Back to all claims

Claim forms for all other services

Postal claims

Simply select the form below that's suitable to your needs, and follow these steps: 

Receipts

Gather your receipts, if this is applicable to the service.

Fill form

Print and complete the relevant form.

Post

Address: Vhi, Po Box 11530, Dublin 18.

Claim forms from A - Z

A - H
Document

Anaesthetists' supplementary claim form

This form is for completion by the Consultant Anaesthetist who provides the service.

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Document

Appliance claim form

This claim form is for submitting appliance claims. Details for each appliance that you are claiming for must be included. The list of Vhi Approved Medical and Surgical Appliances can be found here. 

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Document

Convalescent care claim form

Benefit is payable for a specific period toward the cost of the accommodation. 

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Document

Fertility benefit claim form

Provide details and claim benefit towards your fertility treatment.

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Document

360 Health/Vhi SwiftCare form

Form to claim for care in Vhi SwiftCare or Vhi 360 Health Centre.

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Document

Healthsteps claim form

This claim form is for submitting day-to-day medical expenses covered by your plan. 

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Document

Hospital claim form

This form will be completed by hospital administrative staff.

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Document

Hospital@Home

Claim form for clinical care received in your home with Vhi Hospital@Home.

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Hospital Intensive Care

This form is for completion by the consultant who provides intensive care medicine.

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I - Z
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Maternity claim form

Suitable for members who have received inpatient maternity care.

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Neonatal Intensive Care

This form is for completion by the consultant who provides the care.

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Document

Oncology and Radiology

This claim form will be completed by the administrative team.

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Document

Physio Company form

This claim form is for submitting your Joint Care Programme claims.

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Document

Private ambulance form

Claim form for a private ambulance.

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Surgical procedures

This claim form will be completed by a medical practitioner. 

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Pay and claim back form

Claim form for benefits we pay direct to you The claim form below can be used to claim for any of the following benefits:

Benefits direct form