Reviews and appeals about your Medicare debts or overpayments
There are steps you can take if you disagree with a decision about a Medicare debt or overpayment.
Your review rights
If you think a decision about your Medicare debt or overpayment including Dental Benefit or Pharmaceutical Benefit is wrong, you can either:
- call us so we can check the details and explain our decision
- give us new information
- complete the Review of a Medicare decision form to request an internal review.
You must ask for a review within 28 days from when we tell you about our decision.
If you’re not happy with the outcome of the review, you can either:
- make a complaint to the Commonwealth Ombudsman
- appeal through the court.
You can make a complaint to the Commonwealth Ombudsman if you’re not happy with the outcome of the review.
The Ombudsman can look at whether our decision or actions were fair and reasonable in the circumstances.
If you’ve already sought a court appeal, the Ombudsman needs special reasons to investigate it too. They may choose not to investigate a complaint if rights of review by a court or tribunal exist and you haven’t used them.
Read more about how to make a complaint on the Commonwealth Ombudsman website.
You have the option to seek a court review if you aren’t happy with the internal review outcome.
This is on questions of law under the Administrative Decisions (Judicial Review) Act 1977 to the Federal Court or Federal Circuit Court.
You should submit your application with the Federal Court Registry within 28 days of getting the review decision in writing. They may accept a late application in some circumstances.
For more information you can either:
- contact the Federal Court Registry in your state or territory
- visit the Federal Court of Australia website
- seek legal assistance.
Page last updated: 25 February 2020
This information was printed 14 January 2021 from https://www.servicesaustralia.gov.au/individuals/topics/reviews-and-appeals-about-your-medicare-debts-or-overpayments/34661. 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.