Medicare Claim form (MS014)

Use this form to make a claim for an unpaid Medicare benefit by mail or service centre drop box.

All Medicare benefits are paid directly into your nominated bank account. Make sure you include your bank details on the form.

If you are already enrolled in Medicare or your bank account details have changed since you enrolled, update them.

Depending on the consultation item number, you might be able to submit your claim online. Read more about submitting your Medicare claim online.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
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Page last updated: 15 August 2017

This information was printed Sunday 20 August 2017 from humanservices.gov.au/customer/forms/ms014 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.