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P: 1300 561 454
F: (03) 9899 4234
How to Claim
Navy Health Ltd is currently contracted by the Department of Defence to perform all claims processing for the National ADF Family Health Program.
There is an online claim limit of $1000. For amounts greater than $1000 a manual claim will be required.
All claims must be submitted within 12 months from date of service. Any claim received that is over 12 months from the service date will not be paid.
There are several ways you can claim your ADF Family Health benefits:
- At the point of sale, using your ADF Family Health Card (if the provider has a HICAPS terminal, you can locate a provider with HICAPS here);
- By utilising the online claiming functionality
- By using the ADF Family Health mobile claiming App:
- By faxing or posting your receipts with a Manual Claim Form to Navy Health
The Quick Guide below provides more detail on how to claim your benefits. For further information on how to claim call 1300 561 454.
General Practice Specialist & Diagnostic and Radiology
|Mobile Claiming – Claiming App||Online Claiming|
|Manual Claiming||Private Health Insurance|
||If you have private health insurance it is recommended that you claim your treatment from the private health insurance provider first and then claim any remaining amount via one of the above methods. Please attach a copy of your private health insurer’s receipt before sending in your claim via manual or online methods.|
When submitting manual claims for payment, where there is an associated MBS Item Number and Medicare Rebate, there is a requirement to send a copy of the Medicare ‘Statement of benefit and Payment’ with your claim form.
The following receipts will be accepted when making a claim for a medical service:
*Medicare statement of claim and benefit
*Medicare lodgement advice
*Medicare Claims history
The Medicare statement of claims and benefit/ Medicare lodgement advice, can be obtained at the time the service is provided. The Medicare claims history can be obtained from the Mygov website. If you do not have a Mygov account please click here to set up.
Allied Health Claiming
|Point of Sale Claiming||Online Claiming – Online Member Service Portal|
|Mobile Claiming – Claiming App||Manual Claiming|
|Private Health Insurance|
|If you have private health insurance it is recommended that you claim your treatment from the private health insurance provider first and then claim any remaining amount via one of the above methods. Please attach a copy of your private health insurer’s receipt before sending in your claim via manual or online methods.|