Effective 1 July 2024, the Australian Health Service Alliance (AHSA), which oversees the scheme for see-u by HBF and other Australian health insurers, will be amending certain items on the Access Gap Cover (AGC) schedules.
What does this mean?
This means some items on the Access Gap Cover schedule will have an increase while others may see a decrease or remain unchanged.
If you or others on your policy are being treated by an Access Gap Cover specialist, it's important to understand there might be some changes to your out-of-pocket costs due to these amendments.
If you have an upcoming hospital treatment, please contact your provider(s) and anaesthetist to obtain Informed Financial Consent, so you know what's covered and any out-of-pocket costs you may incur.
Why are the schedules changing?
It’s a good idea to review your benefits from time to time to make sure everything is up to date. We want your providers to keep using Access Gap Cover for you, so it’s important that the benefits we pay are fair and reasonable, especially in relation to what providers are charging.
What's changing on 1 July 2024?
The Australian Health Alliance (AHSA) is updating the fees for some items on the Access Gap Cover (AGC) schedules.
These changes won’t be the same across the board. Some items will see an increase in fees, while others might decrease or stay the same.
What is the Access Gap Cover Schedule?
The Access Gap Cover is a schedule of medical benefits designed to help reduce the medical costs you have to pay when you're admitted to hospital.
Medical costs are the fees your specialist or provider charges for their services while you’re in hospital. With Access Gap Cover, see-u works with your hospital and doctors to help cover some or all of these costs, so you’re not left with a big bill.
I already have a quote from my specialist for a procedure after 30 June 2024, do I need a new quote?
It’s always a good idea to double-check with your specialist to confirm if your benefits have changed. If there have been any updates, you may need to request an updated quote from your doctor to stay on top of any costs.
I have an upcoming procedure after 1 July 2024, how will this impact me?
If some benefits have decreased, it may result in higher out-of-pocket costs. However, if your specialist opts into Access Gap Cover, your out-of-pocket costs won’t exceed $500 (or $800 for obstetric services).
It’s really important to get the right details before any upcoming procedures. Be sure to contact your specialist to receive Informed Financial Consent (IFC) and confirm any costs.