Defence Health limited extras health insurance policy review

Members, ex-members and families of the ADF can compare and choose between 3 extras cover options.

Defence Health Limited has spent decades serving the Australian Defence Force, defence industry and their extended families by offering high quality, cost-effective healthcare.

You are eligible to join this health fund if you:

  • Are a currently serving ADF member, or reservist who trains or serves 20 or more days a year.
  • Have previously served in the ADF
  • Currently work, or have previously worked in the Department of Defence and other related departments
  • Have worked for a defence supplier, or a company contracted by the Department of Defence, where you were involved in the supply of defence goods or services

You can also join if you're part of the extended family. This includes partners, children, siblings, former spouses or partners, or grandchildren of any of the above.

finder.com.au does not currently have access to this health insurance brand. You may wish to compare options available on the health insurance homepage.
Top 3 features
  1. Good for Flexi-limits cover.
  2. Good for no gap on preventative treatments.
  3. Good for laser eye surgery. Defence Health are one of the few providers offering cover for this treatment.

What Extras Cover options are available?

The three extras health plans are Premier Extras, Value Extras and Essentials Extras.

EssentialsValuePremier
Ambulance treatment
  • Unlimited
  • Unlimited
  • Unlimited
Preventative dental
  • $500 combined dental limit
  • Unlimited
  • Unlimited
General dental
  • $500 combined dental limit
  • Unlimited
  • Unlimited
Major dental
  • Surgical extractions only
  • $900
  • $1,100
Orthodontics
  • No
  • $800
  • $1,000
Optical
  • $170
  • $255
  • $300
Alternative therapies
  • $200
  • $300
  • $400
Medical aids and devices
  • No
  • $1,000
  • $1,500
School accidents
  • No
  • $600
  • $800
Laser eye surgery
  • No
  • No
  • $1,500
Health and wellbeing
  • No
  • $100
  • $180
Flexi-limits cover
  • $450
  • $1,100
  • $1,500

Picking a plan

  • Essentials. This affordable plan contains some of the most popular and useful extras, while still letting you claim money back for travel vaccinations and other practical but less commonly-used benefits. This cost-effective plan might be right for people who don't have any particular health issues that might need medical aids, or don't have children and therefore don't want the benefits of school accident cover
  • Value. A balance of cost and cover from this plan means it might be a good choice for many people. It delivers wide-ranging cover and includes benefits that might prove invaluable if something happens. However, the lower limits mean it might not be suitable for people with chronic health issues, or who otherwise know they'll be claiming a lot of benefits.
  • Premier. The high limits and expansive cover of this policy mean it might be the optimal choice for people who are getting older and entering the age of ongoing health issues, or simply want the utmost protection. With cover for laser eye surgery and 100% back on initial flexi-limits consultations there are a lot of ways to make use of this option.

Other benefits of Defence Health Extras Cover

  • Flexi-limits cover. The unique Defence Health flexi-limits cover means you can make full use of treatments as needed instead of including cover without knowing whether you'll ever need it.
  • Dental & Optical network. The Dental & Optical network is available to all members with extras cover, giving you and your family access to dental care at reduced fees as well as optical benefits. You're also able to receive no gap on preventive treatments.
  • Health & Wellbeing programs. If you opt for a combined hospital and extras cover policy, you'll also have access to Defence Health's health and wellbeing benefits, letting you claim expenses up to the annual limits for approved health tests and programs. Some of these services include bowel screening, kidney checks, mole mapping, bone density tests, mammograms, specialist eye tests, quit smoking programs and nicotine replacement therapies.
  • Recognition of already-served waiting periods. If you transfer to Defence Health from another fund where you had equivalent benefits, any waiting periods served under your previous cover will be honoured.
  • School accident cover. Another uniquely useful benefit from Defence Health, this no-waiting-period benefit means you can claim gap expenses, up to the specified amounts, relating to school accidents your children might experience.
  • Laser eye surgery. Claimable every two years, this rare extra inclusion lets you make sure your eyes stay in top shape without needing to wear glasses or contact lenses.
  • Online account management. Stay on top of your current extras limits and make sure you're getting value by checking your extras cover status online.
  • Defence Health app. This app can make it easier to claim, and easier to make full use of your extras cover.

How do the costs work?

Extras cover is cover for treatment and care you usually receive outside of a hospital. Extras cover provides a benefit towards the cost of your out of hospital treatment. The '% back' term that providers use is simply the amount that your insurer will cover; you have to pay the rest.

An annual limit is the maximum amount you are able to claim for on extras services. It's always worth looking carefully at this part of the policy as if you require a lot of treatment, you may reach your claim's limit. They reset at the start of every year and limits vary depending on the provider and level of cover you have.

Waiting periods and limitations

You cannot make claims before the end of the waiting periods. These are:

  • None: School accidents and ambulance cover.
  • 2 months: All extras not otherwise specified.
  • 12 months: Orthodontics, major dental, refractive laser eye surgery, some medical appliances.

The amount you can claim per service depends on your chosen level of cover, as well as the nature of the service. Instead of only giving a set percentage back, Defence Health generally reimburses you a flat amount per item, meaning you're able to predict your expenses more easily, and can take advantage of your extras cover without any out-of-pocket expenses which you might inevitably have with other health funds.

However, certain services are not claimable under Defence Health extras policies:

  • Items that may be payable by another third party or compensation scheme
  • PBS pharmaceuticals
  • Treatments claimed through Medicare
  • Services carried out by unapproved or non-accredited providers

How to make a claim

There are a number of ways to claim. The easiest is generally to download and use the Defence Health app, as you can make claims this way wherever you are, and even if your provider doesn't have the facilities to process an electronic payment card.

Similarly, you can sign in to your online Defence Health account in order to make claims after paying for treatments.

Alternatively, you can swipe your membership card on a terminal where available, to automatically make a claim against your extras cover, and simply pay any difference yourself.

Some items, such as medical aids, may require you to fill out and send in a claims form, with the appropriate sections filled in by your service provider or doctor.

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2 Responses

  1. Default Gravatar
    KayeMay 29, 2017

    Is hypnosis covered under well being and hair pulling out disorder?

    • Default Gravatar
      JonathanMay 31, 2017

      Hi Kaye!

      Thanks for the comment.

      Some health insurers may provide coverage for hypnosis and other specified disorders under “Extras Cover”. You may get the list from this page.

      Take note that some insurers have their respective definitions of each disorder and “cooling off period”, so it’s important to talk this with them directly.

      Hope this helps.

      Cheers,
      Jonathan

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