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Medical Gap

Note: This page is a representation of information published on the PHIAC website prior to 1 July 2015. This information is provided for reference and research purposes only. 

This report collates medical gap data for insurers. Insurers are allowed to pay a benefit in excess of the Medicare Benefits Schedule fee for medical services where they have an agreement with the medical service provider. This allows funds to provide no gap or known gap, in-hospital medical services to insured patients.
Note: Statistics are released approximately six weeks after the end of the quarter.

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Previous Releases

​Release ​PDF Spread sheet​
​March 2015
Gap Mar 15 Gap Mar 15
​December 2014
Gap Dec 14 Gap Dec 14

November 2014​

Gap Sep14

​Gap Sep14
​June 2014

Gap Jun14

Gap Jun14
​March 2014

Gap Mar14

Gap Mar14

​December 2013

​Gap Dec13 Gap Dec13
September 2013
Gap Sep13 Gap Sep13
June 2013
Gap Jun13 Gap Jun13
March 2013
Gap Mar13 Gap Mar13
December 2012
​Gap Dec12 Gap Dec12
September 2012
Gap Sep12 Gap Sep12
June 2012
Gap Jun12 ​Gap Jun12


To obtain older statistics click on Archived Medical Gap.