Defence Health Insurance Review and Cover Comparison

Published: September 13, 2018

If you’re in the Australian Defence Force (ADF) or other military organisation, for example, the army, air force or naval, you and your family are likely to face some unique health-related challenges.

ADF personnel need to cope with inherently stressful situations and often have limited access to regular health care when changing postings every couple of years. A study conducted by the Journal of Military and Veterans’ Health found an increased prevalence of cardiovascular disease, high blood pressure and poor nutrition in ADF members, compared to the average population.

To cope with these challenges, you need good health insurance. Below is a break-down of what the Defence Health fund has to offer its member. However, it’s smart first to shop around and compare policies before purchasing.

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Please note; We do not provide Defence Health insurance quotes, but you can get a quick quote online directly from their website and then compare their benefits and premiums to the Australian private health insurance companies we have access to.

Who can join Defence Health?

For over 65 years, the Defence Health fund has been operating as a not-for-profit private health insurer, protecting Australians in the Military life. Even civilians can generally join the DH if they are ex-Defence Force or if they have a Defence family member.

Full-time and Reservists ADF personnel and their partners and children are eligible to join Defence private health insurance. Including, anyone who is working or has worked in the Department of Defence and other Defence-related departments or work for a company or agency contracted to the Department of Defence, or involved in the supply of goods or services to the Defence.

How does military health insurance for family members work?

Current and ex-spouses/partners, children, grandchildren, siblings and parents of a serving or ex-serving ADF member or ADF supporter can join the Defence Health fund. Find out if you qualify by using the DVA Nominal Roles. Once your eligibility is confirmed, you can join by filling in the application form available on the DH website or call directly on1800 335 425.

The Department of Veterans’ Affairs (DVA) Nominal Roles is a tool you can use to determine whether a family member of yours served in the Australian defence force during World War II, Korean War, Vietnam War and First Gulf War.

What does Defence Force Health insurance cover?

There are 3 Hospital and 3 Extras plans to choose from and 2 ADF specific pre-packaged options that combine hospital and extras into one policy.

Health exclusives available to valid members, include:

  • Lower cost dental care
  • Bone density checks and specialised mole mapping at skin clinics
  • Paid benefits to quitting smoking programs
  • Diverse health programs
  • Telephonic support from Health Nav officers helping you navigate the health system
  • Use the My Medical Expert to get advice from leading medical specialists
  • MyBaby Support Programs helps you through your journey to becoming a parent

The programs you have access to is dependent on the level and type of cover you choose.

Review the below packages and consider the option best suited to your health needs and your family dynamic.

Please note; below has been calculated on September 2018, based on a single adult living in Queensland, paying an excess of $250.

Essentials hospital 250 Value hospital 250 Premier hospital 250
$100.67 per month $191.67 per month $240.89 per month
Covers the basics. Great for people on a budget wanting to avoid the Medicare Levy Surcharge. Covers everything in the Essentials plan, plus more, while remaining affordable. Ultimate cover for starting & growing families and those needing more assistance with their health.
  • Accidental injury
  • Removal of tonsils, adenoid & appendix
  • Hernia repairs
  • Joint investigations & minor repairs
  • Colonoscopy & gastroscopy
  • Surgical teeth extraction
  • Emergency & Non-emergency ambulance
  • Back surgery
  • Brain surgery
  • Cancer treatment
  • Cardiac & cardiac-related procedures
  • Gynaecological services
  • Palliative care
  • Plastic & reconstructive surgery
  • Pregnancy-related services
  • Rehabilitation
  • Home nursing
  • Midwifery
  • Assisted reproductive services
  • Cataracts, eye lens & glaucoma surgery
  • Joint replacements & reconstructions
  • Obesity surgery
  • Psychiatric treatment
  • Renal dialysis
  • Psychiatric treatment
  • Rehabilitation
  • Palliative care
  • Psychiatric services
No restrictions of benefit limitation periods
  • Cardiac & cardiac related services
  • Cataracts & eye lens procedures
  • Pregnancy & birth-related services
  • Assisted reproductive services
  • Hip replacements
  • Dialysis of chronic renal failure
  • Sterilisation
  • non-cosmetic plastic surgery
  • Hospital treatment for which Medicare pays no benefit
  • Cataracts & eye lens procedures
  • Assisted reproductive services
  • Joint replacements (shoulder, elbow, hip & knee)
  • Dialysis of chronic renal failure
  • Hip replacements
  • Gastric banding & related services
  • Hospital treatment for which Medicare pays no benefit
  • Hospital treatment for which Medicare pays no benefit

The legend below indicates which services are covered, restricted and not covered.

  • Fully covered
  • Limits apply
  • Not covered
Compare Leading Health Insurance policies

Defence Health Extras cover

Your choice Extras policy should usually depend on the level of cover you need and what you can afford, as well as your current and possible future health. There are 3 Extras cover options to choose from:

 Essentials extras

A budget-friendly option with limited cover. General dental coverage up to $500 per year with a minimum 15% discount when using the Defence Health dentist network and optical coverage of $170 per annum. Essentials extras only cover pharmaceutical benefits for travel vaccines and excludes cover for:

  • Major dental, endodontic or orthodontic services
  • Podiatry
  • Psychology
  • Hearing aids
  • Blood Glucose Monitors

 Value extras

Comprehensive extras cover for a broader range of benefits with usually no annual limit on teeth cleaning, x-rays and fillings and includes speech, eye and occupational therapies. The Defence Network optical providers offers no-gap glasses and discounts on certain optical purchases.

Includes major dental services, hearing aids and a $1,100 combined limit on physiotherapy, chiropractic and podiatry services.

 Premier extras

Top-level extras include laser refractive eye surgery and an annual limit of up to $1,500 on medically prescribed appliances like hearing aids and blood glucose monitors. This extras package provides the highest amount of coverage of the 3 options available and might be most suited toward people with a complicated medical history and those entering retirement.

Combined cover options for ADF members and their families

You can generally mix, and match Hospital and Defence Health Extras cover to create your combined policy. However, ADF members that are permanent SERCAT 6-7, and reservist SERCAT 3-5 serving 20 or more training days in a financial year, can apply for the ADF Essentials or ADF Total package. If you qualify, your partner and family are also eligible.

ADF Essentials package 250

If you’re still young and healthy, without a family to look after, you might find this affordable ADF health insurance package best suited to your circumstances and budget at $111.36 for a single adult living in Queensland, paying an excess of $250.

  • Limited hospital cover to avoid Government penalties.
  • Comprehensive ambulance cover for emergencies and non-emergencies.
  • Tonsil, adenoid and appendix removal, as well as surgical teeth extraction and joint investigations and minor repairs.
  • General dental of up to $500 per year and optical up to $170.

ADF Total package 250

Provides access to comprehensive hospital cover and a wide range of extras at $217.23 a month with an access of $250 (single adult, living in Queensland, September 2018).

  • No restrictions or benefit limitation periods.
  • The cover includes home nursing, assisted reproductive and pregnancy-related services, psychiatric treatment, and joint reconstructions and replacements.
  • No limit general dental cover and major dental of up to $950 per annum and optical up to $255.
  • Speech, eye and occupational therapy are also included, as well as laser refractive eye surgery and up to $1,000 for medically prescribed appliances, like hearing aids.

How to lodge a Defence Health claim

Call the insurer before going into hospital, so they can make it easy for you to claim. To claim on your Extras cover, you have 4 options:

  1. Claim on the spot by swiping your member card on the terminal.
  2. Download and complete a Defence Health claim form, available through their website, and fax, post or email it to them.
  3. Claim online by registering on their website and logging in.
  4. Download their Mobile Claiming App available from the Google Play store and App store.

Defense Health insurance FAQs

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

There is generally no need to re-serve waiting periods when switching to a Defence Health insurance policy, which is similar to the level and type cover you had before, within 2 months after leaving your current fund. However, you’ll continue to serve the remainder of the waiting periods that you’ve not completed on your former fund.

If you apply for a higher level of cover, you’ll have to serve the waiting period for the additional or increased benefits.

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

The claims you’ve already made this year on your current fund will be reflected in your new fund when switching private health insurance. Benefits will usually reset on 1 July.

Can I claim my gym membership through Defence Health?

No. Defence Health insurance does not currently provide such benefits.

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

No. All members with Extras cover will receive a 15% discount off the usual dental fee when any network dentist performs the treatment.

Do I have to use a Defence Health network provider?

No, you can see any provider you want. However, a network provider might offer discounts and deliver more value.

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