Medicare Two-way

Participating health insurers

Check with your fund to see if they participate in Medicare Two-way.

Submitting claims

Under Medicare Two-way, you can submit your in-hospital and ancillary claims with either your participating private health insurer or us.

If you submit with us

If your Medicare online account is linked to myGov, you can submit your claim online.

To do this:

1. Complete a Medicare Two-way claim form.
2. Sign in to myGov.
3. Attach an image of your original accounts and receipts if paid, and your completed Medicare Two-way form, then submit your claim.

Sign in to myGov

You can also claim by:

• using the Express Plus Medicare mobile app
• visiting a service centre
• mail to the address on the form.

To submit your claim at a service centre, follow these steps:

1. Complete a Medicare claim form and a Medicare Two-way claim form.
2. Attach your original accounts and receipts if paid.
3. 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 the 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.

If you submit with a private health insurer

To submit your Medicare Two-way claim with your private health insurer, you need to follow these steps:

1. Complete your private health insurer’s claim form located on their website.
2. Complete a Medicare claim form.
3. Attach your original accounts and receipts if paid.
4. 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 it 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.

If you submit 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 follow these steps:

1. Complete a Medicare Two-way form.
2. Attach the original accounts and receipts.
3. Submit your ancillary claim at a service centre.

Your claim will be forwarded to your private health insurer for payment.

Getting more information

Find out about participating insurers by phoning us on the Medicare program line, or visiting a service centre.

Read more about Medicare claiming.