- The Access Gap Cover (AGC) benefits have been reviewed in all states and territories effective from 1 July 2024.
- Some benefits have increased, some have decreased, and some have remained unchanged compared to the previous year.
- In March 2024, AHSA released draft schedules to provide early notice of the changes to all doctors, billing agents, and practice staff.
- MBS and AHSA indexation have been incorporated into these schedules where applicable.
Many items have increased, especially where we believed our benefits were too low. Decreases in some benefits occurred only where we believed we were above the industry norm, significantly higher than other AGC states and territories, or where it should not have too much impact on patient gaps.
These changes were designed to keep AGC contemporary. They have not resulted in overall cost savings for the funds; they were designed to better reflect the needs of the members who use AGC. No funding has been removed from AGC. It has been redistributed across the schedules to be non-inflationary.
You may also find the FAQs for AGC Providers document below useful for additional information about the AGC review:
Thank you for your participation in improving the value of private healthcare by removing or reducing medical gaps for private patients.
Please do not hesitate to email access@ahsa.com.au if you have any queries about the changes to the AGC benefits.
If you have any questions relating to your patient’s private health insurance product, coverage or claims, please contact individual funds. Please refer to the Participating Fund Contact List - AHSA.