How to make a claim  

Get more value and benefits from your private health insurance, without the hassle.

Did you know lodging claims with Emergency Services Health is easy? Here's everything you need to know on how to claim with our Extras and Hospital cover.

1 April 2022 changes to your cover

Throughout the pandemic, we've worked hard to provide he best cover, service and value for you, our members. It's a commitment that we've extended into our annual premium review as we seek to offer additional benefits while keeping remium increases as low as possible, as always.

Our approach and continued commitment to excellence has seen us named the Number 1 private health fund for Member Satisfaction, Better Claim Rebates and Customer Service in the 2021 Healthcare & Insurance Australia research survey undertaken by Ipsos Australia.

Find out how we’re building member value in 2022 and beyond

Understanding our ambulance cover

Your private health insurance guide to hospital

Rollover Benefit Explained

Find a Access Gap Cover Doctor 

Access Gap Cover eliminates, or substantially reduces, the out-of-pocket expenses that are part of a hospital stay for people with private health insurance. We have arrangements with a majority of doctors around Australia where, in most cases, our members will be fully covered for in-hospital medical treatment, or will at least be advised prior to treatment of any gaps that might exist.

You can search for participating doctors by specialist group, doctor name, and locality. You can also call us on 1300 703 703 or your doctor to verify if you will be covered in the Access Gap Scheme before treatment.

Find a Contracted Hospital

We have agreements with most private hospitals that are likely to be be accessed by members. These agreements (as part of Police Health Limited) ensure that an agreed schedule of fees (including in-patient accommodation, thatre and special unit accommodation fees as appropriate) is charged by the hospital and paid by us on our member's behalf.  

Please note that a member's benefit entitlements will be affected by factors such as their level and type of cover and the financial status of their membership. This will affect the amount we will reimburse to the hospital. We strongly recommend you contact us on 1300 703 703 to confirm your benefit entitlement prior to recieving hospital treatment. If you choose a non-agreement hospital you may incur out-of-pocket expenses for hospital related sevices irrespective of your level of cover. 

Mobile Claiming App

As a member of Emergency Services Health, we’ve got your back. Our Emergency Services Health App lets you manage your health cover 24/7.

Use the app to:

  • Easily make a claim for you or your dependents

  • Access benefit limits and cover details

  • View your claims history

  • Update your contact details

Who can use the Emergency Services App?

Anyone can access general fund information via the app, but to use features relating to your membership, you must be an Emergency Services Health Member and have registered your online membership account.

Using Your member card

We like to make claiming on your health insurance easy, and one of the easiest ways to make a claim is through HICAPS – the system that lets you swipe your Emergency Services Health membership card to make a claim on the spot. HICAPS claiming isn’t available for everything, but this handy search function will help you identify times when it likely is. 

Nourish Baby

Your one stop shop for all things baby.

If you’re trying or expecting a baby, members can now gain access to the Nourish Learning Hub.