How do I make a claim on my hospital cover?

Hospitals

If your cover has an excess, you will need to pay it directly to the hospital before or on admission.

Our contracted hospitals usually charge us directly and we’ll advise you when we’ve paid the invoice on your behalf. If this is not the case, you can submit the Medicare Statement of Benefits along with a completed claim form via any of the following channels.

1. The TUH app -simply upload a photo!

2. Email us at online.claims@tuh.com.au.

3. Post directly to us.

You may receive separate invoices from the hospital, each of your doctors, and each of the other medical practitioners, or some of these services may be grouped on a single invoice. Your claim will be paid directly into your bank account.  

Doctors

If you doctors or specialist has agreed to charge you under the Access Gap Cover Scheme, they'll usually send invoices directly to us and we’ll pay them for you. 

If your doctor doesn't use Access Gap Cover, they may send you the invoice instead. You can take this to Medicare and then to us for payment. Just use our claim form and make sure you include the “Statement of Benefits” from Medicare with your claim. Medicare will pay 75% of the Medicare Benefits Schedule (MBS) Fee and we will pay the remaining 25% of the MBS Fee. You will need to pay any amount the doctor charges above the MBS Fee. 

Other medical practitioners

Other medical practitioners will usually send you an invoice for payment, which you should submit with your claim to Medicare along with any payment receipts. There are two ways you can do this:

1. Submit your claim to Medicare. When you receive your Medicare Statement of Benefits, send it to us with your TUH claim form and original accounts.

2. Submit your claim to Medicare along with a Medicare Two-way claim form, and they’ll forward your claim to us.