Australia’s largest and only national private health insurance fund, Medibank Private, pays in excess of $40 million dollars annually to help foot the cost of member’s medical expenses under its existing GapCover scheme.
This has been revealed in the midst of strong criticism today from the Australian Association of Surgeons and the Australian Medical Association of Medibank Private’s GapCover arrangements.
"Because gap payments are an enormous frustration to our members, we are determined to do everything we can to lessen the impact on them and provide the value for money they expect from private health insurance."
A new scheme - which is yet to receive Federal Government approval - has been criticised by the AMA.
The new scheme is an enhancement on Medibank Private’s existing GapCover scheme (launched last November) to meet new legislative requirements.
"Our existing scheme has been very successful and strongly supported. A massive 35 per cent of all medical services provided to our members are now being billed via the existing GapCover scheme," Medibank Private’s managing director, Mark Burrowes said.
According to Mark Burrowes, the objectives of GapCover are to eliminate or minimise costly medical gaps for members and to simplify billing practices.
"Clearly doctors are voting with their feet in favour of our existing scheme. They find that not only does it help their billing processes but allows them to inform their patients up-front about the cost of procedures."
"We want to give our members certainty about the cost of medical services and any out of pocket expenses they may incur."
Mr Burrowes strongly refutes AMA allegations that Medibank Private is attempting to control what doctors are charging their patients or to interfere in their relationship with their doctor.
"We are very disappointed given the constructive dialogue we have enjoyed with the AMA on medical gap that they have taken this stance. We wish to work with the profession to find solutions to the problem of medical gap and out of pocket expenses to ensure that our members are well served," he said.
"Our GapCover arrangement is not a contract and doctors are quite at liberty to opt in and out of the arrangement at their choosing - patient by patient or episode by episode.
"We have absolutely no desire to interfere in the clinical relationship between doctors and patients."
Mr Burrowes is very disappointed the AMA is not offering GapCover its support given the enormous success of the scheme.