Access Gap Doctors

Access Gap Cover (AGC) is a billing scheme designed to reduce or eliminate out-of-pocket expenses for medical services received in hospital. Doctors may choose to participate in AGC on a patient-by-patient basis, so you should contact your doctor to discuss if they are willing to treat you under this arrangement. If your doctor or specialist agrees to bill you under this arrangement, you will experience either reduced or nil out-of-pocket expenses for inpatient medical charges.

AGC allows Teachers Health Fund to pay above the scheduled fee for doctors' services provided to you as an inpatient, covering entire doctors’ fees or leaving you with significantly reduced out-of-pocket expenses. If your doctor charges the AGC fee, you may not need to pay anything for your treatment. Even if the charge is above the AGC fee, you will at least be able to establish the 'known gap' you will have to pay before you receive treatment.

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.