits the gap fee to a level set by the insurance company.
*Note that: No (or known) gap schemes are in respect to your surgical fees they may not cover other hospital related expenses, such as blood tests, scans and other doctors’ fees.