Compare No-Gap Hospital Cover
This table shows how many medical services are covered with no out-of-pocket costs, broken down by state and fund. The higher the number, the better the coverage. No more guessing—see who actually pays when it matters.
| State | NIB | HCF | Australian Unity | GMHBA | Frank | HIF | HCI | AHM | Real Health | Seniors Health |
|---|---|---|---|---|---|---|---|---|---|---|
| ACT | 77.2% | 71.8% | 76.5% | 50.1% | 50.1% | 60.9% | 66.3% | 73.8% | 77.2% | 77.2% |
| NSW | 93.1% | 87.8% | 91.0% | 84.3% | 84.3% | 88.9% | 83.5% | 86.5% | 93.1% | 93.1% |
| VIC | 90.0% | 85.7% | 91.4% | 87.4% | 87.4% | 89.2% | 88.8% | 83.8% | 90.0% | 90.0% |
| QLD | 88.1% | 83.5% | 90.1% | 84.1% | 84.1% | 88.6% | 90.8% | 81.5% | 88.1% | 88.1% |
| SA | 94.8% | 83.4% | 89.5% | 83.6% | 83.6% | 83.9% | 85.9% | 80.0% | 94.8% | 94.8% |
| WA | 93.3% | 82.2% | 89.8% | 87.5% | 87.5% | 89.6% | 92.1% | 76.2% | 93.3% | 93.3% |
| TAS | 95.0% | 90.4% | 90.6% | 77.8% | 77.8% | 88.6% | 92.8% | 89.2% | 95.0% | 95.0% |
| NT | 79.3% | 76.8% | 78.3% | 81.7% | 81.7% | 79.8% | 76.9% | 80.5% | 79.3% | 79.3% |
What Is No-Gap Cover?
No-gap cover refers to a health insurer’s agreement to fully cover the cost of certain hospital and medical services—so you’re not left with an out-of-pocket bill.
When you go to hospital, your doctor or hospital may charge more than what your fund covers. The difference is called “the gap,” and without a no-gap agreement, you may have to pay that difference yourself.
Some funds have “known gap” arrangements, where you still pay a set amount (e.g. $500) even when you’re insured. These are allowed, but not always clearly explained.
What many don’t realise is that no-gap performance varies by fund and by state. A fund may cover 95% of services gap-free in NSW, but only 75% in SA.
To help you compare, we’ve used data from the official Ombudsman’s audit, showing how well each fund performs in covering medical services with no gap.
This is factual, publicly available data—not a policy sales pitch. Use it to check whether your insurer is likely to cover you fully when it counts.
