Making a claim

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The quickest and easiest way to claim is with our mobile app! Just snap a photo of your receipt and send it to us via the app. 

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How to make an extras claim: your options

 

EFTPOS-style claiming is easy. Swipe your membership card and claim paid! On-the-spot claiming, called HICAPS, is available at most health providers like dentists, optometrists, physios, chiros and more. You just pay the difference between their fee and your fund benefit – all processed instantly. 

This is what you do if you can’t use your Peoplecare card or you forgot it.

First of all, make sure you get a receipt with the following details on it:

  • Patient’s name
  • Provider’s name and number
  • Date of service
  • Service provided
  • Amount paid

Once you have the receipt with all those details, send your claim to us via the Peoplecare claiming app, Larry. Simply open the app and take a photo of your receipt, add any supporting documents if applicable (like a Declaration of Condition or an Orthodontic Treatment Plan) and hit submit. Simple!

Bonus photo tip: Turn off the flash if using your phone to take a photo of your receipt

Download the Peoplecare app Larry for iPhone or Android.

Upload a photo of your receipt to Online Member Services and you’re done. You’ll be done in a jiffy.

The experience is better on our app, so it’s worth downloading it if you’re a regular claimer.

Just scan your completed claim form with your receipts and email us at info@peoplecare.com.au.

Can’t be bothered with a claim form? Use our app or Online Member Services – we like things easy too!

 

Send your claim to us along with a claim form or by post, addressed to Peoplecare, Locked Bag 33, Wollongong NSW 2500.

Can’t be bothered with a claim form? Use our app or Online Member Services – we like things easy too!

 

Can I swipe my card to claim?

Yes No
  • Acupuncture
  • Chiropractic
  • Dental
  • Dietetics
  • Exercise Physiology
  • Optical
  • Osteopathy
  • Physiotherapy
  • Podiatry
  • Psychology
  • Remedial Massage
  • Speech Therapy
  • Allergy treatments
  • Ambulance
  • Ante/postnatal treatment
  • Health aids
  • Health management^
  • Hearing aids
  • Home nursing
  • Hydrotherapy
  • Hypnotherapy
  • Laser eye surgery
  • Midwifery
  • Natural therapies
  • Occupational therapy
  • Orthodontics*
  • Orthoptics
  • Orthotics
  • Pharmacy^
  • Travel expenses & boarder accommodation

* Submit an Orthodontic Treatment Plan with your claim

^ Submit a Declaration of Condition with your claim

 

There are a variety of reasons:

  • some providers aren’t connected to HICAPS, our swipe claiming provider
  • we need to assess this claim manually
  • supporting info is required (e.g. a Declaration of Condition)

Get a receipt with the following details on it:

  • Patient’s name
  • Provider’s name and number
  • Date of service
  • Service provided
  • Amount paid

Important: We can’t pay your claim without the above information on it. Some providers might just give you a receipt with the price on it and their business name. If this happens to you, just ask for a full receipt with all the details we need.

 

How to make an orthodontics claim

If you or your kids are getting orthodontic work, you’ll need this guide to save you a bit of stress (and hopefully money!).

Do I need to see an orthodontist to claim orthodontic benefits?

Peoplecare pays orthodontic benefits toward treatment performed by both orthodontists and dentists.* Common orthodontic work includes traditional braces and clear aligners like the commonly known Invisalign brand.

I already have orthodontic cover with Peoplecare

Great!

Here are the steps to make an orthodontic claim.

 

Nobody loves waiting. But all health funds have waiting periods to protect their whole membership from ‘hit and run’ claims from new members, people who might join a health fund to claim after the event and existing members who upgrade to a higher level of cover for services not on their previous cover. Sort of like trying to get car insurance after you’ve already had an accident. (We know you wouldn’t do that, but there are some people out there who do!) 

Any orthodontic waiting periods you have served or partly served when transferring from another a similar level of cover with Peoplecare or another health fund within 30 days will be recognised. When upgrading your cover, the full 12-month waiting period applies.

IMPORTANT: We need this before we can pay your claim.

You can’t swipe your Peoplecare membership card to claim orthodontic benefits.

Complete an Orthodontic Treatment Plan (or perhaps your orthodontist has already given you one). This  form  needs to be completed and sent to us with your first payment – so take it with you and complete what you can yourself.

Value tip: Have Premium Extras or High Extras? Consider maximising your claimable Peoplecare benefits by asking to be billed over 3 financial years. See the last section of this page for how our Extras covers work.

Have our closed Comprehensive Extras? You only have a lifetime limit and not an annual limit, so you can pay in a lump sum.

Retain your receipt and make sure it contains all the information required in step 4.

  • patient’s name
  • dental item number(s)
  • amount and date paid & date of service
  • orthodontist’s provider details and address

Otherwise, we can’t pay you benefits.

Take a photo of your receipt & Orthodontic Treatment Plan and send them to us using our app (you can download it from peoplecare.com.au/mobile) or Online Member Services.

Alternatively, if you like filling in forms, you can email or post them to us with a claim form.

P.S. If you’re ever wondering about your benefits & limits, you can check them any time with our app or Online Member Services.

 

I need cover for orthodontics

Peoplecare has two levels of Extras covers with orthodontic benefits

  • Premium Extras: 80% of the cost, up to $1000 per person each financial year. The lifetime limit is $3,000 per person.
  • High Extras: 70% of the cost, up to $800 per person each financial year. The lifetime limit is $2,400 per person.

 Want more info? Please give us a buzz on 1800 808 690 (members) or 1800 808 700 (enquiries) for details.

*To claim orthodontic benefits from Peoplecare, you must have Extras cover with orthodontic benefits, have remaining per person annual and lifetime limits and have served your waiting period.

 

Mistakes to avoid

 

Taking a photo of your extras receipt and claiming through our app, Larry or Online Member Services is the best. Gone are the days of time-consuming claim forms and scanning – or worse – snail mail. Here are some quick tips to get it right first time:

Be sure to take a clear photo that’s easy for us to read

Just send us the provider receipt (jump to the top of the page to see the receipt details we need). We don’t need to see anything from HICAPS

Check your name on the receipt matches the name on your policy

Chronic Disease Management Plans (CDMPs) are for chronic conditions that have lasted for at least six months. CDMP claiming allows you to get help from both the government and Peoplecare if you follow our steps.

How does it work?

Your GP writes the plan for services that you can claim on Medicare first. Usually Medicare provides benefits for five visits. For the sixth and subsequent visits you can then claim from your extras cover and start drawing down on your limits.

What can you claim for?

Lots of services. That’s why extras cover is so handy. These are some of the most popular ones:

  • Chiro
  • Dietetics
  • Exercise physiology
  • Eye therapy (orthoptics)
  • Occupational therapy
  • Osteo
  • Physio
  • Podiatry
  • Psychology
  • Speech therapy

To get the most out of your extras cover, you need to know how to get the most out of your Health Management Benefits. Unfortunately folks this isn’t a chicken or egg question. To claim for the following things you need a diagnosis of a medical condition first from a medical professional (that’s our Declaration of Condition form):

  • Gym equipment
  • Fitness programs
  • Health aids
  • Medications usually used as contraceptives

 

How to claim an ambulance bill

Don’t pay it, just send it straight to us ASAP via Online Member Services or through our mobile app.

We’ll then sort it out for you. We pay 100% of all eligible ambulance claims.

Important: Private Health Funds do not cover additional debt recovery costs for late lodgements. You’ll have to pay those fees yourself.

That’s why it’s critical you send us your ambulance bills as soon as you receive them.