Claiming for Extras

Claiming for Extras

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note that our prices will increase from 1 April

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How to claim

We all want claiming to be fast and hassle-free – here are three ways to get the job done. While you're here, be sure to read our claiming must-haves too – this intel can help make the process as smooth as possible.

And please note that you can check your Extras limits any time via Online Member Services or our member app.

1. On the spot (HICAPS)

If your provider has HICAPS, they can swipe your Nurses & Midwives Health membership card and your claim will be processed straightaway. All you have to do is pay any remaining balance. 

Ask your service provider if they have HICAPS beforehand, so you know what to expect.

There are a few things you can't claim through HICAPS (including Orthodontia and Healthy Lifestyle programs.)

2. Member app

Log in to the Nurses & Midwives Health member app, take a (good quality) photo of your official receipt and submit your claim. And hey presto, it’s done!

Just make sure you keep your original receipt(s) for two years from the date you submit your claim.

  

3. Claim form

Complete a claim form, attach your invoice or receipt and submit it to us:

Once your claim has been approved, your benefit will be paid into your nominated bank account.

Claiming must-haves

​Use a recognised provider

You can only claim for services from recognised Australian providers – find one now.

If you're unsure about your provider, feel free to call us on 1300 344 000 so we can check they're recognised (before you start treatment or spend any money). 

Check your benefits (and limits)

Take a look at your Product Sheet to understand what your cover includes, so you know what you can and can’t claim for.

And keep an eye on your Extras limits (annual and lifetime) via Online Member Services or our member app.

 

Pharmaceuticals

We can only pay benefits for prescriptions that are:

    • prescribed by a Medical Practitioner or a dentist
    • supplied by a pharmacist in private practice or a Medical Practitioner
    • approved by the Therapeutic Goods Administration (the regulatory authority responsible for medicines and vaccines)
    • not covered by the Pharmaceutical Benefits Scheme (a government program that subsidises medicines to make them more affordable).

We know this one can be confusing – it's a good idea to ask your doctor if you may be able to claim for the medication they’re prescribing (given the above rules).

Healthy Lifestyle benefit

To claim the Healthy Lifestyle benefit, you’ll need a health professional (like a GP, specialist, physiotherapist, chiropractor or occupational therapist) to complete the practitioner section of the Healthy Lifestyle program form*, which you’ll also need to sign before submitting it to us.

*You don’t need to submit a form for health screenings or disease management subscriptions.

Get an official receipt

An official receipt is vital – no official receipt, no claim. The receipt needs to be on an official letterhead, or on a receipt stamped with an official provider stamp, and include the provider's:

  • full name, Practice Address and telephone number (must be included as part of the provider's letterhead or stamp and not handwritten)
  • company, trading name, ABN and/or ACN as applicable.

The receipt needs to be itemised with the following details:

  • patient’s full name and address
  • date of service(s) and where the service(s) took place
  • itemisation, description and cost of the service(s)
  • date the account or invoice was issued
  • details of amounts paid and outstanding balances.

 

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