You might need to make a claim after going to hospital, being transported in an emergency ambulance, using a service from your Extras cover, or if you're an international member, for services such as seeing a General Practitioner.
There are a few ways you can claim, depending on the service and your chosen health provider.
Scan your nib card
If your provider has a HICAPS card terminal, you can scan your nib card after your appointment, and the amount we can pay will be instantly calculated so you just pay the gap. If you’re an Apple or Android user, you can scan yourdigital nib card.
Claim online or in the app
If you can’t use your card to claim on the spot, keep your receipt and submit a claim through the nib App or online. Simply take a photo of your receipt (make sure it’s not blurry and that all details can be read!) and submit. We’ll pay Extras benefits like dental and chiropractor straight into your account within five working days.
Complete a Claim Form
You can also claim by post by completing and returning a Claim Form.
Claiming after a hospital visit?
You generally won’t receive a hospital bill if your procedure was included on your health cover, you went to an nib Agreement Hospital and your doctors participated in MediGap. If you did receive a bill, please see our Hospital billing.
Claiming checklist
You’ve checked your annual limits and waiting periods in your member account or by contacting us.
You’ve provided the original document, not copies.
The receipt is itemised with all items and their charges listed separately.
The charge has been paid in full.
The receipt is on the provider’s official stationery or has the provider’s official stamp.
For Healthier Lifestyle claims, ask your medical provider to complete a Health Management Form and submit this with your claim.
Make sure everything is written in English.
You’re claiming within two years of your appointment or treatment - we can’t pay claims after this period.
What happens after I submit a claim?
Claims made in your member account will be processed within 7-10 business days. Extended processing times may result in a slight delay. You’ll be notified when the claim has been paid into your account. If your claim has been rejected, you’ll receive a claim rejection letter via the preferred method of contact we have listed for you. To check or update your contact details, head to Personal Details in your member account or the nib App.
Why was my claim rejected?
There are a number of reasons a claim may be rejected, including:
The service isn’t included on your cover.
Information is missing from the receipt/s provided.
The photo of your receipt was blurry.
The claim is for a service you had over two years ago.
The service is covered by Medicare, which means you must submit to Medicare first, and then complete your claim with us.
If you are unsure why your claim has been rejected, please contact us.
Your claims history
Log in to your member account to view your Claims History. In the app, you’ll find My claims listed in the navigation. Only claims that have already been processed will appear in your account.
