Frequently asked questions

When you transition, your ADF health care arrangements end on your transition date. After that, you’ll manage your health care through Medicare, DVA (if eligible) and the civilian health system.

Register for Medicare (or confirm your Medicare details are current). A Medicare card is essential to access public hospital care and Medicare benefits.

Our exclusive Defence Hospital cover is designed for permanent ADF, Reservists and ex-serving veterans and is very competitively priced. Whether you’re part of a family looking for comprehensive cover or a single or couple wanting to avoid government penalties, you’ll find the cover you’re looking for.

View our Defence Hospital products

Hospital cover helps with costs that the hospital will charge if you’re admitted as a private patient. It can help cover accommodation and hospital charges, depending on your cover and where you are treated.

Extras cover helps with costs for everyday services Medicare does not usually cover, such as dental, optical and physiotherapy. The services and limits depend on your level of cover.

Not always. In private care, doctors and specialists can charge above the Medicare schedule fee. Costs charged above what Medicare and your insurer pay will generally become out-of-pocket costs.

A “gap” is the difference between what Medicare and/or your insurer pays and what the provider charges. Gaps can apply to some specialist and hospital-related medical fees. 

Gap cover is an arrangement that can reduce unexpected medical costs in hospital that is a feature of many (but not all) private hospital products. Some doctors participate in gap arrangements and some do not. It’s a good idea to ask about fees and gap arrangements before planned treatment.

Think about your life stage, health needs and budget. For example: 

• do you want more choice or faster access for planned treatment? 
• do you want help with dental, optical or physio costs? 
• do government rules affect your situation? 

Often, yes. If your family already has cover, you may be able to join their policy. Adding a person can change the premium, so it’s best to ask the insurer for a quote. Are your family members already with Defence Health? Book an appointment to discuss.

No. You can compare options and change funds if you find a cover that suits you better. Waiting periods and transfer rules may apply, depending on your circumstances and level of cover.

If you are registered with Medicare, you can be treated as: 

• a public patient in a public hospital 
• a private patient in a public hospital (in some circumstances) 
• a private patient in a private hospital 

Each option has different costs, choices and waiting times. 

Public hospital care (as a public patient) is covered by Medicare, but you usually can’t choose your doctor and you may wait longer for some non-urgent procedures. 

Private hospital care can offer more choice and, for some treatment, faster access. It may also involve out-of-pocket costs. 

You can still see a GP without a Medicare card, but you may have to pay the full cost of your appointment. A Medicare card helps you access Medicare benefits.

Sometimes. If your GP bulk bills, Medicare covers the full cost and you pay nothing. If your GP does not bulk bill, you will usually pay an out-of-pocket cost.

No. Private health insurance does not cover out-of-pocket costs for GP appointments.

Your GP is usually your first point of contact for most health concerns. They can: 

• treat common issues 
• prescribe medication 
• refer you to a specialist 
• help coordinate ongoing care

In most cases, yes. You’ll usually need a referral from a GP to see a specialist.

Medicare usually contributes to a portion of specialist fees, but many specialists also charge more than the Medicare benefit. That can leave you with out-of-pocket costs.

Medicare does not usually cover: 

• dental 
• physio and other allied health 
• optical items like glasses and contact lenses 
• ambulance services 

Some exceptions may apply in specific circumstances.

If you are eligible, DVA may cover treatment through a White Card or Gold Card. 

A Gold Card generally covers clinically necessary health care. 

A White Card covers treatment for accepted conditions. 

Non-Liability Health Care is support funded by the DVA for certain conditions, including mental health care, without needing the condition to be accepted as service related. Eligibility rules apply, and DVA can confirm what you can access.

The Medicare Levy Surcharge is an additional tax that may apply to higher income earners who do not hold eligible private hospital cover. Thresholds apply.

Lifetime Health Cover loading is a government rule that can increase the cost of hospital cover if you take it out later in life. ADF service arrangements may affect how this applies when you transition.

No. If you travel overseas, consider travel insurance that includes medical treatment and emergency evacuation.

If you’re unsure, start with: 

• registering for Medicare 
• checking what support DVA may provide 
• speaking with a Defence Health specialist about your situation and next steps 

Yes, they are welcome to join the Defence Health family. That includes your partner, children, siblings, grandchildren and parents - they can all join Defence Health because of your service in the ADF. Call us for a quote to find the right cover for your family.