Download and complete the Request for Medicare claims information form.
This form should only be used to request Medicare claims information from more than 3 years ago.
Access your Medicare claims information for at least the last 3 years through myGov.
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.