Medicare claims history and claims history statement online 133-10010000

Customers can view the claims history or request a statement:

• for themselves
• for dependents under 14 years of age listed on the Medicare card

Because of privacy and security reasons, no service provider details show for children under 14 years.

Because of legislation and agency policies, details for young people aged 14-17 years are not available online (including Medicare online account and Express Plus Medicare mobile app).

My Health Record provides an option for a young person 14-17 years old to access their Medicare claiming information. They can create and gain control of their own My Health Record. Children can consent to having claiming information in their record. The amount of information available depends on whether the parents/guardians consented to include it before the child turned 14. If they:

• did consent, the claiming information can include records from 2 years before the My Health Record was created
• did not consent, claiming information can only include 2 years before from when the child consents

Parents can also access this information if the child grants the parents/guardian’s access. Following an amendment in December 2018 to the My Health Records Act 2012, the My Health Record system automatically removes parent/guardian access when the child turns 14. As mentioned above, the child can grant and remove access at any time.

Customers aged 14-17 have 2 options to access their claims history:

• visit a service centre
• submit a Request for Medicare claims information form (MS031). The Resources page contains a link to the form

See Release of claims information in Medicare.

Although the form states it can only be used for claims over 3 years, it can also be used to release information about claims for 14-17 year olds within 3 years.

Customers will get their Medicare claiming information by post or email.

The history includes events from the customer's previous and current Medicare cards within the last 3 years. It does not include rejected or adjusted claims. To view details of adjusted claims or claims older than 3 years, customers must request this in writing. See Release of Information.

The claims history is not used for compensation. Customers will need to complete a Medicare Compensation Recovery Medicare History Statement request form (MO026). See the Resources page for a link to the form.

If a child under 14 years is transferred to a new card with their parent/guardian on it, their previous card’s claim history is not transferred to the new card. This is because of Medicare policy, privacy, and fraud requirements.

Customers must complete a Request for Medicare claims information form (MS031). See the Resources page for a link to the form.

A customer may contact about incorrect or missing details in their claims history. Service Officers should consider that the customer may not understand the information on their statement.

See the Resources page for a link to the Services Australia website page Understand your Medicare Claims History Statement.

Medicare claims history statements include:

• patient details, including:
• full name
• Medicare card number
• date of birth
• service details, including:
• date of service
• item number and brief description
• total cost of the service (amount charged by the provider)
• benefit paid by the Australian Government
• cost to claimant
• payment method
• reason codes and description