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.

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

Page last updated: 9 April 2018