Claiming your medical fees after a hospital admission
When you are admitted to hospital you will be charged separately for medical fees by your doctor, medical specialist, surgeon, anesthetist, radiologist or pathologist.
These fees are in addition to your accommodation and theatre fees.
Before you go to hospital
Your health is going to be your highest priority when faced with a stay in hospital, but it's also important to know what you are covered for and know what to expect prior to your stay. We encourage all our members to give us a call on 1300 362 144 prior to going to hospital.
What you will receive back
Your provider should have advised you of any out of pocket costs prior to your admission, this is called Informed Financial Consent.
You will receive 100% of the Medicare Benefit Schedule (MBS) towards the payment of these fees; 75% paid by Medicare and 25% paid by Latrobe.
One or more of your providers may choose to charge above the MBS amount, if you have received Informed Financial Consent we will pay up to an additional 20% above the schedule fee to assist with reducing your out of pocket costs.
Please contact us prior to any planned hospitalisation with the MBS item numbers, and fees the doctor will be charging, this will allow us to advise you of your cover and calculate any out of pocket amounts you may need to pay.
If your provider sends their invoice(s) directly to us, we are able to claim the Medicare portion on your behalf and forward that and our portion directly to the provider for you. This means you will only be responsible to pay any out of pocket costs they may charge.
Please note that because Informed Financial Consent is not obtained for pathology or radiology services, these services are paid at maximum benefits payable in the first instance.
If you are billed directly by your provider, there are two options to submit your claim for payment:
1. myGov claim
If you have not already registered for your myGov account, go to my.gov.au or download the app. You will need to link your Medicare through this service and follow the prompts to make an online claim.
If the claim is approved, you will be notified with a statement of benefits via your myGov inbox within
7 to 10 days. If the claim is rejected, you will be notified by post.
You can download your statement of benefit and upload this via our online claim form.
The statement of benefit can be submitted via the mobile app however your nominated bank details must already be registered on your membership.
If the account is unpaid, Medicare will pay the provider directly and Latrobe will pay our benefit directly to your nominated bank account. You will need make payment to the provider and settle the account.
If you’ve already paid the account, we will pay our benefit directly to your nominated bank account.
2. Going into a Medicare Office
Medicare will ask for your Latrobe details and once processed, the claim will be submitted to us.
If the account is unpaid, Medicare will pay the provider directly and Latrobe will pay our benefit directly to your nominated bank account. You will need make a payment to the provider and settle the account.
If you’ve already paid the account, we will pay our benefit directly to your nominated bank account.
The fine print
Medicare and Latrobe will pay claims up to the MBS schedule fee plus any additional benefits you may be entitled to.
Please note if you have paid a separate out of pocket invoice please ensure that a copy of this is submitted to Latrobe to ensure maximum benefits are paid.
You will need to make sure your direct credit bank details are up to date with Latrobe.
You can update your details by registering or logging into the Latrobe online member area, completing your details on the Latrobe claim form or by contacting our Member service Centre on
1300 362 144.
Due to privacy legislation, we are unable to contact
Medicare on your behalf.
Download this information as a fact sheet.