Paying back Medicare benefits when you get compensation

When you get compensation for an injury or illness, you aren’t eligible to also receive benefits that relate to that injury or illness.

You may have to repay:

  • Medicare benefits
  • nursing home benefits
  • residential care subsidies, and
  • home care subsidies

Your Medicare history statement

Your Medicare history statement will list all services you’ve used since your injury or illness. This lets you name the services used for your claim. It is used to calculate what you must repay.

Getting a Medicare history statement

A Medicare history statement will be sent to you when you register your compensation case with us.

You’ll only need to request your Medicare history statement if your case has not yet settled and you need information about your Medicare history.

If you need a Medicare history statement, you, your solicitor or the person paying your compensation will need to fill out a Medicare History Statement request form.

We’ll send the Medicare history statement to you. If you want it sent to another person, fill in a Third party authority form.

You’ll also get a declaration form to confirm if you got:

  • nursing home benefits
  • residential care subsidies
  • home care subsidies

Documents we need

You have 28 days to send us your documents. This includes your:

  • Medicare history statement, and
  • declaration

If you don’t return it, you’ll have to repay all the services listed on your statement. If this happens to you, you can ask for this amount to be amended.

If you need more than 28 days, call the Medicare Compensation Recovery line. We can’t give you more time to return your documents once your compensation claim settles.

How much you need to repay

We’ll add up each Medicare benefit for your compensation claim and give you a notice of past benefits. The notice of past benefits:

  • shows how much you need to repay
  • shows all the services you’ve told us relate to your injury or illness, and
  • is valid for 6 months

It will be sent to you and your compensation payer.

If we don’t think you have correctly completed your Medicare history statement, we may send you another one for you to complete and return. This is so we can give you an accurate notice of past benefits.

We’re testing a new website design. Try it out and tell us what you think. Read more about changes to this site.

Page last updated: 13 July 2017

This information was printed Thursday 17 August 2017 from humanservices.gov.au/customer/enablers/you-accept-your-compensation-payment It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.