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Steps to transitioning
Your guide to transitioning
  • Getting started
    Getting started
    There's a lot to think about when transitioning out of the ADF, but we're here to help you navigate the health system.
    Read more
  • Transition and your health
    Transition and your health
    Accessing the right information at the right time is the key to planning a smooth change for you and your family.
    Read more
  • Medicare and you
    Medicare and you
    Medicare ensures all Australians have access to government-subsidised medical, optical and hospital care. How does it work?
    Read more
  • Department of Veterans' Affairs
    Department of Veterans' Affairs
    As a former ADF member, you could be entitled to a DVA Gold Card or White Card. And what does it mean if you already have one?
    Read more
  • Private health insurance - where does it fit?
    Private health insurance - where does it fit?
    Private health insurance can cover both ‘hospital’ and ‘extras’ treatment. These insurances help fill financial gaps in treatment costs, as well as provide cover where Medicare doesn’t go.
    Read more
  • Government Initiatives
    Government Initiatives
    How will you be affected by government initiatives? Learn about the private health insurance rebate, Medicare Levy Surchage, Lifetime Health Cover and more.
    Read more
Introduction
Getting started

This page aims to cover everything you need to know about navigating the health system. It outlines how the private and public systems function, and where you fit as an ex-serving member of the Defence community.

If you can't find the information you need, call Defence Health on 1800 335 425 and we'll be happy to assist you. Because that's what we're here for.

Prepare
Transition and your health

While you’re preparing for transition, it’s a good idea to attend one of the transition seminars that are held on base or at a Transition Centre. They are very useful in explaining all the things that will change when you move to civilian life.

Defence also has a very helpful Transition Handbook to guide you through the process leading up to transition.

You are entitled to medical and dental treatment through Defence up to, but not beyond, your transition date. So it’s important to meet any existing health care needs during the last 12 months of your service.

Even niggling aches or pains should be checked out by Defence before you transition. If you need Department of Veterans’ Affairs (DVA) assistance down the track it will be helpful to have a comprehensive medical record that includes all aspects of your health at the time of leaving the ADF.

Download Transition Handbook

Next step
Medicare and you

First things first - register for Medicare

If you don’t already have a Medicare card, then that’s the first thing you need to do. Medicare is your ticket to ride – it identifies your entitlement to receive publicly funded hospital and medical treatment, as well as subsidised medicine and diagnostic tests.

Medical services

Medicare ensures all Australians have access to government-subsidised medical, optical and hospital care.

Every health service that Medicare funds is itemised in the Medicare Benefits Schedule (MBS). This enormous list defines the fee that Medicare sets for a service. Medicare will then contribute a percentage of the relevant fee for itemised medical treatment.

If you visit a doctor or specialist outside of hospital, Medicare will contribute 85% of the MBS fee. You will have to pay the gap between the Medicare rebate and the doctor’s charge, which is often higher than the MBS fee.

General treatment

Medicare does not fund general treatment (such as dental, physiotherapy or podiatry) or provide any cover for ambulance services.

While Medicare covers the cost of an eye test (every two years or as required), it will not contribute towards the cost of glasses or contact lenses. In special circumstances, Medicare will provide benefits towards general treatment for people with chronic conditions and complex care needs.

It is recommended that you have a state-based ambulance subscription or private health insurance to cover the cost of ambulance treatment. 

Diagnostic tests

Medicare pays 85% of the MBS fee for important diagnostic tests, such as x-rays or blood tests. However, if the provider charges more than the Medicare rebate you will be responsible for the balance of the charge.

 

Pharmacy medication

You cannot purchase any prescription medicine without a prescription from your doctor.

With a Medicare card you are entitled to subsidised prescription medicine under the Pharmaceutical Benefits Scheme (PBS). If you qualify for the Repatriation Pharmaceutical Benefits Scheme, you'll have access to a wider range of subsidised medicine.

The PBS operates with a co-payment arrangement. You pay the first $38.30 (or $6.20 if you're a concession card holder) and the government subsidises the remainder of the cost. The amount of co-payment is adjusted in line with inflation from 1 January each year.

Safety nets kick in if you (or the family) have very high pharmacy costs. If you think you'll need more than 60 prescriptions in a year, keep track of your pharmacy expenses on a Prescription Record Form to qualify for the safety net. The forms are available from pharmacies.

When you give your prescription to the pharmacist (or chemist) you might be asked if you'd like a 'generic' brand. Generic brands have the same ingredients and will treat your symptoms the same way, but are often cheaper than big brand pharmaceuticals.

If your medicine is not listed on the PBS, you will have to pay the full price – which can be very high in some cases. Private health insurance (extras cover) can often contribute towards non-PBS medication.

Register for Medicare

To enrol for a Medicare card, you’ll need to complete the application form which is downloadable from the Department of Human Services website or available at a Centrelink or Medicare service centre.

Download Medicare Application Form

 

  • First things first - register for Medicare

    First things first - register for Medicare

    If you don’t already have a Medicare card, then that’s the first thing you need to do. Medicare is your ticket to ride – it identifies your entitlement to receive publicly funded hospital and medical treatment, as well as subsidised medicine and diagnostic tests.

  • Medical services

    Medical services

    Medicare ensures all Australians have access to government-subsidised medical, optical and hospital care.

    Every health service that Medicare funds is itemised in the Medicare Benefits Schedule (MBS). This enormous list defines the fee that Medicare sets for a service. Medicare will then contribute a percentage of the relevant fee for itemised medical treatment.

    If you visit a doctor or specialist outside of hospital, Medicare will contribute 85% of the MBS fee. You will have to pay the gap between the Medicare rebate and the doctor’s charge, which is often higher than the MBS fee.

  • General treatment

    General treatment

    Medicare does not fund general treatment (such as dental, physiotherapy or podiatry) or provide any cover for ambulance services.

    While Medicare covers the cost of an eye test (every two years or as required), it will not contribute towards the cost of glasses or contact lenses. In special circumstances, Medicare will provide benefits towards general treatment for people with chronic conditions and complex care needs.

    It is recommended that you have a state-based ambulance subscription or private health insurance to cover the cost of ambulance treatment. 

  • Diagnostic tests

    Diagnostic tests

    Medicare pays 85% of the MBS fee for important diagnostic tests, such as x-rays or blood tests. However, if the provider charges more than the Medicare rebate you will be responsible for the balance of the charge.

     

  • Pharmacy medication

    Pharmacy medication

    You cannot purchase any prescription medicine without a prescription from your doctor.

    With a Medicare card you are entitled to subsidised prescription medicine under the Pharmaceutical Benefits Scheme (PBS). If you qualify for the Repatriation Pharmaceutical Benefits Scheme, you'll have access to a wider range of subsidised medicine.

    The PBS operates with a co-payment arrangement. You pay the first $38.30 (or $6.20 if you're a concession card holder) and the government subsidises the remainder of the cost. The amount of co-payment is adjusted in line with inflation from 1 January each year.

    Safety nets kick in if you (or the family) have very high pharmacy costs. If you think you'll need more than 60 prescriptions in a year, keep track of your pharmacy expenses on a Prescription Record Form to qualify for the safety net. The forms are available from pharmacies.

    When you give your prescription to the pharmacist (or chemist) you might be asked if you'd like a 'generic' brand. Generic brands have the same ingredients and will treat your symptoms the same way, but are often cheaper than big brand pharmaceuticals.

    If your medicine is not listed on the PBS, you will have to pay the full price – which can be very high in some cases. Private health insurance (extras cover) can often contribute towards non-PBS medication.

  • Register for Medicare

    Register for Medicare

    To enrol for a Medicare card, you’ll need to complete the application form which is downloadable from the Department of Human Services website or available at a Centrelink or Medicare service centre.

    Download Medicare Application Form

     

You may be eligible
Department of Veterans' Affairs

Your health and your ADF service

As a former ADF member, you could be entitled to a DVA Gold Card or White Card.

DVA health cards can provide access to a broad range of treatment and services including hospital treatment, theatre fees, intensive care, GP services, referred specialist services, allied health, dental care, optical services and ambulance cover. Health card holders can also be covered for a wide range of rehabilitation devices and appliances, pharmaceutical needs and travel for treatment.

The DVA Gold Card will provide cover for any clinically necessary health care needs, whether they are related to war service or not.

A White Card provides cover for the care and treatment of specifically accepted injuries or conditions that are war caused or service related. The White Card will also cover malignant cancer, pulmonary tuberculosis, post-traumatic stress disorder (PTSD), alcohol and substance use disorders, anxiety and depression whether war-caused or not.

If you think you might be eligible for a White Card or Gold Card, you should contact DVA. The fact sheets at dva.gov.au explain who can obtain a health card.

DVA Gold Card Fact Sheet

DVA White Card Fact Sheet

For more DVA guidance see below.

 

 

 

 

Helpful information
DVA guidance

DVA and your health and wellbeing

The Department of Veterans’ Affairs (DVA) provides support to current and former serving members and their families and carers through a range of services and payments (including ongoing or one off payments). These services are designed to assist you to manage your health and lifestyle and support those you care for. 

Just to let you know
Government initiatives - how they affect you

Bulk billing

Bulk billing is the term used when a general practitioner or specialist charges the government directly for your consultation. The doctor only receives the Medicare rebate (85% of the MBS fee) and you, the patient, have no out-of-pocket expense.

If the doctor doesn’t bulk bill, you’re responsible for the gap between Medicare's 85% contribution to the MBS fee and the actual charge.

Private health insurance rebate

Most people who take out private hospital cover receive a sweetener from the government in the form of a rebate on their premium. The amount of rebate is determined by income and by the age of the oldest person on the policy. The government adjusts the rebate each year by an amount linked to the inflation rate. Check the rebate tiers and income thresholds at ato.gov.au

Medicare Levy Surcharge

The health system is partly funded by a 2% Medicare Levy collected when you lodge your tax return. As a permanent ADF member, you would've been either fully exempt from paying the levy, or only paid 1% if you had a family.

The Medicare Levy Surcharge is an additional charge on top of the standard levy. It's applied on a progressive scale to higher income taxpayers who do not hold appropriate private patient hospital insurance. If you are a high income earner, you should consider private health insurance to avoid the surcharge. Check out the income thresholds and tax rates at ato.gov.au to see if you're affected.

Lifetime Health Cover

The government encourages people to take out private hospital cover early in life and to maintain it. Lifetime Health Cover adds a 2% loading to premiums for every year after age 30 that someone remains without private hospital cover.

Once you attract a loading, it can only be removed after 10 continuous years of hospital cover.

Permanent members of the ADF while serving, are considered to have hospital cover. So Lifetime Health Cover doesn't affect you until you discharge.

To cover small periods of time without cover, everyone is allowed two years and 364 days without cover.

If you discharge before your 31st birthday, the normal Lifetime Health Cover rules apply to you.

If you discharge after 1 July following your 31st birthday, you can take out cover without a loading (unless you already had one when you enlisted). If you don't take out hospital cover on discharge, you've got up to two years and 364 days before you'll attract a loading.

 

 

  • Bulk billing

    Bulk billing

    Bulk billing is the term used when a general practitioner or specialist charges the government directly for your consultation. The doctor only receives the Medicare rebate (85% of the MBS fee) and you, the patient, have no out-of-pocket expense.

    If the doctor doesn’t bulk bill, you’re responsible for the gap between Medicare's 85% contribution to the MBS fee and the actual charge.

  • Private health insurance rebate

    Private health insurance rebate

    Most people who take out private hospital cover receive a sweetener from the government in the form of a rebate on their premium. The amount of rebate is determined by income and by the age of the oldest person on the policy. The government adjusts the rebate each year by an amount linked to the inflation rate. Check the rebate tiers and income thresholds at ato.gov.au

  • Medicare Levy Surcharge

    Medicare Levy Surcharge

    The health system is partly funded by a 2% Medicare Levy collected when you lodge your tax return. As a permanent ADF member, you would've been either fully exempt from paying the levy, or only paid 1% if you had a family.

    The Medicare Levy Surcharge is an additional charge on top of the standard levy. It's applied on a progressive scale to higher income taxpayers who do not hold appropriate private patient hospital insurance. If you are a high income earner, you should consider private health insurance to avoid the surcharge. Check out the income thresholds and tax rates at ato.gov.au to see if you're affected.

  • Lifetime Health Cover

    Lifetime Health Cover

    The government encourages people to take out private hospital cover early in life and to maintain it. Lifetime Health Cover adds a 2% loading to premiums for every year after age 30 that someone remains without private hospital cover.

    Once you attract a loading, it can only be removed after 10 continuous years of hospital cover.

    Permanent members of the ADF while serving, are considered to have hospital cover. So Lifetime Health Cover doesn't affect you until you discharge.

    To cover small periods of time without cover, everyone is allowed two years and 364 days without cover.

    If you discharge before your 31st birthday, the normal Lifetime Health Cover rules apply to you.

    If you discharge after 1 July following your 31st birthday, you can take out cover without a loading (unless you already had one when you enlisted). If you don't take out hospital cover on discharge, you've got up to two years and 364 days before you'll attract a loading.

     

     

 

I'm transitioning to the Reserves. What do I need to do?

If you are transitioning to the Reserves and serving 20 or more training days in a financial year, you will remain eligible for one of our exclusive ADF packages. If you’ve already got the family covered, it’s just a matter of calling us and we’ll add you to the policy. If you are transitioning to the Reserves and not serving 20 or more training days in a financial year then you can choose from our mix and match options.

I am transitioning to civilian life. What do I need to do?

If you’re making the step to civilian life we’ve got some great mix and match hospital and extras options for you. Plus, you’ll receive a 10% transition discount on hospital or hospital and extras for the first year of your cover. The discount will apply to the entire premium – family cover included – when you pay by direct debit from your bank account.

Get a quick quote

We're always here to help so give us a call to discuss your options on 1800 335 425.

Prepare
Private health insurance - where does it fit?

Private hospital cover

Medicare does a great job. But patients are treated in public hospitals according to the urgency of their clinical need. That means you could have to wait longer than you'd like for elective treatment.

And it's not just a case of 'join the queue'. As emergencies and more critical patients come along, their clinical needs take priority and you get bumped down the list. Private hospital cover gives you access to a network of hundreds of private hospitals. So you'll get more timely treatment. It also covers a minimum of 25% of the MBS fee when your specialist treats you in a private hospital - and Medicare will pay the other 75%. Most funds will also have some form of 'gap cover' which, if used by your doctor, will cap or remove your out-of-pocket medical expenses. 

Extras cover

Extras cover reduces the cost of the every-day health care services that help keep you well and out of hospital. Dental treatment is the classic example – it’s a must-have treatment that in most cases can’t be claimed through Medicare.

The treatment covered varies from a handful of categories for budget cover, up to a wide range of substantial health and wellness benefits for higher cover.

 

I’ve got a Gold Card – do I need private health insurance?

With the excellent entitlements provided by a Gold Card, you are covered for all clinically necessary treatment within Australia. You should not need private health insurance – but if you choose to have private cover it can provide some additional benefits and extra choice.

I’ve got a White Card – do I need private health insurance?

You should consider private health insurance for the treatment of conditions not accepted under your White Card. 

 

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