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.
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:
- by mail: Nurses & Midwives Health, GPO Box 3874 Sydney NSW 2001
- in person: at the Member Care Centre (in the Surry Hills Teachers Health Centre)
- via email: email@example.com
Once your claim has been approved, your benefit will be paid into your nominated bank account.
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.
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.