Medicare Two-way claim form (MS001)

Use this form together with a Medicare claim form to submit your in-hospital and ancillary claims with Medicare and your private health fund.

This form can also be used to claim gap benefits from your private health fund for in-hospital and ancillary services.

 
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 27 August 2017