How to Make a Claim for a breathing Appliance

Q: What kind of breathing appliances can I claim for?

The breathing appliances we cover are: Nebulisers Spacing devices Peak flow meters If you want to claim for a CPAP-type machine, this is a Hospital claim .

Q: How often can I claim a replacement device?

You can claim for a replacement appliance every 3 years. The conditions and procedure for doing this is the same.

Get everything ready

If your cover includes benefits for a breathing appliance, you can claim for it online.

If you haven't already, you'll need to register for a My Medibank account and have access to either the My Medibank app on your phone or tablet, or My Medibank on the web.

If you haven't paid for your subscription or membership or would like to submit with a paper claim form, you can also make a claim by post or in one of our stores.

Check your cover summary in your My Medibank account if you're not sure if you're eligible to claim.

If you want to claim for a CPAP-type machine, this is a Hospital claim.

Key Information

The appliance needs to have been purchased in Australia, from a business with an ABN
You'll need evidence, dated within the last 12 months, that your doctor or specialist recommended you get the appliance

Before you start your claim

Make sure you have:

- A digital copy of the itemised receipt or invoice that shows the provider ID or ABN and the item number for the item, and is dated within the last two years.
  
  (Note: Accepted digital file formats include: JPEG/JPG, PNG, HEIC/HEIF or PDF. A photo of the receipt is fine, as long as it's clear.)
- Served any relevant waiting periods. If you’re not sure, you can check whether you’ve served your waiting period under "Limits" in My Medibank.
- Proof that your doctor or specialist has recommended you get the appliance, dated within the last 12 months. (e.g. A letter from your doctor or specialist saying that you need the appliance, a prescription for the appliance, or an account from a pharmacy saying that the appliance was prescribed by your doctor or specialist.)

Please review the following information:

1. In order to claim, you need to have bought the appliance in Australia, from a business with an ABN (like a chemist or doctor).

Claiming on App
Claiming on Web

How to claim for a breathing appliance on the app

1. Log in and make a claim

2. Enter name and date of service

Tap Start. If there is more than one person on the policy, you'll be able to select the name of the person who received the service. Check the name listed in Who went? If this is the person who received the service, leave it as is. If it was someone else on the cover, tap Change and select the correct name.

Tap Add Date. Select the correct service date from the pop-up calendar and tap OK.

Note: if you're on a single policy, there's no need to add your name.

3. Enter provider details

You can search for and select a provider in the following ways:

Tap Provider ID to search for a provider using their provider ID.
Tap Other provider details to search for a provider using their full name / business name and postcode.
Tap and select a provider from the previous provider list.

If a provider has multiple practice types you will be prompted to select the matching practice type to your claim.

Sometimes a provider doesn't appear in the search results. If this happens tap Manually enter provider details to add a provider and choose from the practice/item type list to proceed.

4. Add item and treatment details

Tap +Add item(s). On the item screen with the date of service, tap +Add first item. You can add an item by typing in the item number, or scrolling down the list of common items and tapping on the correct one.

If the number under Quantity is correct, leave it as is. If it isn’t, tap the Quantity number and select the correct quantity from the scrollable list that appears. Next, tap Item Charge and type in the amount. Tap the green tick.

If you have more items to claim for, tap +Add another item and follow the same steps.

Tap Confirm.

5. Confirm details and upload receipt

You can upload receipt by taking a photo from the app, or by uploading it from your phone’s photo library. Tap Upload. To take a photo, tap Take a photo and take a photo of your receipt. To upload, tap Upload from Photo Library. Tap on the photo of your receipt to select. Tap on the green tick and then tap Confirm on the Upload receipt screen.

If the item you're claiming for requires supporting documents, you will see a button asking for these. Upload them in the same way you uploaded the receipt.

6. Confirm your payment details and submit claim

How to claim for a breathing appliance on the web

1. Log in and make a claim

2. Select who the claim is for

3. Enter provider details

Select the date of your treatment or service.

Choose from the previous provider list or search for a provider by entering their Provider ID or other provider details (full name / business name and postcode).

Once you have selected your provider, confirm the practice/item type from the drop-down and click Next.

Sometimes a provider doesn't appear in the search results. If this happens you can choose to add the provider manually by clicking use the details above to continue.

4. Add item and treatment details

5. Upload your receipt/s

6. Confirm payment details

6. Review and submit claim

Start your claim online

Make a breathing appliance claim

Download the My Medibank app

Still have questions?

What kind of breathing appliances can I claim for?

How often can I claim a replacement device?

Can I claim for someone else?

You can claim for someone else on your policy, but you can’t submit a single claim form for more than one person at a time. You’ll need to do a separate claim form for each person. Please keep in mind that unless we have the other person’s consent, we won’t be able to discuss the details of the claim once it has been submitted.

To authorise someone else to act on your behalf when dealing with Medibank, apply using this Authority form.

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Things you should know:

If you’re on Overseas Student Health Cover (OSHC), please visit OSHC Help & Support to find out more about claiming for a breathing appliance, or call our OSHC 24/7 Student Health and Support Line on 1800 887 283.

Claims submitted in store will be processed separately (at a later date) and pay benefits to you, the hospital or the provider, as appropriate.

Some claims, like paper based, may take longer to update.