Confused about how to claim on your private health insurance? Find out how to go about lodging health insurance claims.
Private health insurance provides financial protection against a wide range of medical costs, including everything from hospital accommodation and theatre fees to visits to the dentist. But do you know how to claim on your private health cover?
The health insurance claims process can be a little bit confusing and varies depending on the type of service you are claiming, so let’s take a closer look at what you need to do to ensure that your medical costs are covered.
What are the different options available for people wanting to claim?
The options available when you need to make a claim vary depending on the type of claim you want to make and your health fund. You can make an extras claim in the following ways:
- At the health care provider. All you have to do is swipe your health fund membership card when you need to pay for the service.
- Online. Many funds offer online claiming services where you can submit the details of your claim and any receipts.
- Via an app. An increasing number of private health funds offer dedicated claims apps.
- Via email. Some health funds allow you to submit claim details via email.
- Via post. You also have the option to download a claims form from your health fund’s website, print it out and complete and sign it before returning the form back to your fund via post.
- At a branch. Some health funds also allow you to make health insurance claims by visiting a branch.
If you wish to make a claim for medical costs or bills from your surgeons and doctors, the process you need to follow will differ depending on whether or not the doctor participates in your fund’s gap cover scheme. If they do, the doctor will automatically send your bill to Medicare and your health fund for payment.
However, if your doctor doesn’t participate in your health fund’s gap cover scheme, you will be sent the bill. You will then need to take the relevant paperwork to Medicare before forwarding the claim on to your health fund.
Finally, if you are hospitalised for a procedure that is covered by your policy, the only payment you will have to make will be to cover any excess or co-payments that apply.
Claiming options for funds in the finder.com.au panel
Do you need to make an extras claim with your health fund? The table below lists the options available for lodging a claim with several of Australia’s leading health funds.
|Fund||How to lodge health insurance claims with Aussie funds||More info|
|There are three ways you can lodge an extras claim with HIF:|
|AHM offers three options for lodging an extras claim:|
|Australian Unity||Australian Unity offers the following extras claiming options:|
|You can claim extras using the following methods:|
|HCF offers the following options when you need to make an extras claim:|
|Extras claims with health.com.au can be lodged in the following ways:|
|nib offers several options when you need to make an extras claim:|
|You can use any of the following methods to claim an extras service with Transport Health:|
Want to claim through your fund's app?
Check out the table below to see if you fund has a health insurance app:
|Health Care Insurance|
|Mildura Health Fund|
|Phoenix Health Fund|
|Reserve Bank Health Society|
|Teachers Health Fund|
How to claim the Private Health Insurance Rebate
The Private Health Insurance Rebate is a Federal Government incentive that was introduced to encourage more Australians to take out private health insurance. The rebate makes the cost of health insurance more affordable and it applies to hospital, extras and ambulance cover policies.
You’ll need to satisfy an income test to qualify for the rebate, so check the table below to see what level of rebate you are eligible for in the current financial year.
The rebate levels applicable from 1 April 2016 to 31 March 2017 are:
< Age 65
< Age 65
The rebate can be claimed every year in one of two ways:
- You can opt for a discounted premium from your health fund. You will need to inform your insurer how much income you earn in order to receive the correct rebate.
- You can claim it on your income tax return. Your insurer provides you with a statement at the end of each financial year that you can use to apply for the correct rebate.