DVA health card: am I covered for health insurance?

Australians who have served in the defence force may be eligible for a veteran healthcare card. We take a look at what the types of cards are, what benefits they offer, and if having private health insurance could offer additional cover.

The Australian Defence Veterans’ Covenant is a Federal Government-run program that honours “the unique nature of military service and the contribution of veterans and their families”, according to the Australian Defence Force (ADF). Part of that program is the issue of a Veteran Card to current or former members of the ADF, including reservists. This card allows the holder to access a range of discounts or benefits from participating organisations and other concessions.

The Veteran Card program also provides eligible veterans access to free or subsidised health care. Formerly known as a DVA healthcare card, and issued by the DVA according to a range of eligibility requirements, there are three levels of cover:

1. Veteran Gold Card – entitles cardholder to clinically required treatment “for all medical conditions”, as well as other concessions and discounts on costs such as energy, and may also be issued to issued veterans’ family members.
2. Veteran White Card – covers treatment for “accepted service-related injuries or  conditions” and “all mental health conditions” if you meet requirements.
3. Veteran Orange Card – offers concessions for the cost of prescription medicines, wound care items and nutritional supplements only (and not for medical or healthcare treatment).

Do you need health insurance if you have a Veteran Card?

Whether or not a Veteran Card holder takes out private health insurance is a matter of personal choice. However, people who hold a Veteran Gold Card may benefit less from having private health insurance, as the card covers all clinically required medical treatment and associated costs.

As the White and Orange Veteran Cards do not provide complete cover for healthcare costs, holders of these cards may choose to investigate whether or not private health insurance could be of assistance. And, under the non-liability health care (NLHC) program, the DVA may pay for “treatment for some conditions without accepting these conditions were service-related”, including mental health conditions, cancer and tuberculosis, in some circumstances. We explore in further detail, below.

Compare Health Insurance

What does the non-liability health care (NLHC) program pay for?

The DVA’s NLHC program is designed to help veterans suffering from mental health conditions and other illnesses, even if those conditions are not accepted by the DVA as being related to service in the defence force.

• Mental health: Conditions covered by the NLHC may include post-traumatic stress disorder (PTSD), depression and anxiety, and alcohol or substance abuse issues. The DVA states that there are a number of eligibility criteria, but that the veteran does not have to “prove that military service caused their mental health condition”, and they do not require proof of a diagnosis. If the DVA decides to cover the veteran, they would be issued with a Veteran White Card which states they can receive treatment from a mental health professional, according to the DVA.
• Other conditions: Veterans who have a diagnosis of cancer or pulmonary tuberculosis may also be eligible for cover under the program, depending on a range of criteria set by the DVA. If the DVA decides to cover the veteran, they would be issued with a Veteran White Card that says they are covered for treatment for the condition.

Does my Veteran Card cover ambulance transport?

Veteran Card holders may still require private health insurance if they want cover for ambulance transport costs. The DVA states they may pay for ambulance transport if you have a Veteran Gold Card for all health conditions, subject to medical need. The DVA may also pay for ambulance transport for Veteran White Card holders for “accepted war or service-related injury or illness”. As it doesn’t cover ambulance transport in every instance, the DVA says you may wish to take out general ambulance cover. It also suggests you may want to consider taking out travel insurance before going on holidays or travelling.

Compare Health Insurance

Compare Travel Insurance

Do I need health insurance if I have a Veteran Gold Card?

Veteran Gold Card holders’ medical expenses are largely covered by the DVA, so they may not benefit from private health insurance as much as other people who hold it. However, there are a few circumstances where the Veteran Gold Card holder might like to consider taking out private health insurance:

• Ambulance transport: DVA suggests that Veteran Gold Card holders consider general ambulance cover, , as discussed above. Health insurance cover for ambulance services can take a few different forms – some health insurance providers offer a standalone ambulance cover product, whereas most simply cover ambulance costs under their hospital or extras products. Separately, ambulance cover can also be free, as it is for permanent residents of Queensland.
• Family/couples cover: While health-related expenses of the person who is issued the Veteran Gold Card are likely to be covered by the DVA, their family members’ expenses are not unless they have their own Gold Card. For this reason, a Veteran Gold Card holder may decide to consider taking out family or couples private health insurance. Some health insurance providers may also offer a discount to Veteran Card holders.
• Treatment above DVA recommended standards: Private health insurer Defence Health states that Veteran Gold Card holders may consider taking out private health insurance to cover any extra costs that could come with choosing services or medical devices that are above the “clinical standard” covered by the DVA, such as a higher specification hearing aid. It may also help to have private health insurance if you don’t want to share a hospital room with another patient.DVA does not cover single rooms, according to Defence Health.
• To cover funding gaps: Defence Health states that there could be a cap on some treatment under the Veteran Gold Card scheme, such as the yearly cost of certain dental treatments like bridges and crowns, which private health insurance could help cover.

Do I need health insurance if I have a Veteran White Card?

The DVA covers medical costs for Veteran White Card holders for certain medical conditions determined by the DVA to be as a result of your service. There are a range of eligibility conditions which a veteran must meet in order to receive the card. Check with the DVA. For this reason, Veteran White Card holders may consider taking out health insurance, to help with expenses not covered by the DVA, and to cover health conditions not listed on the White Card.

This could include:

• Ambulance transport: DVA suggests that White Card holders consider ambulance cover, as discussed above. Health insurance cover for ambulance services can take a few different forms – some health insurance providers offer a standalone ambulance cover product, whereas most simply cover ambulance costs under their hospital or extras products. Separately, ambulance cover can also be free, as it is for permanent residents of Queensland.
• Family/couples cover: Taking out private health insurance could help with medical expenses for your family, providing coverage for conditions not covered by the White Card. Some health insurance providers may also offer a discount to Veteran Card holders.
• Treatment above DVA recommended standards: Private health insurer Defence Health states that Veteran White Card holders may consider taking out private health insurance to cover any extra costs that could come with choosing services or medical devices that are above the “clinical standard” covered by the DVA, such as a higher specification hearing aid.
• To cover funding gaps: Defence Health states that there could be a cap on some treatment for acceptable conditions under the Veteran White Card scheme, such as the yearly cost of certain dental treatments like bridges and crowns, which private health insurance could help cover. There could also be out-of-pocket expenses that private health could help pay for.
• To avoid paying extra tax: Having private health insurance means you may not have to pay the Medicare Levy Surcharge.

The DVA warns that if a Veteran White Card holder chooses “to be treated as a Medicare or private patient for a condition on your White Card”, they “will not pay any out-of-pocket expenses”.

Compare Health Insurance

Do I need health insurance if I have a Veteran Orange Card?

The Veteran Orange Card only provides financial support for cardholders when purchasing  prescription medicines, wound care items and nutritional supplements related to the conditions specified on the card. The card cannot be used for medical treatment or healthcare services.

Veteran Orange Card holders might like to consider taking out private health insurance to help provide cover for treatment at private hospitals, and for ‘extras’, which includes some allied healthcare services.

Comparing health insurance

If you are considering taking out private health insurance, these articles may be of assistance:

• Is private health insurance worth the cost?
• What is the Medicare Levy Surcharge?
• Health insurance deals and sign-up offers

It is a good idea to read the Product Disclosure Statement (PDS) and Target Market Determination (TMD) before taking out a financial product such as health insurance.

Original author TJ Ryan.

Cover image source: Milleflore Images/Shutterstock.com