Defence Health Fund Review 2024

Defence Health is not-for-profit, so premiums are diverted back to the business to benefit members. Defence Health is a restricted fund, and you'll need to have a connection to the Australian Defence Force to be eligible to join.

Eligible members can choose from five hospital plans, with a basic no-frills policy for the budget-conscious, through to a top tier extensive premium Gold plan. Members also have access to health and wellbeing services, and the MyBaby program for new parents.

Defence Health isn't on our panel but we're confident we can get you a great deal on your health insurance.

Hospital cover

Nobody chooses to go to hospital. But when you do, hospital cover will help you get the treatment you need, where and when you want it. It also helps to pay the bills, as fees for hospital rooms and specialists can add up. Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge. Defence Health offers a choice of plans for members, from two budget covers, through to a Gold plan that covers almost everything. There's also a Silver and Silver plus plan, with different benefits to suit your needs.

Essentials Hospital Basic Plus

Defence Health's budget cover covers accidents and common hospital procedures.

It's suitable for young, healthy singles and couples without children who want to avoid the Medicare Levy Surcharge.

Key inclusions:

• 100% ambulance cover

• Hernia and appendix

• Tonsils, adenoids, and grommets

Everyday Hospital Bronze Plus

An affordable and comprehensive plan that covers accidents and a wide range of hospital services.

Suitable for Australians who don't have specific health needs.

Key inclusions:

• Digestive system

• Ear, nose, and throat

• Gynaecology

Core Hospital Silver Plus

A medium level of cover with a wider range of procedures, including necessary plastic and reconstructive surgery, chronic care programs, and more.

Key inclusions:

• Medically necessary plastic and reconstructive surgery

• Podiatric surgery

• Heart and vascular system

Advantage Hospital Silver Plus

A higher level of cover with a broad range of procedures.

Pregnancy and birth services are not included, making this suitable for older Australians who want top-tier cover.

Key inclusions:

• Cataracts

• Insulin pumps

• Dialysis for chronic kidney failure

Ultimate Hospital Gold

Fully comprehensive cover that includes up to 100% of doctors fees if the doctor chooses to use Defence Health's access no gap.

With midwifery and assisted reproductive services, this plan is suitable if you're starting or growing your family. This plan has a $500 excess.

Key inclusions:

• Pregnancy and birth

• Assisted reproductive services

• Weight loss surgery

Ambulance Cover

All hospital plans include unlimited emergency ambulance trips to hospital, including air and sea services.

Extras cover

Defence Health’s extras reset on July 1 every year. 

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with the health fund.

Take the time to work out what you need and what you're prepared to pay. If this feels a bit overwhelming, our experts are here to help. Defence Health has three extras plans to choose from. There's basic cover if you're on a budget, through to a comprehensive plan that covers just about everything.

Essentials Extras

This is a value extras package with set rebates that covers the basics, including general dental with an annual limit of up to $500 per person, plus physio, chiro, osteo and travel vaccinations.

Key inclusions:

• Access to dental and optical network

• General and preventative dental

• Remedial massage, acupuncture and myotherapy

Value Extras

Mid-level cover that lets you claim 100% on selected optical through Defence Health's partner network (subject to annual limits).

Also includes psychology and antenatal services, as well as no lifetime limit on orthodontics.

Key inclusions:

• Antenatal and postnatal classes

• Speech therapy

• Psychology

Premier Extras

This is the highest and most extensive level of cover with up to 15% off the usual fees at network dentists. It includes a variety of premium extras such as occupational therapy and eye therapy.

It also includes unlimited preventative dental, and up to 100% back on a mouth guard fitting for dependent children each year.

Key inclusions:

• Eye therapy

• Dietitian

• Laser eye surgery

Comprehensive hospital and extras cover

ADF Essentials Package Basic Plus

This cover is available only for singles and couples and has a $250 excess. It covers both hospital and extras, including optical, dental surgery and more.

Key inclusions:

• Gastrointestinal endoscopy

• Joint reconstructions

• Remedial massage, acupuncture and myotherapy

ADF Total Package Gold

This is a comprehensive level cover designed for ADF personnel and their families. There is a $0, $250 or $500 excess option, with high annual limits for extras as well as an extensive range of procedures covered.

Key inclusions:

• Weight loss surgery

• Pregnancy

• Laser eye surgery

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods. Generally, the more expensive the treatment, the longer you'll wait. But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

• 12 months for pre-existing conditions, pregnancy and birth

• 2 months for hospital psychiatric services, rehabilitation and palliative care as well as all other services covered

• Cover for an accident is immediate, including ambulance

Extra waiting periods

• 12 months for major dental services, orthodontics, health appliances and laser eye surgery

• 2 months for all other services, including optical, home and domestic aids and medical aids

Member benefits

Members have access to a dental and optical network that is available to all members with extra cover. This means that members can take advantage of no-gap dentistry and glasses. There’s also a MyBaby Support Program and a Young Adult Support Plan. These programs are structured on expert advice so that members can have all the information they need around pregnancy and teens. 

How to claim

Claim on the spot through the HICAPS payment system at your provider. You can also claim online through the Online Member services, through the Defence Health mobile claiming app, or by email, mail or fax.

Hospital agreements

Defence Health has agreements with most hospital and day surgery providers across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

Defence Health received 1.8% of complaints in 2021, and has a market share of 2.1%^.

Frequently Asked Questions

Is Defence Health a not-for-profit fund?

Yes, Defence Health is a not-for-profit fund. 

Who can apply? Are there restrictions?

Defence Health is a restricted fund. That means there are limitations on who can apply.

Defence Health offers cover to:

• Partners, children and extended families of Australian Defence Force personnel -- past and present

• Anyone who works, or has worked for the Department of Defence or other Defence-related departments -- plus their extended families

• Anyone who works, or has worked for a Defence supplier of goods or services.

• Anyone who is in the extended family network of a serving or ex-member of the ADF or an ADF supporter.

Is it easy to switch to Defence Health?

Defence Health is not on Compare Club’s panel, but we’re confident we can find you a good deal from the other funds we compare.

Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits

Can I change my level of cover?

Yes, you can choose a lower or higher level of cover. If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

Up to what age are children covered?

Defence Health covers dependent children on a family policy up to the age of 21. If they’re studying full time, dependents can be covered as a student under a family policy up to the age of 25. Children must not be married or living in a de facto relationship. Read our guide to learn more.

^Private Health Ombudsman, Defence Health, accessed 13 January 2022.