Medicare two-way
Medicare two-way is an Australian Government initiative designed to make lodging health claims easier for people with private health insurance. Under Medicare two-way you can lodge all your in-hospital and ancillary claims either with your participating private health insurer or with us.
Participating health insurers
Over 35 funds participate in Medicare two-way. A complete list of participating insurers is available below. You can also ask at your local Medicare Service Centre.
- ACA Health Benefits Fund (ACA)
- Australian Health Management Group (AHM)
- Government Employees Health Fund (GEH)
- Illawarra Health Fund (IHF)
- Australian Country Health (ACH)
- Mutual Health (MHF)
- Overseas student Health Cover (OSH)
- Australian Unity Health Limited (AUH)
- BUPA Australia Health Pty Ltd (BUP)
- HBA (HBA)
- ANZ Health (ANZ)
- Mutual Community Limited (MCL)
- TIO (formerly Territory Mutual) (TIO)
- The Card Members Health Insurance Plan AMEX (AMX)
- CSR Health Plan (CSR)
- Super Members Health Plan (SMH)
- Cessnock District Health Benefits (CDH)
- CBHS Friendly Society Limited (CBH)
- CUA Health (CHF)
- Defence Health Limited (DHF)
- The Doctors' Health Fund Limited (AMA)
- GMF Health (GMF)
- GMHBA Limited (GMH)
- Health Care Insurance Limited (HCI)
- Health Insurance Fund of WA (HIF)
- Health Partners Inc. (SPS)
- Hospital Benefit Fund WA (HBF)
- Hospitals Contribution Fund of Australia Limited (HCF)
- Latrobe Health Services (LHS)
- PeopleCare Health Insurance (LHM)
- MBF Alliances Pty Limited (SGI)
- NRMA Health Pty. Ltd. (NRM)
- SGIC Health
- SGIO Health
- Medibank Private Limited (MPL)
- Medical Benefits Fund of Australia Limited (MBF)
- Mildura District Hospital Fund Limited (MDH)
- Navy Health Limited (NHB)
- NIB Health Funds Limited (NIB)
- Phoenix Health Fund Limited (PHF)
- Police Health (POL)
- Onemedifund (OMF)
- Queensland Country Health Limited (QCH)
- Queensland Teachers Union (QTU)
- Railway & Transport Health Fund Ltd (RTH)
- Reserve Bank Health Society Limited (RBH)
- St Lukes Medical and Hospital Benefits Association LTD (SLM)
- Teachers Federation Health Ltd. NSW (TFH)
- Transport Health (TFS)
- Westfund (WDH)
Lodging with us
To lodge your Medicare two-way claim at a Medicare Service Centre you will need to:
- complete a Medicare claim form [PDF, 318Kb] and a Medicare two-way claim form [PDF, 144Kb] - also available at a Medicare Service Centre
- attach your original accounts, and receipts if paid, and
- place them in the 'drop box' or lodge it with a Customer Service Officer.
We’ll pay your Medicare claim and forward your private health insurer claim to your private health insurer for processing. Private health insurer payments will be paid by either Electronic Funds Transfer (EFT) or cheque. You’ll need to check with your private health insurer if they offer EFT facilities.
Note: if you visit your local Medicare Service Centre to claim your benefit in person and your account is paid in full, you don’t need to complete a Medicare claim form.
Lodging with private health insurer
To lodge your Medicare two-way claim with your private health insurer you’ll need to:
- complete your private health insurer’s claim form
- complete a Medicare claim form [PDF, 318Kb] - also available from your private health insurer
- attach your original accounts, and receipts if paid, and
- lodge the form with your private health insurer.
Your private health insurer will forward your claim to us. We’ll pay your Medicare claim and forward your private health insurer claim to your insurer for processing. Private health insurer payments will be paid by either EFT or cheque.
Note: under the two-way agreement private health insurers don’t collect one another’s forms.
Lodging an ancillary claim at a Medicare Service Centre
Ancillary claims, including dental, optical and physiotherapy, don’t attract a Medicare benefit. However, as part of the Medicare two-way program, you can complete a Medicare two-way form, attach the original accounts and receipts and lodge your ancillary claim at your local Medicare Service Centre. Your claim will be forwarded to your private health insurer for payment.
More information
For more information about claiming, visit our Medicare claiming section or call us on 132 011.
Note: we can advise you about participating insurers but can’t answer private health insurer enquiries. If you have questions about private health insurer claims, please call your private health insurer.