Makes submitting health claims easier, if you have private health insurance.
Participating health insurers
Check with your fund to see if they participate in Medicare Two-way.
Under Medicare Two-way you can submit your in-hospital and ancillary claims either with your participating private health insurer or us.
Submitting with us
To submit your claim at a service centre you need to:
- complete a Medicare claim form and a Medicare Two-way claim form
- attach your original accounts and receipts if paid
- lodge your claim at a service centre or post it to the address on the Medicare Two-way claim form.
We'll process your Medicare claim and, if payable, forward your private health insurance claim to your private health insurer. Your private health insurer will pay you by cheque or Electronic Funds Transfer (EFT). You need to check with your private health insurer if they offer EFT.
You don’t need to complete a Medicare claim form if:
- you visit a service centre to claim your benefit in person
- you've paid your account in full.
Submitting with private health insurer
To submit your Medicare Two-way claim with your private health insurer you need to:
- complete your private health insurer’s claim form
- complete a Medicare claim form
- attach your original accounts, and receipts if paid
- submit the forms with your private health insurer.
Your private health insurer will forward your claim to us. We'll process your Medicare claim and if payable, we’ll forward your claim to your private health insurer. Your private health insurer will pay you by cheque or EFT.
Under Medicare Two-way, private health insurers don't collect each other’s forms.
Submitting an ancillary claim at a service centre
Ancillary claims, including dental, optical and physiotherapy, don't attract a Medicare benefit. However, as part of the Medicare Two-way program, you can:
- complete a Medicare Two-way form
- attach the original accounts and receipts
- submit your ancillary claim at a service centre.
Your claim will be forwarded to your private health insurer for payment.
Read more about Medicare claiming.
Page last updated: 12 August 2020
This information was printed 24 November 2020 from https://www.servicesaustralia.gov.au/individuals/subjects/medicare-two-way. 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.