Effective 1 July 2024, the Australian Health Service Alliance (AHSA), which oversees the scheme for Queensland Country Health Fund 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 expect to incur.
What’s changing on 1 July 2024?
The Australian Health Alliance (AHSA) is amending fees for some items on the Access Gap Cover (AGC) schedules.
These changes are not uniform. This means some items on the AGC schedule will have an increase while others may see a decrease or remain unchanged
What is the Access Gap Cover Schedule?
The Access Gap Cover is a schedule of medical benefits designed to reduce the medical costs you need to pay for treatment when you’re admitted into hospital.
Medical costs are the fees your specialist or provider charges for their services when you’re admitted into hospital.
Why are the schedules changing?
To ensure benefits are paid appropriately and are up to date, it is important to review them from time to time. We want providers to continue using Access Gap Cover for you; therefore, the benefits that are paid need to be reasonable, especially concerning what providers are charging.
I have an upcoming procedure after 1 July 2024, how will this impact me?
As some benefits have decreased, it can lead to a higher out-of-pocket cost. Keep in mind if your specialist opts into Access Gap Cover this would not exceed $500 (or $800 for obstetric services). It is important to obtain accurate information concerning any upcoming procedures, please contact your specialist to receive Informed Financial Consent (IFC).
I already have a quote from my specialist for a procedure after 30 June 2024, do I need a new quote?
Please contact your specialist to confirm whether benefits have changed. You may need to request an updated quote from your doctor.
