How to claim - External prostheses

Q: What is an external prosthesis?

An external prosthesis is an appliance or device approved by Medibank, normally associated with the physical replacement of part of the human body. Some examples of external prostheses include: Hearing aids False eyes Arms or hands Legs or joints Wigs.

Get everything ready

If your cover includes benefits for an external prosthesis, 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 prosthesis, or would like to submit with a 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.

Key Information

You’ll need a receipt dated within the last two years. It will also need the provider ID or ABN and the item number you’re claiming for
Check your limits on MyMedibank online or the app before you claim

Before you start your claim

Make sure you have:

- An itemised receipt or invoice that shows the provider ID or ABN and a description of the item, and the date is within the last two years.
- Served any relevant waiting periods. If you’re not sure, you can check under "Limits" in My Medibank.
- Purchased the prosthesis in Australia, from a supplier with an ABN.
- A referral from your doctor or specialist.

Please review the following information:

You cannot claim for an external prosthesis purchased while serving a replacement period.

Claiming on App
Claiming on Web

How to claim for an external prosthesis on the app

1. Log in and make a claim

2. Enter name and date of service

3. Enter provider details

Search and select a provider 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.

Or 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 number

5. Enter treatment details

6. Confirm details and upload receipt and supporting documents (if required)

7. Upload documents

8. Confirm payment details and submit claim

How to claim for an external prosthesis on the web

1. Log in and make a claim

2. Claim health appliance

3. Enter provider details

Select the date of your treatment or service.

Select Other provider details and enter the full name or business name of your provider and their postcode.

Search for the provider and, if no results are found, select click here to use the details above to continue to use those details for your claim.

Once you have entered your provider's details, confirm the practice/item type selected in the drop-down list is Health Support Services and click Next.

4. Enter service details

5. Confirm payment details

6. Submit claim

Still have questions?

What is an external prosthesis?

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 prosthesis, 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.