All Other Claim Forms

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

Anaesthetists' supplementary claim form

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

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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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Convalescent care claim form

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

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Fertility benefit claim form

Provide details and claim benefit towards your fertility treatment.

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360 Health/Vhi SwiftCare form

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

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Healthsteps claim form

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

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Hospital claim form

This form will be completed by hospital administrative staff.

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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

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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Oncology and Radiology

This claim form will be completed by the administrative team.

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Physio Company form

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

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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.

Select form

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:

Return Home Benefit

Available following a hospital stay of 5 days or more on relevant plans.

Parent Accompanying Child

Travel and accommodation expenses for parent/guardian accompanying a child (under 14 years at last renewal date) during that child's hospital stay in excess of 3 days.

Cancer Care Support

Accommodation grant - available when a patient travels for outpatient cancer chemotherapy or radiotherapy treatment and is required to stay overnight in accommodation convenient to the hospital.

Child Nursing

Nursing care at home (for a member under 18 years of age at last renewal date) following a stay in hospital of 5 days or more.

Post-Natal Home Nursing Benefit

Home nursing, by a registered nurse, incurred within 3 days of delivery.

Patient Support

Benefit towards the accommodation costs of a family member as detailed on relevant plans.

Manual Lymph Drainage

Benefit towards the cost of Manual Lymph Drainage. The person providing the care must be a Physiotherapist, or Physical Therapist, or a member of MLD (Manual Lymph Drainage) Ireland.

Benefits direct form

Claim forms for all other services

Postal claims

Receipts

Fill form

Post

Claim forms from A - Z

Anaesthetists' supplementary claim form

Appliance claim form

Convalescent care claim form

Fertility benefit claim form

360 Health/Vhi SwiftCare form

Healthsteps claim form

Hospital claim form

Hospital@Home

Hospital Intensive Care

Maternity claim form

Neonatal Intensive Care

Oncology and Radiology

Physio Company form

Private ambulance form

Surgical procedures

Pay and claim back form

Return Home Benefit

Parent Accompanying Child

Cancer Care Support

Child Nursing

Post-Natal Home Nursing Benefit

Patient Support

Manual Lymph Drainage

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