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Forms & Brochures
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How to make Claims for Medical & Hospital Services
Hospital and medical accounts under Access Gap Cover are usually sent directly to us by the provider and we pay them on your behalf.
For more information about how to claim for all Extra & Hospital benefits.
Easy On the Spot Extra Claiming for Members
Most extras can be claimed using your membership card or just take a photo using your phone!
You can simply download our Emergency Services Health Mobile Claims App and lodge your claims from your mobile phone.
To make your claim simply:
1. Download the free App to your smart phone
2. Register your details in the App
3. Photograph your account items
4. Submit your claim with a press of a button, no claim form required!
Where can I claim on the spot using my 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.
Before you begin your search it’s important to note that this search facility is provided by HICAPS and therefore may include some health providers not recognised by us for on the spot claims, but may still be claimable*. The search may also include health providers not recognised by us for any payment of benefits and therefore won’t be covered by us. These situations are rare however members may wish to confirm that their health provider is recognised for benefits prior to service by contacting us directly.
*On the spot HICAPS claiming is not available for; orthodontic, pharmacy, health appliances (including hearing aids) and eye therapy. However, these claims can be submitted via our app, or by emailing us a claim form.
Find a Doctor - Access Gap Cover Search
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 accessed by members. These agreements ensure that an agreed schedule of fees (including in-patient accommodation, theatre and special unit accommodation fees as appropriate) is charged by the hospital and paid by Emergency Services Health on the 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 Emergency Services Health will reimburse to the hospital.
We strongly recommend if you contact us on 1300 703 703 to confirm your benefit entitlement prior to receiving hospital treatment. If you choose a non-agreement hospital may incur out-of-pocket expenses for hospital related services irrespective of your level of cover.
Complementary Therapies Provider Search
Accepted forms of complementary therapy
Acupuncture involves the stimulation of specific points on the skin, usually by the insertion of needles. In its original form acupuncture was based on the principles of traditional Chinese medicine. Chinese medical writings describe acupuncture channels which transport energy (qi) around and through the body. Traditional Acupuncturists believe that gentle stimulation at precise acupuncture points when applied on the basis of correct diagnosis, will aid the body's own defensive and self-healing systems, thus promoting and maintaining good health.
Myotherapy is the treatment of myofascial pain, injury, and dysfunction affecting movement and mobility.
Remedial Massage Therapy is the systematic assessment and treatment of the muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management. It is performed to create favourable conditions for the body to return to normal health after injury and is defined by the premises that the treatment can reasonably reverse certain physical effects a patient may be presenting. A range of manual therapy techniques may be employed in treatment, such as deep connective tissue massage, Trigger Point Therapy, Muscle Energy Techniques, Direct and Indirect Myofascial Techniques, and Neuromuscular Facilitation, (as well as techniques ranging from Swedish to specialised massage for athletes, babies and pregnant women. Specialists may also practice, Shiatsu Techniques to achieve improvement throughout the body. Aromatherapy and holistic approaches such as Kinesiology may also be used).
These providers meet registration criteria as set by the Australian Regional Health Group (ARHG) in terms of qualifications, continuing education, ethics and quality of practice requirements. Some providers may have multiple practice locations which are not shown here.
Recognised & Registered Service Providers
While the vast majority of private service providers registered and practicing in Australia will be recognised by us for benefits, not all providers are recognised.
If you wish to ensure your provider is recognised by Emergency Services Health, please contact us prior to treatment.
Phone us on 1300 703 703 or email firstname.lastname@example.org
Here to help
Will you pay benefits towards my Pilates treatment?
Contracted and Recognised Hospitals
Contracted and Recognised Hospitals
IVF and other Assisted Reproductive Services
Emergency Services Health's Gold Hospital and Gold Combined includes cover for in-hospital services relating to In vitro fertilis
FAQ: Premium Increase
Premiums have been reviewed by the Minister for Health and will be increasing as of 1 April 2019.
Pregnancy and private health insurance
If you’re thinking of starting a family, now’s a great time to review your health insurance to make sure you’re happy with, and understand, your co
Just received a benefit statement from us and want to know more? Take a look at these frequently asked questions.
Regrettably following negotiations, Emergency Services Health through the AHSA have been unable to reach agreement with Toowong Private Hospital on
Under extras cover you’re eligible to receive pharmaceutical benefits towards prescription items that are not eligible for subsidy under the Govern
Benefits limit for Extras
Private health insurers generally calculate an average charge for services and set their benefits based on those amounts.
Your choice of doctor
We give you freedom to choose.
"Customer service is exceptional and we have always had quick refunds on claims"
EMERGENCY SERVICES HEALTH MEMBER