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5 Tips for Making a Claim

Diana Bui June 5th, 2012 0 comments

Although we have health insurance, we really hope we don’t have to use it but most of us do have to, at least once in a while. When we do have to, we must claim with our health fund in order to reimbursed. Making a claim today is easier than ever in many cases, but it still requires some effort on your part. Since we all want to get the most out of our benefits and pay the least amount we have to, here are five tips for making a health insurance claim.

Photo: DIAC Images/Flickr.

1. Don’t Delay

Time is of the essence when it comes to making a claim. The more quickly you do it, the easier it is, and most health funds require you to make a claim within two years of an accident, illness or procedure.

Claiming electronically at the time of your appointment is the fasted way to claim. Many health care providers in Australia provide this service. After your treatment, you simply swipe your card and your claim will be processed. You will only pay the difference between the provider’s fee and your benefit.

2. Know Your Information

When you file a claim, you’re going to need to know or have access to some information including your member number, the location of your appointment, the name of your health care provider, type of procedure, date of event, and any third party information (such as if you were involved in an accident with another person).

Many health funds now offer a service in which your money can be directly deposited into your financial account. If you are filing a claim and want this to be done, be sure to have your account and financial institution information on hand.

3. Go Online

Most health fundss now offer claim filing online. As long as you have all your information handy, this is an easy way to file your claim from the comfort of your own home. You can have your benefit transferred directly to your bank account.

4. Plan Ahead

If you know you are going to have a certain health procedure or are considering one, check with your health fund about your cover. This way you will know ahead of time if your claim will even be accepted and how much you will be responsible for paying.

If you have just started cover with a fund, there may be a waiting period before certain procedures are covered. A simple call to your insurance company can help you fully understand your benefits and how to go about filing a claim for a procedure you may have in the future.

5. Medicare Two-Way

In an attempt to make lodging health claims easier for people with private health insurance, the Australian Government came up with the Medicare two-way initiative. This program allows users to lodge all in-hospital and ancillary claims either with their participating private health insurer or with Medicare Australia. Understanding Medicare two-way can be helpful when filing a claim. Visit to learn more.

Filing a health insurance claim no longer means filling out numerous forms and waiting forever for payment. Often, it’s as easy as swiping a card. Just be sure to understand your plan and benefits and filing a claim won’t be any trouble at all.

Disclaimer: The above information is correct and current at the time of publication.

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