- COVID-19 Member Support Program
COVID-19 Member Support Program
Defence Health introduced the COVID-19 Member Support Program in March 2020 to help members during the coronavirus pandemic.
Support in these exceptional circumstances includes:
- Suspension of the 1 April 2020 premium increase until 30 September 2020 for all members.
- Cover for COVID-19 related treatment in private hospital for all eligible members with hospital cover, regardless of their level of cover, until 1 July 2021.
- Amending extras claiming criteria to include ‘telehealth’ consultations for dietetics, psychology, speech pathology, occupational therapy, physiotherapy or exercise physiology sessions over video or phone (conditions apply). Telehealth benefits continue to be available to members until 31 March 2021.
- 6 to 12 months financial hardship suspension, including temporary changes to our suspension rules, which allow eligible members with fewer than 12 months’ membership to suspend their policy (available until 31 December 2020).
- Extending the option of financial hardship 3-month suspension to extras-only and Young Adult Support Plan policy holders (available until 31 December 2020).
- Allowing eligible members who had returned from a financial hardship suspension within the last 12 months to suspend their policy again for a further 3 to 6 months during the pandemic (available until 31 December 2020).
- Not charging an excess for members who had paid their hospital excess in 2019–20, had further hospital treatment postponed between 1 March and 30 June 2020 and had that postponed treatment occur in 2020–21. Affected members should call us to ensure the hospital excess is not applied (1800 335 425). Please note, the excess will still apply to any other admissions that were not delayed as a result of COVID-19.
- Maintaining Reservists’ current ADF package or Reservist discount eligibility until 1 October 2020.
- Placing a 6-month extension on the existing 12-month transition discount available to ex-serving members. The extended 18-month transition discount is available to newly discharged members until 30 September 2020.
I am a member and experiencing financial hardship due to the pandemic; will I lose my cover?
Defence Health understands the financial impact the pandemic is having on our members. If you are experiencing financial hardship, we recommend you contact our Member Services team to discuss what we can do for you.
What role are private hospitals playing in the pandemic?
Private hospitals are vital to the capacity of our health system. On 31 March, elective surgery in private hospitals was briefly suspended for around six weeks. This was important to ensure the entire hospital network (including doctors and nurses) would be resourced and ready to respond if there was a surge in COVID-19 cases. Elective surgery in private hospitals is almost back to normal capacity in most states. Your doctor is the best person to speak to about the timing of any elective surgery you may need.
Elective surgery in Victorian private hospitals has been suspended in August and September. We anticipate treatment will recommence later in 2020.
I have hospital cover; will I be covered if I need to get treated for COVID-19 in a private hospital?
We want our members to feel confident they will be cared for through the pandemic. We will cover all members with active hospital cover who may require COVID-19 related treatment – regardless of the hospital product they are on. For example, members on Everyday Hospital Bronze Plus or Essentials Hospital Basic Plus can have peace of mind knowing we will cover them for COVID-19 related treatment in a private hospital until 1 July 2021. And our other hospital products already include the clinical treatment categories for COVID-19 treatment.
Why do I need my private health insurance cover?
- There is a backlog of elective surgery in public hospitals, adding to the wait for public patients. Your private hospital cover gives you greater control over the timing of elective surgery and gives you the choice of doctor for your treatment.
- Your extras cover includes a range of allied health treatment that helps to keep you well. You can visit your provider for face-to-face treatment. Or you can use your extras cover to access ‘telehealth’ benefits for dietetics consultations, psychology, speech pathology, occupational therapy, exercise physiology and physiotherapy sessions over video or phone (conditions apply). The usual waiting periods and annual limits on your cover apply.
- You may also require your cover for private hospital treatment if the unexpected happens; e.g. an accident, injury or illness.
- The Medicare Levy Surcharge and Lifetime Health Cover loading may apply to you if you choose to drop your hospital insurance.
- To avoid waiting periods in the future, you need to maintain your hospital cover.
If you are concerned that you will be unable to make premium payments, please call us to discuss on 1800 335 425.
What’s the best way to claim for telehealth consultation services?
- When you make an allied health appointment, ask the provider if the consultation is billable through HICAPS. If it is, phone us on 1800 335 425 for the number that’s embedded in the magnetic strip on your member card. The provider will use this number to process your benefit.
- If HICAPS is not available, the provider will most likely ask you to pay for the consultation up front and email you the receipt. You can then send your claim to us via your Online Member Services account (for next day payment); our mobile claiming app or by downloading and emailing (or posting) a claim form.
Can I use my Veteran Card for telehealth consultations?
Members with a Veteran Card are advised they can access telehealth services from a medical or health professional at no cost based on their accepted conditions or within non-liability healthcare provisions. If the healthcare provider accepts DVA cards, veterans can continue to receive medical, community nursing and many allied health services via video-conference or over the phone instead of visiting the clinic or practice.
DVA funding for allied health services is broader than the Medicare funding for civilian telehealth services. Ongoing treatment cycles remain in place. And if necessary, you may obtain a GP referral for new clinically required allied health treatment. For more information, contact the DVA directly on 1800 555 254 or visit the DVA website.
Why do I need my extras cover?
Extras cover has become even more flexible as a result of the pandemic. On 13 March 2020, we introduced telehealth benefits for clinical psychology, physiotherapy, dietetics, occupational therapy, exercise physiology or speech pathology delivered online or over the phone. These practitioners, as well as dentists and optometrists are also available for face-to-face treatment in their practices.
If you cancel your extras cover, waiting periods will have to be re-served when you re-join at a later date.
I am an ADF Reservist and am unable to meet the required days served, will I lose my ADF package or Reservist discount?
No. Defence Health recognises the pandemic may limit days served. From 27 March to 30 September 2020, all existing ADF Reservists on an ADF package or Reservist discount will remain on it without providing a declaration of service. Eligibility requirement will recommence after 1 October 2020.
I am currently receiving the ADF transition discount; do I need to do anything to have this extended?
No. If you are an existing member receiving the 12-month transitional discount, it will automatically be extended by 6 months. This will also apply to newly discharged members who join Defence Health before 30 September 2020.
Who should be tested for COVID-19?
Each state and territory is operating its own COVID-19 testing regime. If you are sick and think you might have COVID-19, you can check your symptoms in the federal government’s healthdirect coronavirus symptom checker. If you have serious symptoms, such as difficulty breathing, call 000 for urgent medical help.
Can I claim for COVID-19 testing through my health insurance?
No, testing for the virus (when required) is covered by Medicare.
What is the best way to slow the spread of the virus?
Good personal hygiene is the first step (frequently wash hands or use sanitiser; cough or sneeze into your elbow (or a tissue followed by immediate disposal) and keep your distance from other people.
Other measures include:
- following all Government announcements
- maintaining social distancing measures
- following self-isolation restrictions.
What should I do if I become unwell?
If you develop flu-like symptoms you should call the COVID-19 triage hotline on 1800 020 080 (or phone your GP). Making a call first is important in reducing the spread of the virus.
If you have mild symptoms, you may then be directed to one of ‘pop-up’ respiratory clinics. The clinics are staffed by doctors and nurses who can assess, test and diagnose respiratory illness. This service is publicly funded as part of the government’s COVID-19 National Health Plan.
Tele-health services are also being funded by the government. If a doctor advises you to isolate yourself at home, or if you are deemed a ‘vulnerable person’ (for example, older than 70, indigenous and older than 50, pregnant or new parent, or immuno-compromised) you may be able to access these services for free under Medicare.
Is it true that health funds are making ‘windfall profits’ during the pandemic?
Early in the pandemic the Australia Institute made a prediction that health funds would make extraordinary profits as a result of COVID-19 restrictions. This is simply not the case. Some health services were briefly suspended – but practitioners returned to their practices after just six weeks. This is much sooner than the original scenario of possibly six months.
At Defence Health, we’re seeing a normal rate of claims returning – and that’s what we want. We want you to be able to get the treatment you need, when you need it, and to support your health in the best way we can.
While Victoria is experiencing some interruptions to hospital treatment during August and September, we anticipate this to be a temporary delay and treatment will proceed later this year.