How Medicare Claims Work
When you receive a Medicare-eligible health service, you (or your provider) need to lodge a claim with Services Australia to receive your rebate. In many cases — particularly with bulk billing — your provider does this automatically. But when you pay upfront, you'll need to claim the rebate yourself.
The rebate amount is based on the MBS Schedule Fee for the service, not necessarily what your provider charged. If your provider charged more than the Schedule Fee, you'll receive a rebate on the Schedule Fee portion only, and pay the difference (the "gap") yourself.
Ways to Lodge a Medicare Claim
1. Online via myGov
This is the most convenient method for most people. To claim online:
- Log in to your myGov account and go to Medicare.
- Select "Make a claim."
- Enter your service details and upload a photograph or scan of your invoice/receipt.
- Submit the claim and choose your bank account for the rebate deposit.
Online claims are typically processed within 7 business days, with the rebate deposited directly into your nominated bank account.
2. Express Plus Medicare App
The Express Plus Medicare mobile app allows you to submit claims quickly from your smartphone. The process mirrors the myGov method: photograph your receipt, enter details, and submit. Rebates are paid directly to your registered bank account.
3. At the Doctor's Practice (EFTPOS Claiming)
Some practices offer on-the-spot claiming using your Medicare card and a linked bank account via EFTPOS. You pay your doctor, then immediately receive your Medicare rebate back to your card — all in the one transaction.
4. In Person at a Medicare Service Centre
You can visit a Services Australia service centre and submit a paper claim form along with your original receipt. This is useful if you're not comfortable with digital options.
5. By Post
Send a completed Medicare claim form and your original receipt to Services Australia by post. This is the slowest method and is generally only recommended if other options aren't accessible.
Time Limits for Claiming
Medicare claims must generally be lodged within 2 years of the date of service. Don't leave it too late — if you've paid for health services, make sure to claim your rebate promptly.
Understanding the Medicare Safety Net
The Medicare Safety Net is a crucial protection for Australians who have high out-of-pocket medical costs over a calendar year. Once your out-of-pocket costs reach a certain threshold, Medicare increases its rebates for the remainder of that calendar year.
Types of Safety Net
- Original Medicare Safety Net: Applies to out-of-hospital services. Once your family's gap costs reach the threshold, Medicare pays 100% of the MBS Schedule Fee for the rest of the year.
- Extended Medicare Safety Net (EMSN): Once your family's out-of-pocket costs reach the EMSN threshold, Medicare pays 80% of any further out-of-pocket costs for out-of-hospital MBS services (up to a benefit cap for some items).
Thresholds are indexed each year, so check the current figures on the Services Australia website. Families and couples can register to have their costs combined toward the Safety Net threshold, reaching it faster than individuals claiming separately.
Registering for the Safety Net
Singles are automatically registered. Families and couples need to register by contacting Services Australia (via myGov, phone, or in person) so that all family members' costs are pooled together.
Tips for Maximising Your Rebates
- Always ask your provider if they bulk bill — especially for pathology and imaging.
- Keep all medical receipts and invoices; you have 2 years to claim.
- Register as a family for the Medicare Safety Net if you have dependants.
- Link your bank account to Medicare via myGov so rebates are paid quickly.
- Use the Express Plus Medicare app for fast, convenient claiming on the go.
Claiming your Medicare rebates is straightforward once you know the options. Whether you choose the app, myGov, or an in-person visit, make sure every eligible service is claimed — it's money you're entitled to.