Defence Health Fund Review

Founded over 65 years ago, to support defence personnel and their families, Defence Health provides health and travel insurance to more than 300,000 members. This includes World War II veterans and people transitioning into civilian life.

I’d like health insurance cover for:

Which humans

  I'm  

  looking for  

cover type

  cover and I live in  

.

  I am currently with  

select fund

by Gary Andrews

Last update 15 Apr 2021

Overview

Defence Health is not-for-profit, so premiums are diverted back to the business to benefit members.

It's also 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.

Key Points

Special support for ex-ADF service personnel.
An Australian network of 1,400 dentists for members.
Regularly one of the top-rated funds for customer service.

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

COMPARE & SAVE

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 for 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
  • Dental surgery

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

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.

Key inclusions:

  • Pregnancy and birth
  • Assisted reproductive services
  • Weight loss surgery
  • Hospital psychiatric services

Ambulance Cover

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

Extras cover

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

Simply work out what you need and what you're prepared to pay.

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

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.

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.

Premier Extras

Defense Health's highest and most extensive level of cover with up to 15% off the usual fees at network dentists.

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

COMPARE & SAVE

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.

Essentials Hospital Basic Plus Everyday Hospital Bronze Plus Core Hospital Silver Advantage Hospital Silver Plus Ultimate Hospital Gold

  • 12 months -- pre-existing conditions
  • 12 months -- pregnancy related treatment
  • 12 months -- laser refractive eye surgery
  • 2 months -- rehabilitation, psychiatric and palliative care
  • 2 months -- all other hospital services
  • 12 months -- major dental and orthodontic treatment
  • 12 months -- most devices, aids and appliances
  • 2 months -- all other services

Member benefits

Along with a broad range of hospital and extra covers, Defence Health offers members a range of support programs.

This includes:

  • Health and wellbeing services, like health screening and quit smoking programs.
  • Support for defence personnel transitioning into civilian life.
  • Special family packages for serving ADF personnel.
  • The MyBaby Support Program for new parents.

How to claim

Claim on the spot through the HICAPS payment system at your provider.

You can also claim through the Defence Health mobile claiming app, through Online Member Services, or by email, mail or fax.

Hospital agreements

Defence Health has agreements with most private hospitals and day clinics across Australia.

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

Customer service

In 2019, Defence Health had just 1.1% of all health insurance fund complaints, reflecting their awards for customer service.

COMPARE & SAVE

FAQs

Is Defence Health a not-for-profit fund?

Yes, profits go back into the business to benefit members.

Who can apply? Are there any restrictions?

Yes, 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?

You can only switch to Defence Health if you're eligible to join the fund and you'll need to speak to them directly.

Defence Health isn't on our panel, but we're confident we can get you a great deal on your health insurance if you're looking to switch health insurance or aren't eligible for Defence Health.

Do I need to re-serve waiting periods?

No, providing you transfer to Defence Health within 60 days of leaving your old fund on an equivalent or lower cover.

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.

Do I get the government rebate?

Most Australians are eligible to receive a rebate from the government.

This will depend on your age and income.

To learn what you're entitled to, see this rebate guide.

Do I have to pay the Lifetime Health Cover loading?

If you're joining for the first time and you're 31 or over, you usually need to pay 2% loading for each year you've gone without health cover since your 31st birthday.

You can find out more here.

When do extras reset?

Extras reset on 1 July each year.

What age are children covered up to?

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.

Who underwrites the health policies?

Allianz Australia Insurance Limited.

COMPARE & SAVE

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.