Medicare Two-way claim form (MS001)

Use this form together with a Medicare claim form to submit your in-hospital and ancillary claims with Medicare and your private health fund.

Download and complete the Medicare Two-way claim form.

This form can also be used to claim gap benefits from your private health fund for in-hospital and ancillary services.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 10 August 2020