The ‘Gap’
The Government has a list of fees for services known as the Medicare Benefits Schedule (MBS). Medicare pays 75% of the MBS, and nib pays the remaining 25% as a benefit towards your doctors’ bills, provided the procedure is not excluded on your cover. Some doctors and specialists charge more than the MBS. If this happens, you have to pay the ‘gap’, which is the difference between the MBS and what the doctors charge.
nib MediGap Scheme
The nib MediGap Scheme aims to eliminate the ‘gap’ for nib customers. We’ve built up a network of doctors and specialists who charge nib directly, at no additional cost to you.
Medicare still pays 75% of the MBS, and nib pays the remaining 25% plus an agreed amount set by the nib MediGap Schedule (but not for excluded procedures).