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Defence Health Insurance Review

Defence Health offers health insurance to members of the Australian Defence community. With coverage options for basic and comprehensive medical needs, Defence Health might be the right fund for you.

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Who can join Defence Health?

Defence Health is a restricted fund, with membership only open to current and former members of the Australian Defence Force and their families. It offers memberships to the following people:

  • Anyone who has previously served in the ADF, regardless of whether they served part-time or full-time, as well as their partners and children
  • Anyone who works in the Department of Defence or a related department
  • Anyone who currently works or has previously worked for a Defence supplier
  • Anyone who is the extended family member of anyone listed above. This includes parents, children, siblings, grandchildren, ex-spouses and partners
  • ADF Partners and families
  • Active reservists (anyone serving in the Army Reserve, Air Force Reserve or Naval Reserve), their partners and families.

Permanent ADF members are not required to take out cover for themselves but can cover their partners and children.

Who is Defence Health?

Defence Health is a not-for-profit health fund with over 65 years of experience in the insurance industry. Defence Health is a member-owned health fund that is designed to serve the needs of the Defence community. Rather than being run to benefit shareholders or a big corporation, Defence Health is run in the interests of its members. This means it can offer affordable and competitive cover to Australians with Defence connections – no matter what their health insurance needs are.

What health insurance options are available?

  • Ultimate Hospital Gold. This policy offers comprehensive cover for all that Medicare covers, including everything from joint reconstructions and heart services to pregnancy IVF and psychiatric services.
  • Advantage Hospital Silver Plus. This policy only has 3 exclusions - weight loss surgery, pregnancy and birth, and assisted reproductive surgery - making it suitable for those who want top level cover without pregnancy and birth services.
  • Core Hospital Silver Plus. Core Hospital Silver Plus is Defence Health's mid-range offering and includes the 26 clinical categories required for a Silver rating and covers for the cost of a range of procedures like brain and nervous system, ear, nose and throat, eye (not cataracts) and more.
  • Everyday Hospital Bronze Plus. This policy includes the 18 clinical categories required for a Bronze rating, providing cover for the likes of breast surgery (medically necessary) diabetes management (excluding insulin pumps) and dental surgery.
  • Essentials Hospital Basic Plus. This basic policy includes ambulance and accidents. If you want cover for a selection of basic hospital treatments or simply to avoid being hit with levies and loadings by the government, this policy is designed with you in mind.
  • Premier Extras. This offers top-level extras protection for a range of general treatments including ambulance, preventative dental, general dental, major dental, orthodontics, optical, physio, chiropractic, antenatal and postnatal services, pharmacy and vaccinations, alternative therapies, exercise physiology, psychology, podiatry, speech therapy, occupational therapy, dietitian and more.
  • Value Extras. This mid-range policy covers a similarly wide range of treatments but offers lower benefit limits than a Premier Extras policy. Features include comprehensive ambulance cover, no annual limit on general dental treatment, no-gap glasses deals and much more.
  • Essential Extras. This option is designed to offer wallet-friendly cover on the general treatments you're most likely to use. This includes cover for general and preventative dental, ambulance treatment, optical, physio, travel vaccinations and alternative therapies.

ADF packages are for ADF members, their partners and families only:

  • Total Package Gold. The ADF Total package allows you to take advantage of a range of extras treatments with generous annual limits. It offers higher benefits on dental, speech therapy, physiotherapy, psychology, antenatal and postnatal services and more. As a result of national pricing, your premium stays the same no matter where you are posted.
  • Essentials Package Basic Plus. The ADF Essentials Package is its entry level combined policy, which covers a limited range of hospital and extras treatments.

Young people discount

If you're over 21, single and not studying full-time, you're not covered by your family's health insurance. Defence Health has a Young Adult Support Plan which lets singles under 25 maintain health cover. All you need to do is take out your own Value Extras cover (or Premier Extras) and you can stay on your family's hospital cover.

Member offers

  • Dental & Optical Network. Available to all members with extras cover. Dental & Optical network gives members access to dental care at reduced fees, optical benefits and you can also receive no gap on preventive treatments.
  • Health and Wellbeing Programs. Most members with combined hospital and extras cover have access to Defence Health's health and wellbeing benefits. This includes help to quit smoking and benefits paid for a range of health screening tests
  • Ex-serving exclusives. Defence Health provides a number of exclusive offers to ex-serving members, providing guidance on managing your health and wellbeing after you transition.
  • Young Adult Support Plan. Singles under 25 can maintain hospital and extras cover when they sign up to Value Extras cover.
  • MyBaby Support Program. The MyBaby support program provides members with expert advice, tailored content and practical ante and postnatal support.
  • Life after the ADF. If you're transitioning from the Australian Defence Force (ADF) to a civilian, Defence Health offers several health insurance options so you can continue to be covered. If your family already has a policy, they can simply add you on to it. If you're moving from the permanent ADF (SERCAT 6-7) to Reserves (SERCAT 3-5), you can stay on one of Defence Health's exclusive ADF packages or choose from their mix and match policies and still get special ADF premiums. You'll also get a 10% premium reduction on hospital or hospital and extras cover for the first 12 months following your discharge.

How to make a claim

In many cases, extras claims can be lodged and paid on the spot using electronic claiming; all you have to do is swipe your Defence Health membership card. For all other claims, you will need to claim through Defence Health's mobile claiming app on your smartphone or tablet, online through the member area of the Defence Health website, or by completing a claim form and emailing, faxing or mailing it back to Defence Health.

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