How is a health insurance claim assessed?
Find out how your claim is assessed and what’s involved
In Australia, we’re lucky to have a public health care system – Medicare – that gives us access to medical services, subsidised prescriptions and free care as a public patient in a public hospital.
Regardless of whether you’re treated in a private or public hospital, if you’re admitted as a private patient, Medicare pays 75% of the Medicare Benefits Schedule (MBS) fee for medical costs associated with your treatment and your private health insurance pays the remaining 25% of the MBS fee.
So, if you need to make a Medicare claim – what’s the simplest way to do it?
At nib, we like to keep things simple, so we’ve put together an easy-to-follow guide for claiming Medicare.
An out-patient is someone who receives medical treatment, but has not been admitted to hospital. If you’re an out-patient, you can claim Medicare by following these steps:
An in-patient is someone who is admitted to hospital for treatment. To claim Medicare as an in-patient, follow these steps:
If you are going to hospital, make sure you check out nib’s Going to Hospital Page. We’ve put together all the key things you need to know about health insurance and what you can to do reduce any out-of-pocket expenses.