Current Participating Health Funds – 16th January, 2018

List of participating health funds with “no gap” agreements

A-E: ACA Health Benefits Fund, Australian Unity Health Limited*, Bupa HI Pty Limited, CBHS Corporate Health Pty Ltd (from 01/09/2016), CBHS Health Fund Limited,  CUA Health Limited, Defence Health, Emergency Services Health Pty Ltd (from 09/01/2017).

G-L:  Grand United Corporate Health Ltd, HBF Health Limited (from 13/02/2017),  Health Care Insurance Limited, health.com.au, Health Insurance Fund of Australia Limited, Health Partners, Health Contributions Fund of Australia Ltd (HCF), Latrobe Health Services.

M-Q: myOwn, Navy Health Limited, Nurses & Midwives Health Pty Limited (from 16/01/2017), Onemedifund, Peoplecare Health Insurance, Phoenix Health Fund Limited, Police Health Limited, Queensland Country Health Fund Ltd.

R-Z: Reserve Bank Health Society Ltd, rt health fund,  Teachers Health Fund, Teachers Union Health (previously Queensland Teachers Union Health Society), The Doctors Health Fund Limited,  Transport Health*, Westfund.

 * – subject to policy coverage

Non participating health funds

AHM (from 18 May 2015), GMHBA (including Budget Direct, Fit Health Insurance, Franks Health Insurance, RACT Health Insurance), Mildura District Health Fund , NIB, API Health, St Luke’s Health and Medibank Private (from 18 May 2015).

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What does it mean if I am a member of these participating health funds?

Inpatient procedures: If you have a procedure in a private hospital or accredited day surgery, your account will be sent directly to your fund for payment. You will not receive an account and will not be out of pocket.

Outpatient procedures: Private health insurance does not cover outpatient procedures. You will receive a TissuPath account for our services, part of which can be claimed through Medicare.

What if  I am a member of a non participating health fund?

Inpatient procedures: Non -participating funds will not enter into “no gap” billing arrangements and do not fully insure for inpatient pathology services.  If you have a procedure in a private hospital or accredited day surgery, you will receive a TissuPath account for our services. Most of the account has been claimed through your health fund and Medicare, but you may be out of pocket for the remainder of the bill.

Outpatient procedures: Private health insurance does not cover outpatient procedures. You will receive a TissuPath account for our services, part of which can be claimed through Medicare.

For any questions or account queries, please contact one of our friendly and helpful staff on (03) 9543 6111

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