Can I claim an Abby appointment on private health insurance?

Abby Health bulk bills most telehealth consultations for eligible patients, meaning Medicare covers the consultation in full and there is no out-of-pocket cost for eligible patients. Because there is nothing paid out-of-pocket on a bulk-billed consult, there is nothing to claim on private health insurance. If your consultation is privately billed, some funds reimburse part of the fee under extras cover — your Abby invoice has the itemised detail you need to check with your insurer. Extras cover may still apply to prescription medications, pathology, imaging, or specialist referrals that follow the consult.

Bulk-billed consults and private health insurance

For bulk-billed appointments, Medicare pays the full consultation fee directly to Abby. There is no gap, no invoice to submit, and nothing for you to claim. Private health insurance in Australia is designed to cover services Medicare does not cover — so it does not top up what Medicare has already covered in full.

If you're not sure whether you'll be bulk billed, see is Abby bulk billed? and who is eligible for bulk billing.

Privately billed consults and extras cover

A small number of Abby appointment types are privately billed rather than bulk billed. In those cases, Abby issues an itemised tax invoice with the MBS item number and the fee paid. Some private health funds reimburse a portion of general practitioner or nurse practitioner consultations under extras policies.

Cover varies significantly between funds and policies. To find out what you can claim, call your insurer or check your online member portal with the Abby invoice in hand. The itemised invoice contains everything your fund needs: provider details, date of service, MBS item, and the amount paid.

What your extras cover may still apply to

Even when the consult itself is bulk billed, your private health extras may still cover services that follow the appointment. Depending on your policy, extras cover can include:

• Prescription medications, up to an annual limit
• Pathology tests and imaging that sit outside Medicare's bulk-billed pathways
• Allied health services such as physiotherapy, psychology, or dietetics
• Specialist consultations where a gap applies

Your insurer decides what is covered, how much is rebated, and any annual limits. Abby does not submit claims to private health insurers on your behalf.

How to get the invoice you need

Every Abby appointment generates a receipt. For privately billed consults, the receipt is an itemised tax invoice that your fund will accept. You can download it from your Abby patient account after the appointment, or request a copy from support. For bulk-billed consults, a receipt is still available for your records but there is nothing to claim.

To book, see how to book a bulk-billed appointment on Abby.

Frequently asked questions

Can I use my private health insurance instead of Medicare at Abby?

Medicare is the primary payer for general practitioner and nurse practitioner consultations in Australia. For eligible patients, Abby bulk bills through Medicare — private health insurance is not used as the primary payer for these appointments.

Does Abby issue a receipt I can submit to my insurer?

Yes. For privately billed consults, an itemised tax invoice is generated after the appointment and is available from your Abby patient account. That invoice has the detail your fund needs to assess a claim under extras cover.

Can I claim the cost of prescriptions from my appointment?

That depends on your extras policy. Many funds reimburse a portion of prescription medication costs up to an annual limit. Check with your insurer — your pharmacy receipt is the document you'll need to submit, not the Abby consult invoice.

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