Navy Health – Defend your families health
Although Australians are fortunate enough that some of our medical and hospital bills are covered by Medicare, our national health care system certainly doesn’t provide complete coverage when we’re sick. This is where private health insurance comes in. It is designed to help you cover those medical and hospital bills that aren’t covered by Medicare, providing crucial financial assistance if you suffer from a prolonged health problem.
Navy Health offers a range of competitive policies to protect the needs of Australian Defence Force members and their families. From essentials cover right through to comprehensive protection, Navy Health has policies to suit a wide range of insurance needs and family budgets.
Navy Health Cover Options
Navy Health offers a range of basic and premium cover options to offer the protection you need when your health takes a turn for the worse.
Navy Health Saver Hospital
Navy Health Saver Hospital cover offers essential coverage for the young, fit and healthy. It provides protection against the cost of vital treatment, such as treatment for an accident or getting your wisdom teeth removed, but doesn’t offer any benefits you’re unlikely to use.
Premium Hospital cover
Premium Hospital cover, on the other hand, offers comprehensive cover at more than 490 private hospitals and recognised public hospitals around Australia. Special policy options are also available for Northern Territory residents and for customers who would like to select a different excess.
Navy Health Basic Extras
When it comes to extras cover, the available options start with Navy Health Basic Extras. This offers essential general treatment cover for things like dental, optical, physio and chiro. Healthy Living Extras is the next step up and offers comprehensive cover for a wide range of general treatments, making it Navy Health’s most popular extras cover option. Last but not least, Premium Extras cover provides the highest rebates and annual limits of any Navy Health extras cover option.
Navy health levels of cover
- Premium Hospital / NT Hospital. This policy option provides up to 100% cover for hospital costs at more than 490 private hospitals and recognised public hospitals around Australia. If you’re admitted to hospital, this policy ensures that you will not have to pay any upfront costs or any excess. NT Hospital is only available for Northern Territory residents.
- Healthy Hospital 200 & 500 / NT Hospital 300. These policies offer the same comprehensive cover as the Premium Hospital and NT Hospital policies listed above. However, they provide the flexibility of an excess – $300 for NT Hospital 300 or the choice between $200 and $500 for Healthy Hospital 200 and 500 policyholders – to provide lower premiums.
- Saver Hospital. This option is designed with budget-conscious policyholders in mind, providing basic cover for all the important things but not requiring you to pay for benefits you don’t need. From knee reconstructions to treatment after an accident, this policy allows you to be covered as a private patient in a public or private hospital. Combined Saver Hospital and Extras cover are available through a Saver Plus policy.
- Premium Extras. This offers Navy Health’s highest level of cover for a wide range of general treatments including dental, orthodontic, optical, laser eye surgery, occupational therapy, physiotherapy, chiropractic osteopathy, podiatry, natural therapies, psychology and more.
- Healthy Living Extras. This is Navy Health’s most popular form of extras cover and it offers money back on all of the health and medical services you use the most. It covers all the same treatments as a Premium Extras policy but to lower limits.
- Basic Extras. As the name suggests, this policy provides cover for essential general treatment options. Providing cover for optical, dental, physio and chiro costs, it can be taken as standalone cover or combined with any of the hospital cover options.
- Saver Plus. As mentioned, Navy Health Saver Plus health insurance provides a basic level of combined hospital and extras cover. It provides essential things like hospital, dental and chiro cover but doesn’t require you to pay for benefits you’re highly unlikely to ever use.
What are the general exclusions?
Your Navy Health claim will not be paid if:
- It is for a treatment where Medicare doesn’t pay a benefit
- You make a claim more than two years after the date of service
- The natural therapies provider is not recognised by the Australian Regional Health Group (ARHG) Exercise and Sports Science Australia (ESSA) or HICAPS
- It is for cosmetic surgery of any kind
- The provider is not recognised in a private practice
- For services performed, or products paid for, outside of Australia
- The service you are claiming forms any part of a payment from Workers’ Compensation or Third Party liability cover.
It’s also worth pointing out that certain procedures and treatments may be excluded from cover depending on the policy option you choose. For example, Saver Plus policies do not cover assisted reproductive services, bariatric surgery, major eye surgery, renal dialysis, spinal surgery and more.
How are claim payments calculated by Navy Health?
All Australian health funds allocate different levels of benefit payment depending on the medical service claimed by their members, and Navy Health is no different. Using data taken from the Australian Medical Association's 2016 report card on private health insurers, this table displays the dollar amount Navy Health will pay on claims for 22 common hospital treatments, and includes Medicare's (MBS) benefits for comparison.
Navy Health is a member of the Australian Health Service Alliance, and is listed under that organisations name. More information about the AHSA can be found at the bottom of the table:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genetalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health
How much does Navy Health cost?
A range of factors can affect the cost of your Navy Health premiums, including:
- If you’re a serving Defence Force member, you can save 10% off the cost of cover
- The number of people you insure on your policy. Family cover will obviously cost more than individual cover
- Whether you pay your premiums monthly or yearly
- The level of cover you choose
- Whether you choose just hospital or just extras cover, or whether you select a combined policy
- Your age
- Your annual income.
What is an excess?
The excess is the amount you are required to pay to contribute towards the cost of your claim. With Navy Health, the amount you will have to pay varies depending on the type of cover you have. For example, no excess applies to a Premium Hospital policy claim, while those with a Healthy Hospital policy can choose between a $200 and a $500 excess. Saver Hospital and Saver Plus claims attract a $500 excess.
How can I save on my policy?
The following tips will help you save money on the cost of cover:
- Choose a standalone policy rather than combined hospital and extras cover
- Choose a higher excess in return for a lower premium, for example on a Healthy Hospital 200 or 500 policy
- Choose a lower level of cover
- Pay your premiums yearly instead of half-yearly or monthly
- Serving Defence Force members save 10% off the cost of cover
- Your annual income affects the Australian Government private health insurance rebate amount you are entitled to each year.
How do I make a claim?
You can submit a Navy Health claim by post, email or fax. Every claim must be accompanied by a completed and signed claim form, which can be downloaded from the Navy Health website. Payment of claims is then made by direct deposit into your nominated bank account.
For electronic claiming when visiting a health care provider, simply swipe your Navy Health membership card through the electronic claiming facility. Once electronic authorisation has been provided by Navy Health, all you have to do is pay the remaining balance.
Are there any additional benefits?
Navy Health offers the following additional benefits and programs to its members:
- Online Wellness Portal. The Navy Health Online Wellness Portal is designed to help members improve their overall health. After undergoing a Health Risk Assessment you can then set wellness goals and receive advice and assistance to help you reach those goals.
- Pregnancy Program. This program puts pregnant women in touch with experienced midwives to offer support and assistance throughout their pregnancy and after they have given birth.
- Chronic Disease Management Program. The Health + Care program offers tailored programs to help those recovering from serious medical conditions. Phone and face-to-face support from registered nurses is available to help manage chronic illnesses, while at-home support is also available for things like chemotherapy, wound care and palliative care.
FAQs about Navy Health
Do I have to be in the Navy to join Navy Health?
No, membership is available to all serving and ex-serving Australian Defence Force members and their families.
I’m an ADF member and my family wants to join. Do I have to join as well?
No you do not. Your family members are free to join Navy Health at any time, regardless of whether or not you are a member.
Can I still be a member once I leave the ADF?
Yes, Navy Health’s Member For Life clause means that you continue to access the benefits of Navy Health membership as normal.
What are the benefits of private health insurance?
Private health insurance helps cover the medical and hospital costs that Medicare doesn’t take care of. It also allows you to choose your doctor and choose where and when your procedures are performed. It’s about peace of mind and giving you the freedom to take greater control over your health.
I never get sick – do I really need private health cover?
Even if you’re fit and healthy you can still take advantage of a range of benefits. Extras cover helps cover the cost of things like optical, dental, physio and natural therapies, all of which can ensure that you get your money’s worth from your cover.
I have a Navy Health family membership. For how long will this provide cover for my children?
Children are covered under a family membership until they reach 22 years of age. In addition, if they are studying full-time and still living at home, cover is available until they reach the age of 25.
Can I take out standalone Hospital or Extras cover?
Yes, you can choose to take out one of Navy Health’s Hospital or Extras options as standalone cover, or you can choose to mix and match Hospital and Extras cover to create a combined policy.
What if I receive an overseas posting?
If you are posted overseas, Navy Health will allow you to suspend cover for the relevant period once you have provided supporting documentation.
How do I join Navy Health?
You can join by applying online, posting in an application form or phoning Navy Health.
Apply for Navy Health insurance today
Looking after your health is vital for people of all ages and fitness levels, and Navy Health offers a variety of competitive cover options for Defence Force members and their families. Just make sure to compare its policies with other products on the market to ensure that you end up with the right type and level of cover for your needs.