Access Gap Cover

Access Gap Cover

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What is Access Gap Cover?

Under Access Gap Cover, available through Teachers Health, your out-of-pocket expenses can be reduced - or eliminated – if your anaesthetist, surgeon or specialist agree to charge under a certain rate.

How does it work? If your doctor agrees to charge you under Access Gap Cover, Teachers Health can pay higher benefits for your medical procedures in hospital (up to certain limits). In return, your doctor agrees to charge you a lower fee – either no gap or a ‘known gap’ which is a capped amount.

How do I get Access Gap Cover

All you need to do is ask your doctor if they’ll charge you under Access Gap Cover.

You can also search for doctors who have participated before, using our search tool below. Although, it’s important to note that it’s up to your doctor to choose if they’ll participate on an individual basis.

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

Access Gap Explained

Find an Access Gap doctor

You can search for doctors who have previously participated in Access Gap using the free tool below. It’s an online medical directory which gives you information on how a specialist has previously charged patients (no gap, a gap of up to $400 or a gap of over $400). Your GP can also access this information to guide their selection of specialists for referrals.