How to claim
We recommend you contact Defence Health for a benefit estimate before commencing any major treatment. Benefits are not be payable for services that are claimable from another source such as workers compensation or third party insurance. For full claiming conditions see the claiming conditions page.
In most cases, Defence Health will settle your account directly with the hospital when you are discharged. If your hospital stay is affected by an excess or a waiting period, the hospital will require you to pay the additional charge either at admission or on discharge.
In-hospital medical claims
You should ask your doctor to use Access Gap to minimise your out-of-pocket medical expenses. If your doctor agrees, the doctor’s account will be sent directly to Defence Health to pay.
If your doctor sends his Access Gap account to you, please forward it to Defence Health.
If you receive any other in-hospital medical bills, they should be forwarded directly to Medicare. Medicare will then send you their assessment statement. You should send this statement to Defence Health so we can cover the difference between the Medicare rebate and the MBS fee. Any balance will need to be paid by you.