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If you are referred by a GP to a public hospital specialist clinic (e.g., at The Royal Melbourne or St Vincent’s), the treatment is generally covered by your OSHC with no "gap" fee.
In 2026, Victoria has expanded its network of Priority Primary Care Centres (PPCCs) and Urgent Care Clinics.
Some private specialists choose to "Direct Bill" the insurer, but this is rare.
In 2026, several telehealth-only specialist platforms have launched. Because they don't have the overhead costs of a physical office, their "gap fees" are often much lower (sometimes $20–$50) compared to the $150+ fees of in-person specialists in the CBD.
Remember that for pre-existing conditions, OSHC providers usually have a 12-month waiting period. If you try to see a specialist for a condition you had before arriving in Australia, your insurer may refuse to pay their 85% share, leaving you with the 100% bill.
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