Health Cover - How to Claim

Making a claim

nib offers you many simple and convenient ways to claim on your health cover.

If you are looking to use your policy on the go, then the nib app makes it as easy as taking a photo of your official provider receipt and then uploading with your smartphone. Alternatively, you can claim via online services.

Some points to note:

  • Can you read your claim clearly?
  • Can you clearly see if you have paid for your claim already?
  • Have you included all the relevant documentation?
  • Budget Visitor – claims for hospital Emergency Room treatment.
    If the treatment does not lead to an in-patient admission, the treatment must be certified by the treating doctor as a genuine emergency. Please provide a discharge summary from the hospital with your claim for nib/IMAN to determine benefits payable.
  • Pharmacy receipts are required when claiming eligible pharmaceutical benefits.
  • The claim form contains a declaration regarding GST. It includes questions to enable us to determine if you or another party paying for your Plan, e.g. Sponsor/Employer, has an entitlement to claim part or all of the GST paid as an input tax credit.

Paying Medical Practitioners

Most Medical Practitioners will require payment at the time of consultation. Chemists also require payment for all prescription medicines dispensed.

nib/IMAN has a network of Medical practitioners who offer little or no out of pocket expenses and you won't be required to pay at the time of consultation in most instances. Please follow this link to find your nearest Medical Practioner.

Hospital Claims

For hospital expenses claims, we can arrange payment directly to providers. Please request the receptionist or hospital admissions officer to call us on 1300 853 530 and provide details of the account.

Time Limits

Please note that benefits are only paid if the claim is made within 2 years of when you received the service or treatment, and if covered under the terms of your Plan. Claims will not be paid if your Plan is not financial. Plans are not financial if your premiums are in arrears. IMAN may cancel your Plan if it is more than 2 months in arrears.