Membership FAQ

How can I transfer from another fund to Defence Health?

Once you join Defence Health, all you need to do is complete the Cancellation and transfer authority form and cancel any automatic payments you may have with your existing fund. Defence Health will do the rest. Any waiting periods served under your previous cover for comparable benefits will be honoured.

Is there a cooling off period?

If for any reason you change your mind within the first 30 days and have not made a claim, simply write to us and we can cancel your membership and refund any premiums you have paid.

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To what age are my children covered under my membership?

Your children can be covered under your membership:

• under the age of 21 years, unmarried and not living in a defacto relationship, or
• under the age of 25 years, unmarried, not living in a defacto relationship and undertaking full-time study in an approved course as defined by Defence Health

If you have children who are over 21 but under 25, are no longer full time students and are not married or living in a defacto relationship our Young Adult Support Plan may help.

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What do I need to know before suspending my healthcover?

With the agreement of Defence Health, you may suspend your cover for any of the following reasons:

• overseas posting
• ADF Reservists on continuous full-time study
• financial hardship, or
• overseas travel.

We strongly recommend you seek advice regarding any implications of the Medicare Levy Surcharge before suspending your hospital cover. The surcharge is payable by high-income earners during any period of suspended hospital cover.

For more detail you can download a Suspending your health cover information sheet or the Membership suspension application form.

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What is the Young Adult Support Plan?

If you have children who are over 21 but under 25, are no longer full time students and are not married or living in a defacto relationship, they may remain covered for hospital benefits under your family cover if they purchase and maintain their own Top Extras cover.

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Change of cover

Can I transfer to Defence Health from another fund?

If you already have cover with another fund you can transfer to Defence Health at the same or a lower level of cover without serving additional waiting periods – this is called portability. Defence Health will give you credit for any waiting periods you have already served with your previous fund. If you upgrade your level of cover in the transfer you may have to serve waiting periods on the upgraded cover.

Under the Government's Lifetime Health Cover initiative, your established ‘certified age at entry' with your previous fund will be recognised by Defence Health, and if you join immediately after the expiration of your current cover you will not have any additional ‘days without hospital cover' recorded on your account.

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Will I be penalised under Lifetime Health Cover?

No. When you switch to Defence Health from another health fund, your entitlements under Lifetime Health Cover will be maintained if you take out Defence Health hospital cover. And if you join immediately after the expiration of your current cover you will not have any additional ‘days without hospital cover' recorded on your membership.

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Will I lose the Federal Government 30% Rebate that I currently receive?

No. You will continue to be eligible for the Federal Government 30% Rebate. You will however need to reapply to receive the rebate as a reduced premium if you are transferring between funds.

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Will I have to go through waiting periods again?

If you join Defence Health before your current cover expires you will maintain continuity of cover, so you can switch to Defence Health with the reassurance that you won't have to wait again before you can start making claims on your health cover. However for any benefits you weren't previously covered for waiting periods may apply.

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If I have earned increased annual limits on some of my benefits (e.g. dental cover) do I lose them now?

Unfortunately yes. Loyalty bonuses can take many forms; from higher benefits after a set number of years to the ability to roll over benefits not used in previous years. Whatever form they take they are always given as a reward for your length of membership with the particular fund or specific product. For this reason loyalty bonuses are exclusively applied to the membership of a particular fund or specific product of a fund; they are not transferable to other funds or products.

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Can I upgrade my cover?

It is possible to change your level of cover to meet your changing needs at any time. If you increase your level of cover by adding a new benefit type, increase your benefit level, or move from an excess product to a lower excess or excess free product, waiting periods will apply to the higher benefits of your new cover.

You will, however, be entitled to the benefits of your previous cover.

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Can I add a new born to my membership?

If you currently have single or couples cover and wish to add a newborn child, you can transfer to family or military family cover from the date of your child's birth. As long as you add your newborn within 2 months of their birth, with premiums paid from the date of birth, cover will be immediate with no waiting periods.

If you already have a family membership  you can simply add your baby's name to your cover. Your baby will be covered effective from their date of birth as long as we are notified before your child is two months old.

Government initatives

What is the gap?

When you go to hospital, the benefits you're entitled to for the medical procedures you receive are based on the Federal Government Commonwealth Medicare Benefits Schedule. However, doctors can charge above this schedule. The 'gap' is the difference between the doctor's charge for the services they provide in hospital and the total benefits you receive from Medicare and Defence Health.

To help avoid or reduce the 'gap' Defence Health has introduced Access Gap Cover. Participation in Access Gap Cover is at your doctor's discretion and you will need to check with them if they'll be using Access Gap Cover for you. Click here for a list of doctors who have participated in Access Gap Cover in the past. back to top

How do I claim the Federal Government Rebate on private health insurance?

If you are eligible for Medicare benefits and have private health insurance with Defence Health then you can get the Rebate in one of three ways:

• an automatic reduction in premiums - click to download a form for registering to have the Rebate as a reduction in premiums
• a tax offset on your annual income tax return or
• a direct refund from a Medicare office

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What is Lifetime Health Cover?

This Federal Government initiative rewards those who take out hospital cover early in life and maintain it, by allowing them to pay lower premiums throughout their life compared with others who take out hospital cover when they're older, or who allow their cover to lapse for long periods.

Under the current LHC provisions, people who do not have private hospital cover on the 1st of July following their 31st birthday must pay more for their premiums. They must pay a 2% loading on top of a base rate premium for each year they remain without hospital cover.

For more detail regarding Lifetime Health Cover click here.

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Is the GST applicable to private health insurance premiums?

No, private health insurance premiums are GST-free.

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What is the Medicare Levy Surcharge?

The Medicare Levy Surcharge is an additional 1% Medicare Levy for people who do not have an appropriate level of hospital cover, and who earn over $50,000 per year as an individual, or over a combined taxable income of $100,000 per year for couples and most families. (This threshold increases by $1,500 for each additional child after the first). This 1% is in addition to the standard Medicare Levy of 1.5% of taxable income.

All Defence Health hospital covers exempt members from paying the additional 1% Medicare Levy Surcharge. back to top

Rather than being in a health fund, wouldn't it be easier to save the money in a separate account and 'self-insure'?

It may sound like a good plan, but once you start adding up potential medical expenses your savvy financial strategy might wind up with some serious holes. By the time normal health bills such as dental, optical and physiotherapy are paid, there may not be much left for unexpected procedures or emergencies. Having private health insurance ensures there will always be money to help you meet your health needs and choices.

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