How to claim - Dental services

How to claim for dental services

Dental surgery in hospital

If you’re being admitted into hospital as an inpatient for your dental surgery and have hospital cover that includes dental surgery, your claim has two parts:

a) Claiming for related medical services, such as the anaesthetist, with Medicare before claiming from Medibank. You can identify these by their 5-digit item numbers.

b) Claiming for the dental portion of the surgery through your extras. You can identify this by its 3-digit item number.

To claim for medical portion of your surgery

You can claim from both Medibank and Medicare by either:

Lodging a claim with Medicare using the Medicare two-way claim form. This is the quickest and easiest way to claim from both Medicare and Medibank. You can opt to pay the bill in full and lodge as a ‘paid claim’, or not pay and lodge as an ‘unpaid claim’. When you submit to Medicare, you'll also have to include a completed Medibank Claim Form – select "Medical" as the claim type.
Lodging a claim with Medicare with the Medicare Claim Form and then lodging a claim with Medibank, providing the Medicare Statement of Benefit.

To claim for the dental portion of your surgery

This is an extras claim. You can do this in any one of two ways:

On the spot with your Medibank membership card or digital card if they offer HICAPS or ISOFT.
My Medibank claim online or through the app

Before making a claim, make sure that:

- The treatment is in Australia.
- You’ve served any relevant waiting periods. If you’re not sure, you can check what annual limits you have under “Limits” in the My Medibank app or My Medibank online.
- The provider is a recognised provider with Medibank and has a provider number. The number is usually on the invoice or receipt they’ve provided, and they can also provide it on request.
- You have an itemised receipt or invoice that shows the provider ID and the item number for the service, the charges for the service and how much you’ve paid, and is dated within the last two years.

Dental surgery in the chair

This is an extras claim. You make this in any one of two ways:

On the spot with your Medibank membership card or digital card if they offer HICAPS or ISOFT.
My Medibank claim online or through the app

Before making a claim, make sure that:

- The treatment is in Australia.
- You’ve served any relevant waiting periods. If you’re not sure, you can check what annual limits you have under “Limits” in the My Medibank app or My Medibank online.
- The provider is a recognised provider with Medibank and has a provider number. The number is usually on the invoice or receipt they’ve provided, and they can also provide it on request.
- You have an itemised receipt or invoice that shows the provider ID and the item number for the service, the charges for the service and how much you’ve paid, and is dated within the last two years.

Major dental

You can make this claim in any one of two ways:

On the spot with your Medibank membership card or digital card if they offer HICAPS or ISOFT.
My Medibank claim online or through the app

Before making a claim, make sure that:

- The treatment is in Australia.
- The treatment is carried out in the presence of a dentist (ie. it’s not a telehealth appointment).
- You’ve served any relevant waiting periods. If you’re not sure, you can check what annual limits you have under “Limits” in the My Medibank app or My Medibank online.
- The provider is a recognised provider with Medibank and has a provider number. The number is usually on the invoice or receipt they’ve provided, and they can also provide it on request.
- You have an itemised receipt or invoice that shows the provider ID and the item number for the service, the charges for the service and how much you’ve paid, and is dated within the last two years.

General dental

You can make this claim in any one of two ways:

On the spot with your Medibank membership card or digital card if they offer HICAPS or ISOFT.
My Medibank claim online or through the app

Before making a claim, make sure that:

- The treatment is in Australia.
- The treatment is carried out in the presence of a dentist (ie. it’s not a telehealth appointment).
- You’ve served any relevant waiting periods. If you’re not sure, you can check what annual limits you have under “Limits” in the My Medibank app or My Medibank online.
- The provider is a recognised provider with Medibank and has a provider number. The number is usually on the invoice or receipt they’ve provided, and they can also provide it on request.
- You have an itemised receipt or invoice that shows the provider ID and the item number for the service, the charges for the service and how much you’ve paid, and is dated within the last two years.

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How to claim for dental services

How to claim for dental services

Dental surgery in hospital

To claim for medical portion of your surgery

To claim for the dental portion of your surgery

Before making a claim, make sure that:

Dental surgery in the chair

Before making a claim, make sure that:

Major dental

Before making a claim, make sure that:

General dental

Before making a claim, make sure that:

Frequently Asked Questions

Can I claim if I haven't paid for the service/product yet?

Can I claim for someone else?

How can I find out how much I'll get back when I make a claim?

I'm having my wisdom teeth out in hospital! Why is this a general dental claim?

How do I register for My Medibank?

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