FAQs

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Joining or switching to Defence Health

Switching

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  • Why should I switch to Defence Health?

    You’ll find the grass really is greener over here. We offer great value, not just value for money, but also great value advice and assistance. We have 60 years of experience so we know what we're doing. And we think you'll love being treated as part of the Defence family. So just give us a call and we’ll give you a hand over the fence.

  • How do I switch to you?

    You’ll be amazed how simple it is to switch to Defence Health.

    • Choose your product and your level of cover
    • Join online – or call 1800 335 425
    • Sign a couple of forms we send you
    • Start enjoying our award winning service and generous benefits.

    We’ll deal with your old fund. We’ll get the paperwork to you super-fast. And if you’ve already served your previous waiting periods, you can start using your cover immediately. If you’re upgrading your cover, you’ll only have to serve waiting periods for the higher portion of benefit.

    If you’re not sure about what cover to take – just ask us. We’ll explain things in plain English and help you choose the cover that’s the perfect fit.

  • What if I change my mind after taking out cover with you?

    If you change your mind within 30 days of joining and haven’t made a claim, we’ll refund your premiums in full and cancel your membership – no questions asked.

  • How will switching affect my level of cover?

    As long as you switch within two months of leaving a fund, there’s no need to re-serve waiting periods. If you upgrade to a higher level of cover (or remove or reduce an excess), you’ll be covered immediately for the equivalent level of cover, but the applicable Defence Health waiting period will apply for the higher level of benefit. This includes any excess or co-payments that applied on your previous cover.

  • If I switch to Defence Health, how long must I wait before I can claim benefits?

    If you join Defence Health within two months of leaving a fund there’s no need to re-serve waiting periods. So if you take out an equivalent level of cover, you can claim immediately.

    You will need to serve the applicable Defence Health waiting period for any higher level of benefit, but you’ll be entitled to benefits at your previous level of cover while you’re serving the waiting period. This includes any excess or co-payments applicable on your previous cover.

  • Is it hard to switch from my current insurer?

    Not at all. You can join Defence Health over the phone or online. We’ll do the paperwork for you and notify your old fund. There are no contracts or penalties when you switch. And any payments you’ve made in advance will be refunded to you by your previous insurer.

  • What happens to benefit limits when I switch to Defence Health?

    When you switch to Defence Health, your available benefit limits will reflect claims you've made this year at your old fund. Your benefits on most services will reset on 1 July.

  • High quality customer service is important to me. How can I find out about a fund’s performance?

    The Commonwealth Ombudsman regulates all funds and publishes extensive performance data relating to complaints, benefits to members, out-of-pocket expenses and member retention. Research shows Defence Health members are among the most satisfied in the industry – in 2015 98% of members said they are satisfied with their membership. 

  • Why should I care about a fund’s Management Expense Ratio (MER)?

    The Management Expense Ratio indicates how much of your premium goes towards the marketing and management of the fund. The lower the MER, the more there is for members.

  • Where can I get independent advice about health insurers?

    The government has a useful website to help you compare all health funds.

  • What are ‘lifetime limits’ and how do they affect me?

    Some funds use ‘lifetime limits’ to cap the total benefit you can receive from them during your lifetime. Defence Health doesn’t use lifetime limits. Most of our benefit limits re-set on 1 July each year.*

    *Some medical appliances may only be claimed every three years and laser refractive eye surgery benefits are payable every two years.

  • Why choose Defence Health?

    ADF families are our heroes. We’re here for you and we understand the extra care your families need. You’re on the move with deployment. There can be long periods with only one parent at home. And sometimes, it’s just the kids who need the cover.

    We get that. And we’ve got the products designed to cater for your needs. We offer ADF families exclusively packaged and priced cover. We’ve got a one-year transition discount when the time comes to leave the ADF. And if you happen to fancy our civilian products while you’re still serving, we’ll give you a special price on them too.

    The choice is simple. At Defence Health you get extra care because you’re one of the family.

    Eligible Defence community members can also enjoy our excellent service and flexible cover. With a range of mix and match hospital and extras cover, ex-serving, extended family and Department of Defence employees and contractors can still feel part of the family and maintain their Defence connection.

    Not everyone can join Defence Health. But if you’ve got a Defence connection, you're one of the lucky ones. 

Joining

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  • Do I need to maintain my ambulance membership?

    As a Defence Health member you are fully covered for all ambulance treatment provided by a state-appointed ambulance service. You do not require a separate subscription.

  • I pay an ambulance levy/membership to my state based ambulance service. What happens when I join Defence Health?

    Our ambulance cover is comprehensive and covers you nationally for air, sea or land based ambulance treatment. The state governments of Queensland and Tasmania provide state-based ambulance services to their residents, within their state.

    Defence Health pays an ambulance levy on behalf of our members in NSW and ACT. It’s important that we know if you have a concession, Health Care Card or DVA card as this affects the amount we pay for ambulance treatment.

  • What if I change my mind after taking out cover with you?

    If you change your mind within 30 days of joining and haven’t made a claim, we’ll refund your premiums in full and cancel your membership – no questions asked.

  • Why choose Defence Health?

    ADF families and active Reservists are our heroes. We’re here for you and we understand the extra care your families need. You’re on the move with deployment. There can be long periods with only one parent at home. And sometimes, it’s just the kids who need the cover.

    We get that. And we’ve got the products designed to cater for your needs. We offer ADF families and active Reservists exclusively packaged and priced cover. We’ve got a one-year transition discount when the time comes to leave the ADF. And if you happen to fancy our civilian products while you’re still serving, we’ll give you a special price on them too.

    The choice is simple. At Defence Health you get extra care because you’re one of the family.

    Eligible Defence community members can also enjoy our excellent service and flexible cover. With a range of mix and match hospital and extras cover, ex-serving, extended family and Department of Defence employees and contractors can still feel part of the family and maintain their Defence connection.

    Not everyone can join Defence Health. But if you’ve got a Defence connection, you're one of the lucky ones. 

Comparing health funds

Comparing health funds

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  • Where can I get independent advice about health insurers?

    The government has a useful website to help you compare all health funds.

  • Why should I care about a fund’s Management Expense Ratio (MER)?

    The Management Expense Ratio indicates how much of your premium goes towards the marketing and management of the fund. The lower the MER, the more there is for members.

  • High quality customer service is important to me. How can I find out about a fund’s performance?

    The Commonwealth Ombudsman regulates all funds and publishes extensive performance data relating to complaints, benefits to members, out-of-pocket expenses and member retention. Research shows Defence Health members are among the most satisfied in the industry – in 2015 98% of members said they are satisfied with their membership.

Understanding your cover

Excluded or restricted cover

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  • What does restricted cover mean?

    If the treatment you require is restricted under your cover, the benefit we will pay is equivalent to what Medicare would pay if you were in a shared ward of a public hospital. You will still have significant out-of-pocket expenses.

Extras benefit limits

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  • What are ‘lifetime limits’ and how do they affect me?

    Some funds use ‘lifetime limits’ to cap the total benefit you can receive from them during your lifetime. Defence Health doesn’t use lifetime limits. Most of our benefit limits re-set on 1 July each year.*

    *Some medical appliances may only be claimed every three years and laser refractive eye surgery benefits are payable every two years.

  • What happens to benefit limits when I switch to Defence Health?

    When you switch to Defence Health, your available benefit limits will reflect claims you've made this year at your old fund. Your benefits on most services will reset on 1 July.

Premiums

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  • Should I pay annually or every fortnight when I’m paid?

    At Defence Health it makes no difference to your premium if you pay annually or fortnightly. So it all depends on what suits you and your household budget. Some people prefer to make a fortnightly or monthly direct debit, while others like to pay a year in advance.

Gym memberships

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  • Can I claim my gym membership through Defence Health?

    No, legislation defines the type of health benefits insurers are permitted to pay. Benefits for activities that are primarily sport, recreation or entertainment in nature are not allowed.

    Some funds may pay ‘lifestyle’ benefits on exercise or weight loss programs delivered by their approved providers. To comply with the legislation, the participant must be referred by a GP or physiotherapist as part of a health management plan that is intended to improve the person's specific health condition. Defence Health does not currently pay such a benefit.

Accidental injury benefit

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  • What is the accidental injury benefit?

    Under the ADF Essentials Package, Essentials Hospital and Value Hospital covers, your cover is expanded to include all services required to treat bodily injuries received as a result of an accident, provided you meet the Accidental injury benefit requirements outlined.

    You can receive private patient benefits if you’re involved in an accident after you join this cover and require hospital treatment for your injury. An accident means an unplanned or unforeseen event leading to bodily injuries caused solely and directly by external means and requiring urgent treatment from a registered practitioner. To be covered you must provide documented proof from your registered practitioner that you sought treatment within 72 hours of the accident. If treatment in hospital is needed as an admitted patient, you will need to be admitted within 180 days of the initial treatment. After this 180-day period, any hospital treatment will be paid as per the level of benefits on your cover (that is, some benefits may be excluded or restricted).

Flexi-limits

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  • What are flexi-limits?

    We've introduced flexi-limits for a range of general treatment under some of our extras cover.

    With the new flexi-limit, you can claim more of your favourite treatment under an overall limit. The flexi-limit can be claimed across the range of included treatments, or you can choose to use it on your favourite included treatment. Flexi-limits cover the below treatments:

    ADF Total Package, Premier Extras and Value Extras
    Physiotherapy, chiropractic, osteopathy, ante - & post-natal services, exercise physiology, psychology, podiatry/chiropody, occupational therapy, speech therapy, dietitian, eye therapy, audiology, pharmacy and vaccinations.

    ADF Essentials Package & Essentials Extras
    Physiotherapy, chiropractic, osteopathy, exercise physiology and travel vaccinations.

  • Why aren’t dental and optical included in the flexi-limit?

    You still get great benefits on dental and optical. Dental, optical (and the other standalone treatment categories) are fundamental to general health. Dental care is a must have. If you wear glasses, you need your optical benefits. So we’ve kept them separate for you to make the most of all aspects of your extras cover. 

  • Do I get flexi-limits on my product?

    Flexi-limits are available on the following products:  ADF Total Package, ADF Essentials Package, Premier Extras, Value Extras & Essentials Extras

    If flexi-limits are not available on your product, you may want to consider moving your extras to one of the above. If you have hospital cover, you may have to change your hospital cover as well. 

  • I would like flexi-limits, but they aren’t on my product

     

    If you would like the extra flexibility of flexi-limits, you are able to move to a suitable product that does include flexi-limits. If you are on a closed product and you would like to change your extras product, you may also need to change your hospital product to an open product. 

    After this change, you will be unable to move back to a closed product. 

    Waiting periods may apply if you are increasing your level of cover. 

    You can change your cover here, or give us a call on 1800 335 425.

Using my membership

Suspending cover

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  • Can I suspend my cover?

    In certain circumstances we are able to temporarily suspend your hospital cover. If you are:

    • Posted or travelling overseas
    • A Reservist on continuous full-time service
    • Facing financial hardship
      we may agree to you suspending your cover for a minimum of 28 days and maximum two years.

    If you are a high income earner you may be liable for the Medicare Levy Surcharge during the period of suspension.  

    Give us a call if you’d like to chat about suspending your cover.

Online member services

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  • How can I access Online Member Services?

    Our secure Member Area allows you to keep your finger on the pulse – 24/7.

    Register for access at https://member.defencehealth.com.au and we’ll send you an activation code. Then log on using the password you registered and the single-use activation code. Explore your member site and discover all the services available to you any time of the day or night.

  • What if I have forgotten my password?

    No drama. Just click the link on the login screen and we’ll email it to you.

Reducing your gap

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  • What is Access Gap?

    Access Gap is a major feature of our hospital cover and helps keep your medical costs down. Basically, we agree to pay a slightly higher amount to your doctor if he or she agrees to charge you a no-gap or low-gap fee.

    If your doctor agrees to use Access Gap, the most you will have to pay out-of-pocket is $400 for each Medicare item number, or $800 for obstetric services. Your doctor will confirm with you, prior to treatment, how much you will have to pay.

Adding a baby

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  • I’m expecting a baby, when do I have to add my baby to my health insurance?

    Cover for a baby is immediate when you call us with your baby’s name and date of birth within two months of the birth. We can back-date the cover if the baby needed cover from birth. If it’s your first child, we’ll need to change you to one of our family policies. 

    If you and your partner are full-time serving and expecting your first child just take out kids-only cover within two months of the baby’s birth. We will back-date the cover to the date of birth if necessary.

  • How do I add my baby to my health insurance cover?

    Make sure you share the good news with us. Just give us a call within two months of the birth and the little one is covered immediately. We will back-date the cover to his or her date of birth if necessary.

  • What if my baby is born early and I haven't served the whole 12 month waiting period?

    With our pregnancy cover, if your baby decides to arrive early and you can provide confirmation from your doctor that the expected due date was outside the 12 month waiting period - you will be covered.  

Tax time

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  • What happens at tax time?

    At the end of each financial year we will send you important information you’ll need to complete your tax return. You will receive your tax statement in the post within the first couple of weeks of July. You can download your statement from the Member Area of our website from 2 July. Find out more information.

Covering dependants

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  • Until what age do kids remain covered on my family policy?

    Your kids remain covered until age 21 – or 25 if they’re single and studying fulltime. To help ease 21 year-olds into their own cover, we’ve got a Young Adult Support Plan which helps them maintain hospital cover for the cost of their own Value or Premier Extras. 

Making the most of the Australian Government's inititatives

Rebate

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  • What is the Australian Government Rebate on private health insurance?

    To encourage more people to take out private health insurance, the Australian Government provides a rebate to make health insurance more affordable.  The rebate amount is based on the age of the oldest person covered by the policy (the older the better) and by your annual earnings (the lower the better).

    The table shows the current level of rebate available for different age and income levels.

    Level of annual income for surcharge purposes 2015-18
      Base tier Tier 1 Tier 2 Tier 3
    Singles ≤ $90,000 $90,001 to $105,000 $105,001 to $140,000 ≥ $140,001
    Families ≤ $180,000 $180,001 to $210,000 $210,001 to $280,000 ≥ $280,001
    Rebate - 1 April 2017 to 31 March 2018
    64 and under 25.934% 17.289% 8.644% 0%
    Age 65 to 69 30.256% 21.612% 12.966% 0%
    Age 70 plus 34.579% 25.934% 17.289% 0%

    Families include single parents and couples, whether married or de facto. For families with children, the thresholds are increased by $1,500 for each child after the first. The Rebate is adjusted annually on 1 April, but the government has fixed the income thresholds until 30 June 2018. Age relates to the oldest person covered by the policy.

  • How is the level of Australian Government Rebate determined?

    The rebate is based on family income and the age of the oldest person on a policy. You can select a rebate tier based on your expected combined income for rebate purposes. The Tax Office will calculate the correct level of rebate based on your actual income when you submit your tax return.

  • My income has changed. What should I do?

    You can change your rebate any time you like. You can call us or make the adjustment to your rebate online. Or you can keep your current rebate and reconcile the amount at the end of the year through your tax return.

  • What if I choose the wrong rebate?

    When you submit your tax return the Tax Office will reconcile whether you’ve received too much or too little rebate. This means if you received too little rebate the Tax Office will refund you and if you received too much you will need to pay the Tax Office. You will not be penalised if you choose the wrong tier. 

  • Who is eligible for the rebate?

    Most Australians are entitled to receive a rebate from the government. People on Tier 3 income levels do not receive it.

  • Can I receive the rebate on extras cover?

    Yes, as long as your income is less than the Tier 3 income threshold. 

  • Can Defence Health choose the right income tier?

    No we can’t. We don’t have any access to your financial details. Only you or your accountant can estimate your income for the rebate.

  • My partner has a separate policy. Do family or single income thresholds apply?

    Couples – including de facto couples – should refer to the family income thresholds.

  • I’m in the ADF and only cover my partner and children. Can I receive the rebate?

    Yes, you can receive the rebate. You should refer to the family income thresholds.

  • I’m in the ADF and have a kids-only policy. Can I receive the rebate?

    Yes, you can receive the rebate on cover for your children.

  • I’ve separated from my partner. Should I change my rebate?

    You should refer to the single income thresholds. If you need to adjust your rebate tier you can call us or make the change online. Or the Tax Office will reconcile your rebate entitlement at tax time.

  • Why isn’t the rebate applied to my total premium?

    If you have a Lifetime Health Cover loading, the rebate does not apply to the loading component of your premium.

  • My partner and I are considered a family. How is our family’s age determined?

    The rebate is based on the oldest person covered by a policy. 

  • I am planning to marry during the financial year. Which threshold should I use?

    Your marital status on the last day of the financial year is used to determine which threshold you should use. Therefore, if you marry, or enter into a de facto relationship, during the financial year, your income will be tested against the family thresholds.

  • Do I receive the rebate on my Lifetime Health Cover loading?

    No, the rebate is only applied to the base premium.

Medicare Levy Surcharge

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  • What is the Medicare Levy Surcharge?

    The Medicare Levy Surcharge (MLS) is an additional tax on higher income earners who don’t have hospital cover for themselves and their family. The surcharge is in addition to the Medicare Levy of 2% that applies to most taxpayers. No MLS is payable if you take out any of Defence Health’s ADF packages or any other Defence Health hospital cover.

    Serving ADF personnel should note that although you do not need private health cover yourself, if your combined family income is above $180,000 your family will need to take out private hospital cover to avoid the MLS.

    Level of annual income for surcharge purposes 2015-18
    Income thresholds Base tierTier 1Tier 2Tier 3
    Singles ≤ $90,000 $90,001 to $105,000 $105,001 to $140,000 ≥ $140,001
    Families ≤ $180,000 $180,001 to $210,000 $210,001 to $280,000 ≥ $280,001
    Medicare Levy Surcharge - 1 July 2014 to 30 June 2015
    All ages 0% 1% 1.25% 1.5%

    Families include single parents and couples, whether married or de facto. For families with children, the thresholds increase by $1,500 for each child after the first. The government has fixed the income thresholds until 30 June 2018. 

  • Who must pay the Medicare Levy Surcharge?

    The Medicare Levy Surcharge must be paid by people who do not have private hospital cover with incomes in Tier 1 or higher. If you are in this income threshold the only way to avoid the MLS is to take out private hospital cover. All Defence Health hospital covers will exempt you from the MLS. 

  • How can I estimate my income?

    The Tax Office looks at your income for surcharge purposes. Use your taxable income as a guide and add back deductions such as fringe benefits and reportable superannuation contributions. The Tax Office has more information and an online calculator to help you.

  • How is the MLS calculated?

    Your level of income for surcharge purposes determines the rate of MLS. The Tax Office will calculate the actual amount of the levy when you submit your tax return.

    The Medicare Levy Surcharge is charged on the number of days in the financial year that you haven’t held hospital cover. For example, if you take out hospital cover on 1 August, you’ll pay the levy for the 31 days in July that you didn’t have hospital cover. The following 334 days of the financial year will be exempt from the levy.

  • I have children. How does that affect my income thresholds?

    If you have dependent children, the family thresholds apply.

    If you have one dependent child, the threshold will not be affected. For families with multiple children, the threshold will increase by $1,500 for each child after the first.

    Family income includes the combined income of both adults. For single parents, only the adult’s income counts towards the threshold. The income of dependent children is not included.

  • Does the MLS apply to my dependants?

    If you are a family or a couple, the Tax Office will assess your combined income. If you do not have hospital cover for yourself and all your dependants, the MLS will be applied at the relevant income threshold to your combined earnings.

  • What if my partner is full-time ADF?

    Your partner will not require hospital cover. But the Tax Office will assess your combined income and apply the MLS at the relevant threshold if you and your children do not have hospital cover.

  • Are de facto couples and single parents considered a family?

    Yes. Single parents and couples (including de facto couples) are subject to the family tiers.

  • Can I avoid paying the Medicare Levy Surcharge?

    If you are single and earn more than the income threshold you can avoid the Medicare Levy Surcharge by purchasing private health insurance hospital cover for the whole of the financial year.

    If you are a family (or couple) that earns more than the income threshold you can avoid the Medicare Levy Surcharge by purchasing private health insurance hospital cover for all members of the family for the whole of the financial year.

    If you or any family members are not covered for part of the year the Medicare Levy Surcharge will apply only for the number of days they were not covered. So if your income does make you liable for the Medicare Levy Surcharge, you can still minimise it by taking out hospital cover sooner rather than later.

    Permanent ADF personnel should be aware that they are not exempt from the Medicare Levy Surcharge if their combined family income is above the income threshold unless they cover their partner and child dependents for the whole financial year.

  • What is private health insurance hospital cover?

    Private health insurance hospital cover for Medicare Levy Surcharge purposes is hospital cover with a hospital excess of $500 or less for singles or $1,000 or less for couples/families. All Defence Health hospital covers meet this requirement.

    Extras cover is not hospital cover. You will still be liable for the Medicare Levy Surcharge if extras is your only private health insurance cover.

  • Will I have to pay the Medicare Levy Surcharge if my partner or children don’t have private health insurance hospital cover?

    Yes. If your income is above the family threshold, you will pay the Medicare Levy Surcharge if you do not have private health insurance hospital cover for yourself, your partner and any dependent children.

  • What’s the difference between the Medicare Levy and the Medicare Levy Surcharge?

    The Medicare Levy is paid by most Australians to help fund the public health system. You will pay the Medicare levy regardless of your private health insurance hospital cover or income. It is taxed at 2.0% of your salary.

    The Medicare Levy Surcharge is an additional tax on people that earn over a certain amount and don’t have private health insurance hospital cover. All Defence Health members with hospital cover are exempt from the MLS. 

     

     

Lifetime Health Cover

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  • What is Lifetime Health Cover?

    If you are 30 or over, and you are not in a member of the permanent ADF, you will be impacted by Lifetime Health Cover (LHC). This is Federal Government legislation designed to encourage people to take out private hospital cover earlier in life and to penalise people who don't.

    If you take out hospital cover later than the 1 July following your 31st birthday, you will pay a loading of 2% on your premium for each year you are aged over 30. Once you incur a loading, it will not be removed until you have maintained hospital cover for a continuous 10-year period. As an example, a person who first takes out hospital cover at age 40 will pay 20% more in premiums each year than someone who takes out hospital cover at age 30. The longer you leave it, the higher the loading. The maximum loading is 70%.

    To cover small gaps in your hospital cover for any reason, you are permitted to be without hospital cover for up to two years and 364 days without incurring a loading.

  • Why do I have a loading on my premium?

    The government encourages people to take out private health insurance early in life. By ‘early’ the government means by age 31. If you wait longer than 1 July after your 31st birthday, a loading will be added to your premium.

  • How much of a loading could I pay?

    If a loading applies, you’ll pay 2% for each year you are over 30. So if you take out hospital cover at age 40, you’ll pay an extra 20% in LHC loading. If you wait until you’re 50, you’ll pay 40% more. Wait until 65 and you’ll pay a hefty 70% more for your hospital cover.

  • How long am I stuck with a loading?

    Once you have a loading, it will stay in place for 10 years of continuous hospital cover.

  • What if I go overseas for a year?

    You’re allowed gaps in cover, up to a total of 1094 days. If you need to travel for an extended period, ask us to suspend your cover – rather than cancel it – because a period of suspension does not count as ‘days without cover’.

  • I’m in the ADF. How does LHC affect me?

    You don’t need hospital cover while you are serving in the permanent ADF. But if you discharge after the LHC deadline after your 31st birthday, you’ve got 1094 days before a loading will apply. If you discharge before the LHC deadline, the normal rules apply.

  • What if I am a new migrant to Australia?

    If you are a new migrant to Australia, and are aged over the LHC deadline (1 July following your 31st birthday), special conditions apply.

    As a new migrant to Australia you do not have to pay a LHC loading if you take out hospital cover within 12 months of being registered for Medicare. After this time you have to pay a LHC loading of 2% more for each year you are aged over 30 when you take out hospital cover.

    As a migrant it is a good idea to consider taking out hospital cover in the first year after you register for Medicare.

  • What if I have a Department of Veterans' Affairs (DVA) Gold Card?

    If you hold a Department of Veterans' Affairs (DVA) Gold Card you are considered to have hospital cover. If you have held a Gold Card at any time since 1 July 1999, and the card was subsequently withdrawn by DVA, you may claim the period you held the card as a period with hospital cover.

  • What if I was born on or before 1 July 1934?

    If you were born on or before 1 July 1934, you are exempt from the LHC loading. You can take out hospital cover at any time in the future and pay the base rate premium.

  • Where can I find out more about Lifetime Health Cover?

    There is a government website that provides information on private health insurance and Lifetime Health Cover. Visit www.privatehealth.gov.au. Alternatively you can call the toll free line of the Department of Health on 1800 020 103.

I am/my partner is in the ADF

ADF

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  • I am transitioning to the Reserves. What do I need to do?

    If you are transitioning to the Reserves (SERCAT 2) 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. 

    Give us a call to discuss your options on 1800 335 425.

  • 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. Give us a call to discuss your options on 1800 335 425.

  • My partner and I are full-time serving and expecting our first child. Can we get cover just for our baby?

    Sure can! Just take out kids-only cover within two months of the baby’s birth and the little one will be covered immediately. And if you need cover from his or her date of birth you can back-date up to two-months. 

  • My family uses the ADF Family Health Program. Do I still need health insurance?

    The two can complement each other and relieve pressure on the family health budget

    • The annual ADF Family Health Program allowance can ‘top up’ extras benefits and reduce out-of-pocket expenses
    • GP and out-patient specialist consultations can be topped up with the ADF Family Health Program allowance – that’s something private health insurance can’t do
    • The ADF Family Health Program does not extend to private hospital treatment – so you need insurance for that.
  • What happens to my health cover if I am sent overseas on an accompanied posting?

    Just give us a call and we’ll suspend your cover for up to two years. We can arrange an extension if the posting goes beyond two years. Make sure you call us on 1800 335 425 to reinstate the cover within one month of returning to Australia.

     

  • Can I suspend my cover if I am a Reservist on continuous full-time service (CTFS)?

    Absolutely. If you’re on CFTS for more than 28 days we can suspend your cover, or vary it to only cover your dependants for the period of service. Just make sure you call us on 1800 335 425 to reinstate your cover within one month of the completion of your CFTS. 

  • I’m serving in the ADF. Is my partner exempt from the Medicare Levy Surcharge?

    No. Although you do not require hospital cover, your combined income will be used by the Tax Office to assess your combined Medicare Levy Surcharge liability if you do not have hospital cover for your family. 

  • I have a Gold Card. Do I need private health insurance?

    Your Gold Card provides comprehensive benefits for your clinical health care needs. So we do not recommend you hold private health insurance for yourself. But please talk to us about how we can cover your family. 

Dental

General

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  • How can I maximise my orthodontic benefits?

    Unlike many other funds, Defence Health does not have a ‘lifetime’ cap on orthodontic benefits. So we encourage you to pay-as-you-go for your orthodontic treatment. Payment by instalments ensures we can pay up to your maximum annual benefit in each financial year, for the duration of the treatment. 

  • I’ve been seeing the same dentist for years. Do I need to change health care providers if I change funds?

    No, there’s no need to change providers. You can see any provider you choose. You will receive the applicable benefit at any accredited provider. While you’re welcome to maintain your relationship with your providers, you might want to check the additional value available through one of our network dentists.

  • Where can I find information about dental benefits?

    The dental schedules can be found in 'Additional References' here.

Dental network

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  • How does our dental network actually work?

    We’ve joined forces with smile.com.au to deliver better value dental cover for our members. The smile.com.au network of dentists gives members access to lower cost dental care compared with others visiting the same dentist.

    If you have extras cover you can access our dental network and get great value from your health insurance. You will save a guaranteed minimum of 15% off the usual dental fee for all treatments performed by any network dentist throughout Australia.

    And if you have our Premier, Value or Top Extras or the ADF Total Package you also receive no-gap cover on any preventive dental treatments like your annual scale and clean at any network dentist (within limits).

    Lower fees at a network dentist and great value benefits from Defence Health mean you could reduce your out-of-pocket expenses and receive more treatments within your benefit limits. So that all adds up to a whole lot more value for you.

  • Who is smile.com.au?

    smile.com.au is an established network of dentists who agree to provide a minimum of 15% off their usual dental treatment fee to smile.com.au members. All Defence Health members with extras cover are automatically smile.com.au members.

  • How do I find my nearest network dentist?

    Visit our dental network page and select Find Your Network Dentist. You can then search by postcode or suburb.

  • How can I tell what I’ll pay if I visit a network dentist?

    For all dental quotes we need to know the item numbers that will be used in your planned dental treatment. We can let you know what benefits you will be entitled to but we can’t tell you the fee the dentist will charge because this varies at an individual practice level. But if you do visit a network dentist you’ll be guaranteed a minimum of 15% off their usual treatment fee.

  • What if I am still serving waiting periods?

    There is no waiting period to access our dental network. You can immediately access a guaranteed minimum of 15% off the usual dental treatment fee by any network dentist so you will have lower out of pockets compared to others visiting the same dentist. You will need to serve your dental waiting periods to receive benefits from Defence Health.

  • How can I see my dental claims for this financial year?

    You can log into Online Member Services and visit View History in the My Claims section. If you don’t have an Online Member Services account, you can easily register for one here.

    Alternatively, give us a call on 1800 335 425 and we’ll send your claims history directly to you.

  • I’m already a member of smile.com.au, can I get a refund?

    If you joined smile.com.au prior to 1 October 2015 you’re eligible for a pro-rated refund for the length of the plan after 1 October 2015.

    If you joined smile.com.au after 1 October 2015 you will be refunded the cost of your smile.com.au plan. Simply contact smile.com.au directly on 1300 238 648 or email member@smile.com.au to arrange your refund.

  • Are any of the network dentists specialists?

    Network dentists practice general dentistry and perform a wide range of general treatments. They are not specialists. If you require specialist treatment, you will need to see a specialist. However, some specialist treatments are available at some network dentists. Visit our dental network page and select Find Your Network Dentist to find your nearest network dentist. From there, simply confirm with the network dentist directly whether they perform the treatments you require.

  • Does the level of Defence Health extras cover impact dental network fees?

    No. All Defence Health members will have access to the same schedule of reduced fees regardless of their level of extras cover. This means all members with extras cover will save a guaranteed minimum of 15% off the usual dental fee for all treatments performed by any network dentist.

    The benefit you can claim back from Defence Health will differ depending on your level of extras cover.

  • What’s the benefit of provider networks (e.g. dental or optical)?

    Provider networks give us the opportunity to add extra value for members.

    Our dental network saves members at least 15% off the usual fee at a smile.com.au dentist. And on most of our extras cover, there are no-gap preventive treatment benefits that make dental care more affordable for the whole family.

    The optical network of Specsavers and VSP Vision Care provides superior benefits for members in terms of value, services, discounts and range of no-gap glasses.

    As a member you have the choice to see any provider; our networks provide greater value.

  • Do I have to use a Defence Health network provider?

    You can see any provider you choose. You will receive the applicable benefit at any provider. A network provider will deliver greater value.

Orthodontics

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  • What is orthodontics?

    Orthodontics is a field of dentistry that specialises in the prevention and correction of alignment issues of the teeth and jaws. Commonly orthodontic treatment will involve the use of braces, plates or head gear to bring the teeth into alignment. 

  • How can I tell if I’m covered for orthodontics?

    If you have Top Extras, Value Extras, Premier Extras, Standard Extras or the ADF Total Package you’re able to claim benefits for orthodontic treatment.

    Your annual benefit limit will depend on your level of cover. Check the product guide relevant to your cover so you know the orthodontics limit that applies to you. 

  • How can I maximise my orthodontic benefits?

    Unlike many other funds, Defence Health does not have a ‘lifetime’ cap on orthodontic benefits. So we encourage you to pay-as-you-go for your orthodontic treatment. Payment by instalments ensures we can pay up to your maximum annual benefit in each financial year, for the duration of the treatment. 

  • Is there a waiting period for orthodontics?

    There’s a 12 month waiting period for orthodontics if you’re new to health insurance or have upgraded from a cover that didn’t offer an orthodontic benefit.

    If you’ve switched from another fund and have already served your 12 month waiting period for orthodontics you won’t need to wait to claim. Just be aware that benefits will only be payable for orthodontic instalments made after you’ve joined Defence Health. 

  • Is there a lifetime limit for orthodontics?

    No. Defence Health does not apply a lifetime limit for orthodontics. This means that you’re able to claim orthodontics benefits up to your annual limit for the full course of treatment. There is no cap on the number of years or episodes of treatment you may claim. 

  • How should I pay for orthodontics?

    You should discuss your payment options with your dentist or orthodontist. Paying in instalments will help you maximise the benefits you receive back on your treatment. It’s also easy to continue to provide benefits to you should you need to move dental providers during the course of your treatment. Give us a call and we’ll help you make the best choice for you. 

  • How do I claim orthodontics benefits?

    If you’ve chosen to pay in instalments you can claim:

    • on-the-spot if your dentist or orthodontist has a HICAPS or iSoft terminal
    • by using the Defence Health Mobile Claiming App on your smartphone
    • by downloading a claim form, which you can email, fax or post to us.

    If you’ve chosen to pay for your treatment upfront, benefits will be paid up to your annual limit in each year over the course of treatment. You will need to supply your itemised treatment plan. Defence Health will confirm with your dentist or orthodontist that the treatment is ongoing before paying your annual benefit. You will not be eligible for orthodontics benefits if you cancel or suspend your membership.

Claiming

How to claim

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  • How do I claim for extras?

    The easiest way to claim is to swipe your member card on the terminal available at most extras providers. It will automatically calculate how much Defence Health will pay for the service and all you do is pay any remaining gap. If your provider does not have an electronic terminal for this purpose, there are three other options:

    • For the simplest claiming, use our mobile claiming app.
    • For the fastest refund, claim online. Login or Register for Online Member Services to claim now. 
    • Or complete a claim form and submit it by email, fax or post. 

    Please see make a claim for more information. 

  • How do I claim for hospital admissions?

    If you’re going to hospital, call us first to check your level of cover and waiting periods. And make sure the hospital is on our list of Agreement Hospitals. At an Agreement Hospital your hospital charge will be 100% covered by us.

    Ask your doctor to use our Access Gap cover to minimise any out-of-pocket medical expenses. If you have an excess on your cover, you’ll be asked to pay that at the time of admission. The hospital account will be sent directly to us for payment.

    If your doctor agrees to use Access Gap, his or her account should come directly to us. If your doctor doesn’t use Access Gap, send the doctor’s account to Medicare first. Then forward the statement you get from Medicare to us.

  • How long do I have to make an extras claim?

    You have up to two years from the date of service to make an extras claim.

Can I claim for....?

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  • Can I claim a benefit for skin checks or mole removal at the GP?

    Defence Health cannot pay a benefit when Medicare provides a rebate. However, if you undertake a ‘mole-mapping’ service without a GP referral, Defence Health may pay a Health and Wellbeing benefit (depending on your level of combined cover). See your product guide for the benefits available to you.

  • Can I claim a podiatry benefit for surgical treatment of an ingrown toenail?

    Unfortunately, podiatry benefits only cover non-surgical consultations with the podiatrist. We recommend you speak to your GP about the Medicare rebate available for ingrown toenail treatment.

  • Can I claim for a midwife?

    Yes, we will pay a benefit (depending on your level of cover) for a private midwife to deliver your baby, as long as a doctor does not need to intervene.  

  • Can I claim for glasses purchased online?

    Yes, you can claim for prescription/sight correcting glasses purchased online provided the supplier is a registered Australian company. Benefits cannot be paid for purchases from overseas suppliers.

  • Why can’t I claim for Bowen Therapy?

    Defence Health relies on the expertise of the Australian Regional Health Group (AHRG) in its accreditation of all alternative therapy providers. The ARHG has strict accreditation criteria for individual alternative therapists as well as types of therapy. It requires that a therapy is supported by an educational or government agency; that qualifications, ethics and ongoing education is monitored by a professional association; and the claims about the benefit of the treatment can be substantiated. Bowen Therapy, as a treatment category, is not accredited by ARHG. 

  • Can I claim from you as well as workers compensation/DVA?

    Defence Health cannot pay health benefits to you if they are claimable from another source such as workers compensation DVA or accident compensation. Some top-up private patient benefits may be available. Give us a call on 1800 335 425 if you have any queries. 

Waiting periods

Waiting periods

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  • When do waiting periods apply?

    Waiting periods apply to people who are:

    • New to health insurance
    • Have had a break in cover of more than two months
    • Upgrading to a higher level of cover (includes removing an excess)
    • Determined as having a pre-existing condition
  • Why do I have to wait?

    Waiting periods help keep health insurance fair for everyone. Health insurers would not be able to pay the benefits they do if people joined just when they decided they need treatment.

  • I’m switching from another fund. Do I have to wait?

    If you’ve served the relevant waiting periods for an equivalent level of cover, then you don’t need to wait again. But if you’ve taken out a higher level of cover with us, it’s a good idea to check with us before receiving treatment.

  • How long must I wait?
    • 2 months for most hospital and extras treatment, including ambulance cover, home nursing, pharmacy, optical and physiotherapy.
    • 12 months for a pre-existing condition, obstetric treatment, laser refractive eye surgery, major dental and orthodontic treatment, and certain medically prescribed appliances.
    • Cover for an accident is immediate unless the claim is the responsibility of a third party insurer (such as DVA, workers compensation or transport accident insurance).
  • What is a pre-existing condition?

    A pre-existing condition is an illness or ailment where signs or symptoms existed in the six months prior to you joining or upgrading to a higher level of cover. Defence Health may require you and your treating doctor(s) to complete a pre-existing ailment form in order to obtain facts about your illness. We would then appoint a doctor to make an informed judgement as to whether your condition was pre-existing. 

    Whether you’ve been diagnosed or not, you could have a pre-existing condition. If signs or symptoms were present in the six months before joining (or upgrading cover) then you’ve possibly got a pre-existing condition. If we think this is the case, we will need to investigate your condition and obtain the opinion of an independent doctor.

Providers & hospitals

Providers & hospitals

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  • How do I know if a provider is registered?

    Most medical and general treatment providers will display their registration and professional association membership in their practice, on their invoices and on their website. In the case of alternative therapists, we require they be accredited by the Australian Regional Health Group, which monitors their qualifications and ongoing professional development. If you are in doubt about a provider’s registration, just give us a call.

  • Do I have to use a Defence Health network provider?

    You can see any provider you choose. You will receive the applicable benefit at any provider. A network provider will deliver greater value.

  • I’ve been seeing the same dentist, chiro and optometrist for years. Do I need to change health care providers if I change funds?

    No, there’s no need to change providers. You can see any provider you choose. You will receive the applicable benefit at any accredited provider. While you’re welcome to maintain your relationship with your providers, you might want to check the additional value available through one of our network dentists or optometrists.

  • What’s the benefit of provider networks (e.g. dental or optical)?

    Provider networks give us the opportunity to add extra value for members.

    Our dental network saves members at least 15% off the usual fee at a smile.com.au dentist. And on most of our extras cover, there are no-gap preventive treatment benefits that make dental care more affordable for the whole family.

    The optical network of Specsavers and VSP Vision Care provides superior benefits for members in terms of value, services, discounts and range of no-gap glasses.

    As a member you have the choice to see any provider; our networks provide greater value.

  • How do I find an agreement hospital?

    We have agreements with over 500 hospitals around the country. This significantly reduces your out-of-pocket expenses. You can search for an agreement hospital here. 

  • How do I find a provider?

    You search for your nearest extras provider, Access Gap Doctor and dental or optical network partners here. 

Understanding excess

Excess

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  • What is an excess and how is it applied?

    An excess is an amount you agree to pay if you go to hospital for an overnight or same day procedure. The excess rules apply within each financial year. An excess helps to lower the premium you would otherwise pay for your hospital cover.

  • Do I need to pay an excess for my kids?

    An excess is not payable if a child is admitted to hospital.

  • What happens if I remove my excess or change to a lower excess?

    If you decide to remove your excess, or pay a lower excess, the old excess will continue to apply for two months for most hospital treatment (or 12 months for a pre-existing condition or obstetric treatment).

Ambulance cover

Ambulance cover

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  • Do I need to maintain my ambulance membership?

    As a Defence Health member you are 100% covered for ambulance services by state-appointed ambulance providers across Australia, so there's no need for a separate subscription. There's no limit on the number of times you can use the ambulance service when needed including emergency services, non-emergency dispatch, mobile intensive care and air and sea ambulance services. Transport services by Patient Transport vehicles are not ambulance services and are not covered.You do not require a separate subscription. 

  • I pay an ambulance levy/membership to my state based ambulance service. What happens when I join Defence Health?

    Our ambulance cover is comprehensive and covers you nationally for air, sea or land based ambulance treatment.

    The state governments of Queensland and Tasmania fund state-based ambulance services (with some restrictions) for their residents. We cover any gaps in ambulance cover in these states.

    Defence Health pays an ambulance levy on behalf of our members in NSW and ACT. It’s important that we know if you have a concession, Health Care Card or DVA card as this affects the amount we pay for ambulance treatment.

    You can relax knowing Defence Health provides the highest level of ambulance cover available. 

Health Programs

Health Programs

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  • What are the Health Programs?

    We’ve expanded the programs on offer to members to include:

    •          chronic heart disease
    •          diabetes
    •          lung disease (chronic obstructive pulmonary disease)
    •          peripheral vascular disease (circulation disorders)
    •          Osteoporosis and bone health
    •          rehabilitation in the home
    •          hospital in the home
    •          falls prevention and safety in the home
    •          complex and integrated care
    •          other risk factor management
  • Why is Defence Health offering the programs?

    We want to do more to improve the health and quality of life for members with chronic conditions. The best way to prevent or reduce the risk of further health issues is to improve your health. The programs achieve life changing results and we’re offering them to members with serious health challenges.

  • Who is Remedy Healthcare?

    Remedy Healthcare is a leader in the health management space. We’ve partnered with Remedy Healthcare for several years with the heart disease and diabetes programs we’ve offered. So we know that with years of experience and clinical expertise in delivering integrated care programs, Remedy Healthcare achieves outstanding results.

  • How is the program delivered?

    Over-the-phone consultations are conducted every few weeks with a qualified Health Coach. The program will run for four to six months – or up to 12 months for the Heart Failure Program. If you’re invited to participate, you’ll have an individual health management plan tailored to address your particular condition. The coach’s advice is evidence-based and complements the treatment plan of your other specialists.

  • I’m fit and healthy. Where’s the value for me?

    All members will benefit from the good results the programs achieve. The chronic conditions that we’re tackling have a huge impact on the hospital and medical benefits we pay. Improving the health of the chronically ill – and keeping them out of hospital – will help to reduce the pressure on everyone’s premium.

  • How do I join a program?

    If you have ADF Total Package, Premier Hospital, Value Hospital, Top Hospital, ADF Top Hospital, Public Hospital or ADF Public Hospital cover and have served relevant waiting periods, you are able to access the Health Programs. Defence Health identifies potential program participants based on our hospital claims data. If you’ve had a qualifying hospital visit for a chronic condition, we might send you an invitation to join a suitable program. Your hospital or doctor may also refer you to a program. If you believe you are eligible for a program and haven’t received an invitation or referral, please give us a call on 1800 335 425 for a confidential chat.

  • I’ve got a chronic condition but haven’t received an invitation. Why not?

    It could be we don’t have a program that meets your needs. Or, you may not have been identified because you haven’t had a qualifying hospital admission. If you believe you are eligible, please give us a call on 1800 335 425.

  • Do I have to participate if I receive an invitation?

    The programs are optional. We have sent you an invite because we think you may benefit from participating. If you have received an invitation and do not wish to participate, give us a call on 1800 335 425 or email info@defencehealth.com.au to opt out.

  • How long will the program take?

    The duration depends on the particular program.

    Program

    Support

    Duration

    Chronic heart disease

    Phone consultation every 3 – 4 weeks, approx. 30 minutes

    12 months

    Type 2 diabetes, peripheral vascular disease, chronic obstructive pulmonary disease and bone health

     Phone consultation every 3 – 4 weeks, approx. 30 minutes

    4 – 6 months

    Complex and integrated care, risk factor management

     Phone consultation every 3 – 4 weeks, approx. 30 minutes

    4 months

    Rehabilitation  in the home, hospital in the home, falls prevention and safety in the home

    These programs arrange for tailored individual support and care for your needs.

    6-12 weeks

  • What will it cost me?

    Absolutely nothing. We will fund 100% of the cost of the program. If your Health Coach refers you to other specialists and health care providers, you will be advised of the likely fees you will have to pay.

  • Will my premium be affected?

    No. Whether you choose to participate – or not – your level of cover and premium will not change.

  • How is personal information handled?

    Your personal information will remain private and confidential. Defence Health will provide Remedy Healthcare with some personal information to make initial contact with you. Any information you share with your Remedy Healthcare Coach will be subject to the Remedy Healthcare Privacy Policy. It can be viewed at www.remedyhealthcare.com.au 

  • Will Defence Health receive personal information about me from Remedy?

    No. We will be informed if you choose to participate in a program and we will receive some de-identified aggregate information about the programs. No health-related results, progress reports or personal information is passed from Remedy Healthcare to Defence Health.

Health Check

Health Check

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  • What is Health Check?

    Health Check is an online tool, run by Remedy Healthcare. After entering information about your health and lifestyle, the tool assesses your risk of developing diseases such as diabetes. Based on this assessment you are provided with tips and advice to reduce your risk factors.

    You can access the Health Check here.

  • What does Health Check use to calculate the risk outcomes?

    Health Check uses the Australian Type 2 diabetes risk assessment tool (AUSDRISK), which was developed on behalf of the Australian and State Governments to help understand a patient’s risk of developing Type 2 diabetes in the next 5 years.

    This calculates risk factors based on the following information:

     

    General profile information Clinical profile Health profile
    • Age
    • Gender
    • Location of birth
    • Waist measurement
    • Height
    • Weight
    • Blood pressure
    • Blood glucose
    • Family history of diabetes
    • Total Cholesterol
    • LDL ‘bad’ and HDL ‘good’ Cholesterol
    • Smoking/non-smoking
    • Fruit and vegetable intake
    • Exercise/physical activity
  • What if I don’t know an answer?

    Many of the clinical questions have an option to tick “I don’t know”.  The more information entered, the more accurate the results will be, but there can still be meaningful outcomes with limited information.

  • Who are Remedy Healthcare?

    Remedy Healthcare are a leading provider of targeted, evidence-based self-management and health coaching programs. They have been a trusted partner of Defence Health for many years. They are now providing us with Health Check, an online health risk assessment tool.

  • Will Remedy receive identifiable information about me?

    You can feel comfortable to complete the Health Check and know that your health information is not identifiable. You do not have to provide any identifiable information unless you choose to opt into a Health Program, at which point Remedy will know your health information, name and member number.

  • Will Defence Health receive identifiable information about me?

    You can feel comfortable to complete the Health Check and know that your health information is not identifiable. You do not have to provide any identifiable information unless you choose to opt into a Health Program, at which point Defence Health will be informed that you have participated in a particular program. No health-related results, progress reports or personal information will be passed from Remedy Healthcare to Defence Health.

  • Why does Defence Health have a Health Check?

    We want to help our members manage their health, particularly by putting them in touch with trusted health information and support. Health Check can help members better understand their health risks, access information to help them maintain or improve their health and give eligible members access to the Health Programs.

  • Why does Defence Health want to know my health information/risk profile?

    Defence Health does not want to know your health information. Defence Health will not receive your individual, identifiable health information, or notification of your risk profile. If you choose to opt into a Health Program, we will receive notification. However, this is only to confirm your eligibility for the service, and then to pay your claim so there are no out of pocket costs for you to participate.

  • Will Defence Health raise my premiums, charge me more, or limit my claiming based on my Health Check results?

    No. Defence Health will not receive your individual health information. We will not calculate or change your individual premium on the basis of your personal health information or risk factors.

Norfolk Island Residents

Information for Norfolk Island Residents

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Norfolk Island residents have new health care arrangements from 1 July 2016.

For the first time, Australian citizens (and permanent residents) who live on Norfolk Island will qualify for Medicare-funded health treatment and prescription medication under the Pharmaceutical Benefits Scheme.

You may also choose to purchase private health insurance for private patient treatment on the mainland of Australia.

  • Can I join Defence Health?

    If you have full Medicare entitlements then you may like to consider taking out private health insurance. To join Defence Health you will need to have an eligible connection to the Australian Defence Force. Call us on 1800 335 425 to join. 

  • Do I need private health insurance?

    That’s something only you can decide. But you should keep in mind that you’ll need to travel to the mainland to access a private hospital or accredited general treatment providers. If you would like to discuss your needs, give us a call on 1800 335 425. 

  • How do I get a quote?

    If you would like to get a quote and discuss your needs, give us a call on 1800 335 425. 

  • Can I claim for ambulance services through private health insurance?

    The Australian Government will cover the cost of emergency medical evacuation. To access a private hospital for elective surgery, you will need to fund your own travel to the mainland.

  • How does Lifetime Health Cover affect me?

    Lifetime Health Cover is the government loading designed to encourage people into private health insurance earlier in life and to maintain it throughout life. It makes cover more expensive for people who take our private health insurance later.

    To allow for the changes on Norfolk Island, you have until 1 July 2017 to join a private health fund without any penalty – no matter how old you are. If you do not take out cover before then, the normal Lifetime Health Cover rules will apply.

    You will not incur a penalty if you never take out private health insurance. 

  • What if I currently have overseas visitor health cover?

    We will recognise the level of overseas visitor health cover you have held and waive the waiting periods on Defence Health cover (as appropriate).

  • How do I find out if my provider is accredited?

    You can claim benefits for treatment by accredited providers only. You should ask a provider if they meet the Australian accreditation standards and hold registration with the appropriate professional association. Services currently provided on Norfolk Island do not qualify for private health insurance benefits. 

  • Where can I find information about the Medicare Levy Surcharge and Government Rebate?

    You can find information about the Medicare Levy Surcharge and Government Rebate on the Department of Health website.