Defence Health has tailored health insurance with special features just for you.
Can I join Defence Hospital cover?
- Permanent ADF – your partner and kids are eligible
- Reservist (SERCAT 3-5) – you and your family can be covered
- Ex-serving - this is the recognition you deserve.
You deserve the best of care
Our Defence Hospital cover is designed for you and it has features our other hospital covers don’t offer.
Defence Hospital Basic Plus
Hospital cover to get you started – with more than the basics
Defence Hospital Bronze Plus
Affordable hospital cover – for a wide range of treatments
Defence Hospital Silver Plus
Hospital cover that meets most needs – including heart and vascular procedures
Defence Hospital Advantage Silver Plus
Hospital cover for peace of mind
Defence Hospital Gold
Comprehensive hospital cover with special features for ADF families, ex-serving and Reservists
Features and exclusive benefits
Veteran discount
We recognise your service with an ongoing veteran discount of 5%
Age-based discount
Discount available for under 30s
Travel and accommodation benefit
Benefit paid when your hospital treatment is more than 100km (in a straight line) from home
Transitioning from the ADF?
While it might seem a little daunting, there is support to help you ease into civilian life. We want you to feel confident about the decisions you need to make. Whether you’re single or married with kids, we're here to help. Watch our video to hear from two Defence Health members who’ve been through the transition process.
Benefits for veterans
Veteran Support Program
We have a dedicated team to help you navigate the health system for the care and benefits you’re entitled to.
The Department of Veterans’ Affairs (DVA) provides benefits for certain health conditions, without the need to prove they were caused by your ADF service. If you don’t already have a Veteran White Card, we can help you obtain one for cover under DVA’s Non-Liability Health Care.
In addition to any other accepted conditions, Non-Liability Health Care covers treatment for mental health conditions and some cancers.
Our friendly veteran support team can help you claim DVA benefits and lower your out-of-pocket medical expenses. We have the specialist knowledge to personally guide you through the claims process, with the aim to reduce stress and maximise your health and wellness.
Veteran discount
We're grateful for your service. That's why permanent ADF, Reservists and ex-serving veterans (with a DVA White Card) will all receive an ongoing 5% discount off their premium.
At Defence Health you'll always get a competitive premium and the respect you deserve.
Other benefits
MyBaby Support Program
We understand the challenges that posting cycles and deployment can place on Defence families. Especially families with young children. The MyBaby Support Program provides expert advice and practical ante and postnatal support during pregnancy and after a baby’s birth.
The program includes high quality online content, first-aid for children eBook, and telephone consultations with specialists in infant and toddler settling. MyBaby is provided at no-cost to serving and ex-serving veterans and reservists with eligible hospital cover.
Age-based discount
For couples or singles under 30 years, the age-based discount provides further long-term savings on your premium. For couples, the applicable discount is the average of the combined entitlement. Join before age 26 for the maximum 10% discount, or before age 30 for a 2% discount.
If a discount applies, you retain it for every year that you maintain the policy (or another eligible cover) until age 41. From age 41 the discount phases out by 2% each year, eligible hospital products only.
| Age 18 - 25 | 10% discount |
| Age 26 | 8% discount |
| Age 27 | 6% discount |
| Age 28 | 4% discount |
| Age 29 | 2% discount |
Travel and accommodation
Getting to hospital can sometimes involve lengthy travel. And you might need overnight accommodation before or after a hospital admission.
We’ve got a benefit – only available with Defence Hospital cover – to help with these additional expenses.
When the round trip to hospital and back exceeds 200 kilometres, you may claim a benefit for travel (set benefit based on level of Defence Hospital cover). If the journey to hospital requires you (or your carer) to stay in commercial accommodation, you can also claim a benefit towards that expense.
- Travel and accommodation benefits are payable once per hospital admission.
- Round trip must exceed 200km for either benefit to be claimed.
- Accommodation charge must be invoiced by a commercial provider.
- Accommodation benefit may be claimed for night before hospital admission, duration of treatment, and night of discharge, until the available benefit is exhausted.
- Benefit is paid to the member when a corresponding hospital claim is received by Defence Health.
- Claims must include a confirmation of admission letter from either the hospital or treating medical practitioner.
| Product | Travel and accommodation benefit |
|---|---|
| Defence Hospital Basic Plus | Travel $35, Accommodation up to $65 |
| Defence Hospital Bronze Plus | Travel $70, Accommodation up to $130 |
| Defence Hospital Silver Plus | Travel $105, Accommodation up to $195 |
| Defence Hospital Advantage Silver Plus | Travel $105, Accommodation up to $195 |
| Defence Hospital Gold | Travel $125 Accommodation up to $230 |
Common questions
All Australians are entitled to receive Medicare-funded treatment in a public hospital. However, the waiting list for public patient treatment can be very long. With private hospital cover you can receive treatment for the clinical categories included in your policy almost immediately.
When you take out cover for the first time, or if you upgrade your cover, a waiting period may apply before you can receive treatment and make a claim for new or higher benefits. We will recognise waiting periods served with another fund. And we’ll waive all waiting periods if you join within 60 days of discharge from the ADF.
The excess on a policy lowers the premium. The excess is payable once per financial year, per adult admitted to hospital. There is no excess when children are admitted to hospital.
The Medicare Benefits Schedule (MBS) is the government’s price list for all medical procedures. Medicare and Defence Health together will cover 100% of the MBS fee for medical treatment in a private hospital. But when medical specialists charge more than the MBS fee, patients are left with a ‘gap’ to pay. Access Gap is a billing arrangement that helps to keep out-of-pocket expenses lower for patients. In return for Defence Health paying a slightly higher benefit for the medical procedure, the doctor agrees to limit the fee to the patient. When doctors use Access Gap, patients have either a small gap to pay, or no gap to pay. Your doctor must inform you about any out-of-pocket expense before you go to hospital.
Out-of-pocket expenses are charges that cannot be reimbursed by either Defence Health or Medicare. When doctors charge more than the MBS fee for a hospital procedure, or extras providers charge more than the benefit payable by us, the patient is left with an ‘out-of-pocket’ expense to pay. We encourage all members to talk to their doctor about Access Gap when preparing for a hospital admission. And check your product guide for the benefits payable for extras treatment.
Your product guide indicates the clinical treatment categories included in your hospital cover. It also details the range of extras treatment you may receive, the annual benefit limits, and the benefit payable for each service. You can also check the benefits you have available in the Member Portal.
The clinical categories excluded from your hospital cover are detailed in your product guide. Regardless of the level of cover, Defence Health cannot pay benefits for:
- treatment that’s not recognised by Medicare
- out-patient consultations with specialists
- medical fees higher than the MBS when not billed through Access Gap
- in-hospital medication not covered by the hospital contract
- high-cost medication not covered by the Pharmaceutical Benefits Scheme (PBS) or hospital contract
- take-home items such as crutches
- personal expenses in hospital (such as phone calls, newspapers or TV hire)
- hospital stay beyond 35 days that’s not supported by an acute care certificate.
Going to hospital can be confusing. We’ve explained the process and created some helpful checklists in our ‘Going to Hospital’ brochure.