How to make a health insurance claim
There are a number of convenient ways you can claim. These include:
Claiming for your Extras Services
Once you have had your treatment, or made a purchase (for example, a new pair of glasses), the next step is to make a claim. It's actually pretty simple. Your options are:
On-the-spot
Electronic claiming is the fastest way to claim your benefits. Around 20,000 dentists, physiotherapists, chiropractors, podiatrists, naturopaths, remedial massages therapists, acupuncturists and optical outlets around Australia provide this service. After your treatment, swipe your membership card and the claim will be processed automatically. There are no forms for you to complete and you'll only pay the balance of the account.
Claim online
Simply log into your online account at mymbf.com.au and enter your invoice details via the ‘claim online' section. We'll transfer the payment directly to your bank account (have your BSB and account number ready).*
Your Statement of Benefit will be sent to you in the mail.
Post
Fill out a claim form, attach your invoice and receipt and post to:
MBF Reply Paid 9809
Brisbane QLD 4001
and we'll make the payment by EFT or cheque.
If you have not provided your EFT details on the claim form, then a cheque will be sent directly to you.
Where there is an unpaid amount the cheque will be made out to you but you may still need to settle any outstanding amount with your provider.
Your Statement of Benefit will be sent to you in the mail.
*Not available for claims on ambulance, health aids and appliances, orthodontics, travel and accommodation, pharmacy or medical claims.
Claiming for your hospital expenses
For your hospital expenses - Use one of MBF's Network Hospitals and you might not even see a bill. The bill will be sent directly to us by the hospital so we can take care of the finances. If you do receive a bill from the hospital, just sent it to us with a claim form from your local MBF centre or download one from mymbf.com.au
All Hospital Statement of Benefits are issued on a weekly basis.
For your medical expenses that are incurred whilst you are a patient in hospital (for example, your specialist/doctors' fee) - this depends on whether your doctor uses MBF's Gap Cover Scheme. If they do, they'll bill us directly. We'll take care of the fees. 100% of the payment will be paid directly to the medical provider on your behalf. When your doctor uses MBF's Gap Cover Scheme, no cheques are sent directly to you.
If your doctor does not use MBF's Gap Cover Scheme, they may send you a bill for their services. You can then take it to Medicare and then MBF for payment.
If you take your claim to a Medicare office, Medicare will pay 75% of the Medicare Benefits Schedule. You then need to take your claim to an MBF centre where the remaining 25% of the Medicare Benefits Schedule is then paid.
Alternatively if you don't have time to visit Medicare, you can use a two-way claim form. When you complete one of these forms, Medicare will forward your claim directly on to MBF on your behalf. Both Medicare and MBF will send you a benefit.
When there is an unpaid amount - For any claims where there is an unpaid amount for any medical services, the cheque will be sent to you but will be made out to the provider/doctor who provided your medical services. You will be required to forward this onto the medical provider to settle the account for the medical services you received.
Your Statement of Benefit will be sent to you at the same time as the cheque.
Out-of-pocket expenses - If you have any out-of-pocket costs, your doctor should have informed you of these costs before your admission. In most cases with MBF's Gap Cover Scheme there is no gap. Just check with your doctor.
