Claiming from your HCi cover
We offer a range of claiming methods that are fast, easy-to-use and, if you choose, even paperless.
// CLAIMING FROM HCi
Lodging extras claims is easy!
HCi extras cover helps cover your health expenses away from hospital.
Once you have used a service, you simply let us know via OMS (the quickest and most secure option), emailing a completed claim form or when visiting our Burnie office.
// CLAIMING EXTRAS
OMS
- the HCi member portal
Logging into OMS makes claiming securely and easily!
When it's time to claim, simply take a photo of the receipt(s) or upload a pdf then submit! Easy!
// SUBMITTING CLAIMS
HCi OMS
Login and submit the invoice – easy!
PO Box 931, Burnie, TAS 7320
In person
25 Cattley Street, Burnie
Whether submitting via OMS or by filling out a claims form, all accounts and receipts must include the following:
- patient’s name
- provider details (provider name and provider number)
- appropriate item number and description of the services / products being claimed
- amount paid
- date of purchase/supply/service
- script number (for pharmacy claims)
- prescribing doctor’s details, including provider number (for pharmacy claims).
Tip – submit documents securely through OMS – and avoid filling in a claims form!
// CLAIMING EXTRAS
You can often claim your extras benefit on the spot, with health service providers such as dentists, optometrists, chiropractors, physiotherapists, and podiatrists. Unfortunately, this is generally not yet available for pharmacy purchases.
Swiping of your HCi membership card at the providers office, your entitlements will be assessed and authorised immediately. You will need to pay any difference between the fee and your Extras cover, which HCi pays directly to the practitioner.
If your claim is not processed at the point of treatment through an electronic swipe card system, you can submit your claim in OMS or by mail, email or in person.
// CLAIMING HOSPITAL COVER
Under hospital cover, HCi pays towards treatment provided to you by a doctor whilst you are a patient in hospital.
Generally, the hospital will invoice us on your behalf. They will then invoice you for anything not covered.
Out of pocket expenses cannot be claimed for hospital treatment. If your provider chooses to charge above the Commonwealth Medical Benefits Schedule (MBS) fee, you may have to pay the gap.
Claiming from Medicare first
If you receive bills from your doctor for medical treatment you received whilst in hospital, you must lodge your medical claims with Medicare first, before submitting to us.
You may choose to use the Medicare two way form. This is submitted to Medicare and they will pass it onto us once they have processed it.
Alternatively, you can claim from Medicare first and then submit those claims via OMS or by completing our claims form. Note you will need to provide a Medicare Remittance Statement* with your claim.
* A Medicare Remittance Statement can be found in your MyGov Inbox, usually listed as Your Statement of Medicare Benefit by EFT.
// CLAIMING PHARMACY COSTS
Having HCi extras cover can help offset the cost of Non-PBS medications. HCi has a co-payment* per prescription and pays 100% over and above this amount up to $100.00, depending on the cover you have.
Our pharmacy claims fact sheet provides more information on these claims.
*The Federal Government sets and applies the co-payment amount annually. Since 1 January 2026, the co-payment amount is $25.00.
Extras claims are often processed the day they are received, assuming they include all the necessary information.
Claims are processed within 3 business days of receipt. Payments may be delayed by bank processing times, depending on your bank/financial institution and account type.
// CLAIMING PAYMENTS
Receiving payments from HCi claims
With electronic claiming on the spot, we pay the provider for you – easy!
When you pay the provider and then put in a claim, we will assess and pay the claim as quickly as possible. In most cases extras claims are processed within 3 days of being received, assuming they include all the necessary information. Please note that bank delays may result in longer waits for money to arrive in your account.
The claims payment, or refund, will be made into your nominated bank account if you have already paid the provider.
However, if you have not paid the provider we will pay the appropriate claim amount directly to the provider electronically.
// WHEN CLAIMING PRODUCTS FROM HCi
You need to complete our medically eligible declaration* with an extras claim for:
Medical appliances including CPAPs, blood pressure monitors, blood glucose monitors, circulation boosters, TENS machines, and nebulisers. Note that continuous glucose monitor systems are excluded from HCi cover.
Contraceptive medication used to treat medical conditions (we do not cover contraception).
Medical botox or medicinal cannabis
Non-surgical prostheses such as breast prostheses, surgical bras, and surgical stockings.
Custom made and/or fitted medical braces such as CAM walkers, wrist/knee/ankle brace, or a post-surgical brace.
Fitted and/or custom-made surgical footwear
Custom-made and/or fitted wigs
It’s easy to submit your medical eligibility form and supporting evidence via OMS, too!
* Unfortunately, we can no longer accept a doctor’s letter or medical certificate. Please use the medical eligibility declaration instead.
// WHEN CLAIMING FROM HCi
It’s important to know:
Services / products must be provided by practitioners operating in private practice and who are approved by HCi.
Claims must be lodged within 2 years of the service.
Eligible HCi claim payments are calculated on the date services/products are provided.
Goods and services claimed must be supplied by registered Australian providers and websites within Australia.
All relevant waiting periods must be served before claims will be assessed.
Claims are not payable during any period in which your membership is unfinancial (ie not paid at least 2 weeks in advance) or suspended (eg while overseas).
Vaccination claims require a receipt confirming details of who received what vaccination.
Medically required braces and supports can be claimed only if they are custom made for the patient – cover does not include off the shelf items.
HCi may change its products, benefits, and terms and conditions from time to time. We will notify members as soon as practicable before any detrimental changes.
// CLAIMING HCi COVER
Exclusions from cover
Our extras cover doesn’t include a few things, such as
- treatments and services provided by a family member or business partner (unless our CEO gave written prior approval)
- services where you may be able to claim compensation, damages or benefits from another source (eg WorkCover). This applies whether or not you receive compensation from that source.
- non-prescription glasses and sunglasses, or optical consultations
- items for sport, recreation or entertainment
- exercise accessories and equipment
- repeat treatments or services on the same day
- things you didn’t actually pay, such as a discount or gift voucher (eg if you had a discount so paid $40 instead of $60, we will only assess a claim for $40)
- materials or supplies associated with Chinese medicine
- pharmaceuticals without a prescription, contraceptives, anabolic steroids and any drugs not approved in Australia.