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Make a claim

Make a claim

Your guide to making a claim on your health insurance, from what to do first to the easiest ways to get your benefit back.

Once you’ve had a treatment, you might need to submit a claim to us to get your money back. The claiming process will depend on where you received your treatment.

Making a hospital claim

If you’ve had a hospital procedure your claim will be submitted directly to us in most cases, although you will be charged for any out-of-pocket expenses before you leave, for example your policy excess. If you’re unsure why you might have received a bill or whether your claim has been processed, please contact us.

Making an extras claim

If you’ve had treatment with an extras provider (like a dentist, optometrist or physio), you’ll generally be able to claim on the spot through a system called HICAPS. Swipe your HBF member card when you pay and you should receive your rebate straight away.

Other easy ways to claim

Claim in myHBF

Log into myHBF and follow the prompts to upload your health provider’s account and receipts, and your Medicare Statement of Benefit if you’ve claimed from Medicare for in-hospital medical services. Your benefit will be paid into your nominated bank account or by cheque if you haven’t set up direct credit.

If you claim electronically, your benefits will automatically be deducted from the provider fee, so you'll only ever pay the difference between the provider's fee and the HBF benefit.

Claim in the HBF Health app

Download the HBF Health app for free, take a photo of your treatment account and receipt and upload it to claim. Your benefit will be paid directly into your nominated bank account.

Claim in your local branch

Drop into an HBF branch with your member card and original account and receipts. Depending on your claim type our team will then organise for your benefit to be paid directly into your nominated bank account that day, although any hospital and medical accounts need to be sent to our head office for processing. Cheques are no longer issued in HBF branches.

Claim by mail

Download and complete a claim form and attach the original account(s) and receipt(s) you received from your health care provider, and your Medicare statement if you have claimed from Medicare for in-hospital medical services.

Post your claim to HBF, GPO Box 1440, Perth WA 6839

Don’t forget to complete all the questions and make sure your membership is paid up until at least the day of your treatment.

Essential health claims knowledge

What happens after I submit a health claim?

We’ll process online claims within two days for ancillary treatment and ten working days for hospital and medical treatment. Once your claim is complete you’ll receive a Statement of Benefit notification by email or letter, summarising the benefit HBF has contributed towards the claim. It may also include your cheque if you haven’t registered for direct credit.

Once your health claim has been fully processed you’ll receive your benefit within two working days to your nominated bank account, or seven working days if you’ve requested a cheque.

Don’t forget to check that your current direct credit details are up to date in myHBF.

Have you processed my claim?

If you received treatment in a Member Plus hospital, or made a claim electronically via myHBF or the HBF Health app, we’ll have received it automatically. If you mailed your claim, contact us and we can confirm if we have it.

  • Your claim will be processed instantly with HICAPS (where you claim on the spot by swiping your HBF member card) and your benefit is automatically deducted from the provider’s fee.
  • In your local branch your claim is also usually processed on the spot (hospital claims may take a little longer) and you’ll receive a receipt.

How can I find out how much I have left to claim?

The Extras services that your policy covers have annual maximum claim limits. Find out the balance on your remaining Extras limits by contacting us.

How much money will I get back?

For most treatment covered by your Extras policy, use our Quote Calculator tool to find out how much you’ll get back. For more in-depth treatment (like a hospital procedure), ask your health provider for their provider number, treatment item numbers, the total cost, and where the treatment is being carried out.

Where can I see my claims history?

Login to myHBF to see a full list of your past claims.

Why was my claim rejected?

Your claim may have been rejected for a number of reasons, for example:

  • You haven’t yet served your waiting periods
  • Your account is ‘unfinancial’, which means your HBF premiums are in arrears
  • There was a mistake in your claim or you didn’t supply the right documentation
  • Your claim is over two years old
  • Your claim needs to be submitted to Medicare first
  • Your treatment isn’t covered by your policy or by HBF
  • You’ve reached your annual Extras benefit claim limits
  • We’ve already paid this claim

If your claim is rejected you will receive an email or letter notification explaining the reasons and any action you should take.

Direct credit payments

Register or confirm your details for direct credit in myHBF to have your claim benefits paid directly into a nominated account.

Time limits

Please note we only pay for claims made within two years of the date you had your treatment.

Statement of benefits

After your hospital and medical claims (from doctors and specialists) have been processed, we’ll send you statements showing what has been paid on your behalf.

Claim quotes

You can login to myHBF before treatment to use our Benefit Quote tool and find out how much you can get back and any out-of-pocket costs on Extras and dental claims.


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