Heading to hospital can be daunting enough without the prospect of unexpected bills. That’s why we have special agreements with providers in select locations across Australia to reduce your out of pocket costs when you go to hospital. These arrangements are for certain procedures and available to Australian residents only.
These No Gap^ services can be accessed if the procedure or treatment is included in your policy (and you've served any waiting periods). The only cost will be your Hospital excess, if you have one.
No Gap hip and knee replacements
nib Clinical partners
Did you know that the average hip or knee replacement costs around $25,000? Our Clinical Partners program, opens in a new tab offers members access to a network of experienced orthopaedic surgeons, who won’t charge you any extra costs. Providing your hospital cover includes total hip and knee joint replacement surgery (item numbers: 49518, 49521, 49318, 49321, 49519 and 49319), you will only pay the hospital excess for your procedure (partial hip and knee replacements are not covered).
If your surgeon thinks you’re eligible, you can also recover in the comfort of your home through our Rehab at Home service, with experienced physiotherapists and other allied health professionals coming to you.
The Clinical Partners program is currently available in most locations across Australia.
Search our network of Clinical Partners here to find one closest to you.
No Gap and Known Gap networks
MediGap network
nib MediGap, opens in a new tab aims to eliminate or reduce gap payments for specialist fees in hospitals for Australian resident nib members.
If your specialist chooses to participate in MediGap for your procedure, they agree to charge either a No Gap or a Known Gap of up to $500 for their services. This program is designed to provide you with clarity and peace of mind about potential costs so you can better manage your healthcare expenses. Ask your specialist if they'll participate in MediGap for you. Learn more about the MediGap network, opens in a new tab or Find a Provider, opens in a new tab who participates in MediGap.
GapSure Diagnostics
nib's GapSure Diagnostics network guarantees No Gap for inpatient radiology and pathology for eligible members. Under an agreement with diagnostic provider Healius Limited, opens in a new tab, there will be no out-of-pocket costs for hospital inpatient pathology and radiology services for eligible members.
Helius Limited’s state-based brands include QML Pathology, opens in a new tab, Laverty Pathology, opens in a new tab, Dorevitch Pathology, opens in a new tab, TML Pathology, opens in a new tab, Abbott Pathology and Western Diagnostic Pathology. Additionally, Healius Limited’s radiology division Lumus Imaging, opens in a new tab has a significant number of in-hospital facilities.
GapSure Cardiology
If you’re looking for a cardiologist, nib has partnered with a number of trusted providers to reduce your out of pocket expenses. Use our Find a Provider, opens in a new tab tool to find a GapSure Cardiologist near you.
nib's GapSure network guarantees No Gap for cardiology procedures to help limit your out of pocket costs. Ask your specialist if they are part of our GapSure network^.
If you’re covered for cardiology procedures, you may still need to pay your excess. An easy way to reduce your out of pocket expenses and make the most of your health cover is to attend an nib Agreement Hospital for your procedure.
Check the fees for your anaesthetist and assistant surgeon before you book surgery as they are not a part of this arrangement and could charge you an out of pocket cost.
GapSure Anaesthetists
nib's GapSure Anaesthetists network guarantees a No Gap or Known Gap up to $500 for anaesthetic services to help limit your out of pocket costs. Ask your specialist if they can work with an anaesthetist who is part of our GapSure network, or use our Find a Provider tool to find a GapSure Anaesthetist.
Our network of GapSure Anaesthetists is expanding.
^No Gap means there are no out-of-pocket costs for you to pay for your chosen cardiologist because we have an arrangement with this network of specialists that won’t charge you a fee above what we will pay for a cardiology procedure. Cover depends on level of cover, policy exclusions, waiting periods, hospital excess and limits and whether you go to an nib Agreement Hospital, a non-agreement private hospital or a public hospital. Out-of-pocket expenses may apply. For example, if your anaesthetist is not covered under nib’s GapSure, you will have to pay the gap fee.
