Extra's claims |
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Making Dental and other Extras claims
Receiving your claim payments
How to use HICAPS (Health Industry Claims & Payment Service)
Your treatment by registered GU Health providers
What benefits are excluded?
Making Dental and other Extras claims
There are three ways you can make Dental and Extras claims:
- Make claims on the spot through HICAPS by presenting your GU Health Member Card to participating dentists, optometrists, physiotherapists, chiropractors, osteopaths and podiatrists, or
- Complete a claim form, include a copy of the original account (and receipts if the account has been paid), and mail to GU Health in one of the postage‑paid envelopes provided, or
- FreeFax your completed claim form and the original account (and receipts if the account has been paid) to 1800 656 778.
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Receiving your claim payments
For fast, automatic direct deposits into your nominated bank account, use GU
Health's FastBack claims payment system. Simply complete the FastBack Authority
section of your application form to pre‑nominate the account where you'd like claim
payments deposited.
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How to use HICAPS (Health Industry Claims & Payment Service)
As a GU Health member, you have access to convenient HICAPS on‑the‑spot
claim processing using your GU Health Member Card. Simply swipe your Member Card through
the HICAPS terminal at participating service providers ‑ you'll only pay the difference
between the treatment fee and the GU Health benefit amount.
If you need to make changes to your GU Health membership in the future ‑ like adding
or deleting dependents or changing your level of cover ‑ please contact GU Health and
request a new application form. Changes to your contact details can simply be made over
the phone or through GU Health online services (web registered members only).
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Your treatment by registered GU Health providers
Benefits are only payable for services performed by registered providers ‑ those
practitioners accredited by the GU Health recognised accreditation process. To find
out if your practitioner is registered, call your GU Health Member Relations Team.
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What benefits are excluded?
Naturally, there are some things that GU Health can't cover
In addition to specific product exclusions, benefits cannot be paid:
- if an application form contains false or inaccurate information in respect
of the member and/or registered dependants
- during any waiting period a member is serving
- for any period in which a member is not a financial member as defined by
GU Health
- when health services are claimed or claimable under any policy of insurance,
third party or workers' compensation
- for the remainder of a membership year where an annual benefit limit has
already been reached
- for any claim lodged after two years from the date of service
- for any claim made for professional services rendered by a provider to members
of his/her own family or to a partner or partner's family (except for the
wholesale costs involved in providing the services)
- for services received or products purchased while overseas, except where
payable under an applicable GU Health cover
- for services provided by a practitioner who is not a registered GU Health
provider
- for hospital costs for items not covered by Medicare
- for treatment as a Nursing Home Type Patient (requiring non‑acute care after
35 consecutive days' hospitalisation) limited to the amounts set down by the
Minister for Health and Ageing
- for exceptional drugs not covered by our agreements, drugs covered by the
Pharmaceutical Benefit Scheme (PBS), and drugs issued for discharge
- for treatment at a private hospital emergency ward if you're not admitted to
hospital
- for allied health services provided by a private practitioner in hospital,
e.g. physiotherapy
- for personal items while in hospital such as newspapers and magazines, and STD,
mobile and international phone calls.
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