Find out the different ways you can make a Medicare claim after you’ve paid your doctor.
Claim Medicare benefits at your doctor’s office
The quickest and easiest way to claim is at your doctor’s office straight after you pay.
To do this you need to both:
If your doctor bulk bills, you don’t need to pay.
When you pay at the doctor’s office, ask if they can make an electronic claim for you. If they can, they’ll do it on the spot. We’ll process the claim as soon as possible and pay your Medicare benefit into either:
- the account for the EFTPOS card you used to pay
- the bank account you’ve registered with us.
If we’re paying into your bank account, we need your correct details. Find out how to update your Medicare details.
If you pay using cash, we’ll pay your benefit electronically into the bank account you have registered with us.
If you can’t claim at the doctor’s office, you can submit a Medicare claim online using either:
We can't accept online claims for services over 2 years old.
Using the Medicare online account
If you don’t have a myGov account linked to a Medicare online account, you’ll need to set them up.
When you submit a claim online, you’ll usually get your benefit within 7 days.
You can read our online guide about how to update your bank details using your Medicare online account.
Using the Express Plus Medicare app
You can make a claim with the Express Plus Medicare mobile app on your mobile phone. Don’t submit a claim if your doctor has done it for you.
To use the app, you need a myGov account linked to Medicare. If you don’t have these accounts yet, you’ll need to set them up.
Before you start your claim, make sure you have both:
- your account and receipt
- details of the service you want to claim.
When you claim, we’ll ask you to either give us or confirm your bank account details.
When you make a claim through the app, you’ll usually get your benefit within 7 days. We pay electronically into the bank account you have registered with us.
Find out how to download the Express Plus Medicare mobile app.
Claim Medicare benefits by mail
If you can’t claim at the doctor’s office or online, you can claim by mail. To do this, complete a Medicare claim form and post it to us. The address is on the form.
When you submit a claim by mail, you’ll get your benefit within 28 days. We pay electronically into the bank account you have registered with us.
Claim Medicare benefits at a service centre
You can also make a claim at a service centre. When you do we’ll pay you straight into your bank account. So it’s important to ensure your bank details are correct. We’ll confirm your bank details when you make your claim.
If you make a claim at a service centre, you’ll get your benefit within 28 days. We pay electronically into the bank account you have registered with us.
Claim Medicare benefits for someone else
You can claim for someone else if either:
- their name is on your Medicare card
- you’re managing their Medicare account.
When you claim for someone who’s on your Medicare card, you can claim in one of these ways:
- at the doctor’s office
- by mail
- at a service centre.
If they aren’t on your card, you’ll need to apply to manage someone else’s Medicare account. You can then claim by mail or at a service centre. You can’t claim online.
If we reject your claim, we’ll let you know. Reasons why we might reject a claim include:
- you or your doctor have already claimed it
- we need more details to assess your claim
- there was a mistake with your claim.
We may also reject a claim if you have already received the maximum allowable benefits for that service.
To find out more about why your claim was rejected, call the Medicare enquiries line.
Page last updated: 21 February 2020
This information was printed 24 October 2020 from https://www.servicesaustralia.gov.au/individuals/subjects/how-claim-medicare-benefit/medicare-claims. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.