Making a Claim

Necessities - electronic claiming

You can make your claim on the spot at any provider who has electronic claiming facilities and is registered with GMF Health.
This means you can receive your benefit on the spot for services such as dental and you only need to pay any out-of-pocket cost you may incur.
The great news is there's no paperwork and you don't have to pay the full consultation fee up-front and then wait for the reimbursement of your benefit.
Electronic claiming is available at many dental, optical, physio, chiro, speech pathology, clinical psychology, dietetic, osteopathy, and podiatry providers.
To find out if your provider has electronic claiming facilities just give them a call.

Necessities - manual claiming

If you have fully paid your provider's account you have the option of receiving your benefit via direct credit to your account or receiving a cheque.
Our direct credit option is called ‘EasyClaim’. If you would like to use ‘EasyClaim’ please ensure that item 4 on your claim form has been completed and the account has been fully paid, otherwise we will forward a benefit cheque to you. We can’t direct credit your benefit into a credit card account, so make sure you include details of a statement or savings account.
To claim benefits, complete a Claim form, attach your provider's original account, including receipt (if paid) and visit your local GMF Health Service Centre, Agent or send your claim to PO Box 513 Kalgoorlie WA 6433.

Hospital

In most cases hospital in-patient and day-patient accounts will be forwarded directly to GMF Health for payment. However, if you do receive an account, complete a Claim form, attach the original account and post to PO Box 513 Kalgoorlie WA 6433.
An important note: Please do not send medical accounts for in-patient or day-patient hospital services to Medicare. You must send these accounts directly to GMF Health to enable us to process any Gap Benefits you are entitled to. We will electronically claim your Medicare benefit on your behalf.
Also, before you receive hospital in-patient or day-patient medical services (services provided by a doctor or Specialist Medical Practitioner) you should obtain a quote for the services and submit it to GMF Health so that we can provide you with a benefit quotation before your treatment begins.
For full details of GMF Health's Medical Gap arrangements please refer to our Membership Guide or call one of our Member Service Consultants on 1300 653 099.

Are you a provider interested in HICAPS services?

If you are a dental, optical, physio, chiro, osteopathy or podiatry provider and you would like to submit a request to HICAPS for an application please visit the HICAPS website. If you would like further information about HICAPS please visit the HICAPS website.