HICAPS: how it works and where it can be used

Rather than wait to be reimbursed, HICAPS lets you claim benefits on the spot.

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Rather than submitting your extras claim online and waiting to get reimbursed, HICAPS lets you claim your benefits there and then at the healthcare provider. Lots of providers have a HICAPS machine these days and it can be used for several different services including dental, chiro and physio.

Compare extras cover with HICAPS discounts

What is HICAPS?

HICAPS is an acronym for Health Industry Claims and Payments Service. It’s an electronic health claims system that allows you to claim Medicare, WorkSafe Victoria, or private-health Extras benefits at the time of payment.

When a service provider gives you the bill for your treatment, you hand them your Medicare, WorkSafe Victoria, or health-fund membership card, and they swipe it through an electronic HICAPS machine. The machine then automatically processes your claim. If you are claiming from your health fund, its contribution will be processed on the spot, and you pay the remaining gap if applicable.claim.

HICAPS covers most ancillary services from a variety of providers including participating doctors, dentists, optometrists, chiropractors and physiotherapists.

Which funds use HICAPS?

HICAPS is a service provided by most Australian health funds. These include:

What services can be claimed on HICAPS?

The following list summarises the services that can be claimed through HICAPS by some of the leading health funds.

Health FundAcupuncturistDieticianExercise PhysiologistMyotherapistNaturopathOccupational TherapistsPsychologistRemedial Massage Therapist
AHM logoahm health insurance
CUA logoCUA Health
NIB Health logo
Medibank logoMedibank Private
Suncorp logoSuncorp
Qantas logoQantas Health Insurance
Australian Defence Force Family Health logoAustralian Defence Force Family Health
Australian Unity logoAustralian Unity
Apia logoAPIA
Bupa logoBupa
CBHS health insurance logoCBHS Health Fund
CBHS Corporate logoCBHS Corporate
Defence_Health_Logo_100Defence Health
Emergency Services Health logoEmergency Services Health
Frank health logoFrank
GMHBA health fund logoGMHBA
GU Health logoGrand United Corporate Health
Health Care Insurance logoHealth Care Insurance
HIF health insurance logoHIF
Health Partners logoHealth Partners
Latrobe Health Services logoLatrobe Health Services
Mildura logoMildura Health Fund
Navy Health Logo
Navy Health
Nurses & Midwives Health logoNurses & Midwives Health
Peoplecare Health Insurance logoPeoplecare Health Insurance
Phoenix health fund logoPhoenix Health Fund
Police health logoPolice Health
Queensland Country Health Fund logoQueensland Country Health Fund
RT Health Fund logoRT Health Fund
St.lukes health logoSt.Lukes Health
Doctors' Health Fund logoDoctors' Health Fund
Teachers Health logoTeachers Health
Transport Health logoTransport Health
UniHealth logoUniHealth
Westfund logoWestfund


If you appreciate the convenience of paying for your extras treatments via HICAPS you’re going to love the new HICAPS Go app.

Recently launched in Melbourne, HICAPS Go is a one-stop healthcare app that allows you to locate practitioners, get quotes, pay for your consultation and claim your private health benefit all from your smartphone or mobile device.

What is HICAPS Go?

HICAPS Go takes the current NAB-owned HICAPS payment and claiming terminal system to the next digital level. Developed in partnership with Medipass, an Australian tech firm specialising in digital health payment solutions, HICAPS Go currently has over 400 practitioners on its platform.

The service focuses on allied health professionals such as physiotherapists, chiropractors, myotherapists, osteopaths, podiatrists and remedial massage therapists in the greater Melbourne area and there are plans to expand this to include dentists and optometrists as well.

While the current HICAPS service manages patient claims and payments through a terminal installed in the practitioner’s clinic, HICAPS Go is a digital platform that runs either through the practitioner’s PMS (Payment Management System) or via the Medipass portal on their PC or mobile device.

Only Medibank Private and AHM are currently available on the app, but the developers are in discussions with the other funds and expect more to be onboard very soon.

Benefits of HICAPS Go

The app has a range of benefits for both patients and practitioners.

Benefits for patients include:

  • Find a preferred provider in your area using location services
  • Get a quote and see your benefit contribution and any out-of-pocket costs upfront
  • Make an appointment and manage your booking
  • After the consultation, instantly claim your benefit and pay only the gap portion

Benefits for practitioners include:

  • Reduced administration time, freeing you up for more time with patients
  • Improved patient trust through greater cost transparency
  • No additional transaction charge for existing HICAPS customers

How to get HICAPS Go

Existing Medibank and AHM customers can start using HICAPS Go straight away. Simply download the app from the Apple App or Google Play store. You will need to have iOS 8.0 or later for Apple devices or 4.1 or later for Android users.

Then just enter your private health membership details and credit or debit card payment details. Once your account is set up, you can start making claims and payments immediately on your device simply by tapping “Approve” once a practitioner has created a claim.

Compare extras policies that let you take advantage of HICAPS

Picture: Shutterstock

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