How do I make a claim on private health insurance?

Welcome to the hassle-free guide to make a private health cover claiming easier! We’re here to simplify the process for you.

Pre-Claim Checklist: 

Before you dive into making a claim, make sure you’ve got these bases covered:

Bank Details: Ensure we have your up-to-date bank details. That’s the secret for a seamless claim process so funds go right into your nominated account.

Know Your Coverage: Take a moment to check that your treatment or service is covered, and you’ve patiently served any waiting periods. Make sure you’re eligible for the services you’re claiming and that you have served relevant waiting periods for each service.

Timing Matters: You can’t claim in advance. So, make sure you’ve already had the treatment or service, and you’re within two years of the date of service.

Read the Fine Print: Read all the Terms and Conditions of your private health insurance, though often overlooked, these are a crucial part of the journey. Make sure you’ve read and agreed to the provider’s T&Cs.

Keep in Mind: Sometimes, your private health provider might need a bit more info to process your claim smoothly. So they may reach out for some extra details.

Ways to Claim: 

Now, let’s explore the avenues you can take to claim back some of your healthcare fees:

Online: If you’re the tech-savvy type, claiming online via your provider’s website on your desktop is the way to go. It’s like online shopping but for your health benefits.

Membership Card: For those who prefer the old-school choice of presenting a physical card, most extras providers offer the convenience of on-the-spot claiming using your membership card in store.

Via Traditional Mail: Simply send your provider a letter with your completed claim form and the original invoices or receipts. 

Mobile App: If you have a smartphone, simply download your provider’s app, and your digital card to make your claim. This option is effortless at health providers with a HICAPS machine.


Q: What’s a Benefit?

A: It’s the reimbursement private health funds give back to you for a service or treatment you’ve had. Think of it as a health bonus – you deserve it!

Q: How Much Will I Get Back from an Extras Claim?

A: The amount depends on a few things, like the item number of the service, your level of cover, and how much you’ve already claimed in the calendar year. 

Q: How Long Does Claim Processing Take?

A:Claims typically take about 7 working days to process. Once we’re done, the private health fund will deposit your benefit into your chosen bank account. 

Still Confused? Talk to Us!

If you’re still unsure how to make a claim for a hospital stay, extras treatment or ambulance journey speak to us today on 1300 861 413 or email us

We will assist you with finding the best private health insurance provider. 🎉🏥💪

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