How to claim on Health Insurance

Claim on extras treatments

Extras treatments include things like dental, optical, physiotherapy, remedial massage and natural therapies.

Not sure which extras you can claim on or how much you can claim? Log in to your account to find out what’s included for your cover.

With most extras claims, the money will be credited to your nominated bank or credit union account within 2-3 business days, and you’ll receive an SMS to let you know when payment has been made.

 

Ways to claim

Claim On-the-spot

If your extras provider has a HICAPS or CSC machine, simply swipe your Australian Unity membership card on the spot.

Once your claim is authorised, you simply pay any difference between the Australian Unity benefit and your provider’s fee.

App or online

You can claim up to $300 at a time:

  • Use the mobile claiming app for quick claiming — simply upload photos of your receipts and we’ll do the rest.
  • OR, log in to your account to submit your claim.

Available on the App Store Available on the App Store

On the phone

If you have questions or need help filling out your claim form, call Australian Unity to get your claim processed over the phone:

1800 807 144
Monday to Friday, 8:30am to 5pm AEST

Mail, Email or Fax

  1. Complete a health cover claim form.
  2. Attach your receipts to the form.
  3. Send the completed form and receipts to Australian Unity (you can find the reply paid address, email address and fax number on the claim form).

Claim on emergency ambulance

Depending on your level of hospital cover, you may be able to claim for emergency ambulance transportation or for ambulance attendances where you are not taken to hospital.

Not sure whether you can claim on emergency ambulance? Log in to your account to view details about your health cover.

How to claim

  1. Complete a health cover claim form.
  2. Attach your ambulance receipt to the form.
  3. Mail or fax the completed form and receipt to Australian Unity (you can find the reply paid address and fax number on the claim form).

Once your claim is approved, the money will be credited to your nominated bank or credit union account and you’ll receive an SMS to let you know when payment has been made.

Note that if you haven’t nominated an account for your claims payments, you can do that here.

 

Claim on hospital procedures

The hospital procedures (including day surgeries) that you can claim on will vary depending on your level of cover:

Not sure which hospital procedures you can claim on? Log in to your account to view details about your health cover.

Accommodation and theatre fees

Most private hospitals and day facilities have an agreement with Australian Unity, which guarantees that you’ll be covered for 100% of the accommodation and most other services like theatre fees.

Search the list of agreement hospitals

In most cases, the hospital will bill Australian Unity directly, and all you’ll need to pay is any excess or co-payment that applies to your cover.

Medical costs

The way you claim the bills from your surgeons and other doctors will vary depending on whether they’re participating in Australian Unity’s Gap Cover scheme.

Participating doctors

Will send your bill to Medicare and Australian Unity for payment. You’ll only receive a bill if there is any money still owing after Medicare and Australian Unity have paid your doctor.

Non-participating doctors

Will present you with a bill for payment. You then need to

  1. Take your paperwork to Medicare, and get them to issue a cheque for your doctor and medical statement for Australian Unity.
  2. Complete an Australian Unity health cover claim form and attach the medical statement from Medicare.
  3. Mail the form and medical statement to Australian Unity (you can find the reply paid address on the claim form). When your claim is approved, Australian Unity will send you a cheque for your doctor.
  4. Send the Medicare and Australian Unity cheques, together with any amount still owing, to your doctor.

If your surgeon requests full payment up front, you can follow the process described above for non-participating doctors. Just provide Medicare and Australian Unity with proof that the bill has been paid, and they’ll issue the cheques in your name.