Hospitals
The following information relates to DVA entitlements for hospital admissions for Entitled Persons.
If you have a Repatriation Health Card For All Conditions (Gold Card) this information is regarding all your hospital treatment.
If you have a Repatriation Health Card For Specific Conditions (White Card) this information concerns hospital treatment for your accepted disabilities (both War-Caused and Treatment only).
Note: Services available to overseas Entitled Persons may be different to, or require different authorisation to, those available to Australian Entitled Persons. For specific information on the services available, contact your nearest DVA office.
See: Overview of Health Services available to the Veteran Community (Factsheet HSV01)
Note: For members of the Australian Defence Forces (ADF), please contact your nearest Department of Defence Area Health Service for information regarding your access to these services.
DVA has arrangements and agreements with the vast majority of hospitals across Australia.
These arrangements are classified in Tiers:
- Tier 1 Hospitals – All public hospitals, former repatriation hospitals, contracted ‘Veteran Partnering’ private hospitals and contracted day surgery facilities;
- Tier 2 Hospitals – Contracted (non Veteran Partnering) private hospitals; and
- Tier 3 Hospitals – Non contracted private hospitals and day surgery facilities.
Treatment at other than a Tier 1 hospital requires DVA’s prior financial authorisation.
How do I get admitted to a hospital?
There are two ways to be admitted or treated at a hospital.
Emergency admissions/treatment – If you fall ill at home or even while travelling you can be treated at the nearest suitable hospital facility. This can be organised via ambulance transfer, in which case the ambulance will take you directly to the closest hospital with an Accident and Emergency Department that can treat your condition.
Elective admissions/treatment – Your treating doctor or specialist will arrange your elective or pre-arranged admission/treatment. Certainly discuss with your treating doctor or specialist your preferences for which hospital you wish to be admitted to, however this will normally be dependant on where your doctor or specialist has visiting/admitting rights.
Which hospital can I attend?
Tier 1 hospitals
Routinely tier 1 hospitals do not require DVA prior financial authorisation for your admission/treatment. However, there are some exceptions mentioned below:
- Public hospitals - You have access to all Public Hospitals for inpatient and outpatient treatment in each State and Territory, regardless of which State you live in;
- Former Repatriation hospitals – DVA has arrangements with all former repatriation hospitals should you request treatment at these hospitals;
- Contracted ‘Veteran Partnering’ private hospitals– DVA has agreements in place with the vast majority of Private Hospitals in each State and Territory across Australia. Click on this link to access a full list of these hospitals.
- Contracted Day Surgery Facilities - DVA has agreements in place with the vast majority of day surgery facilities in each State and Territory across Australia. Click on this link to access a full list of these hospitals.
See: Hospitals page
Tier 2 hospitals
To ensure the greatest possible choice of hospital treatment, DVA also has agreements in place with a small number of Tier 2 (contracted non Veteran Partnering) private hospitals as a ‘safety net’ to ensure services are available to you in a timely manner. All tier 2 hospital admissions require DVA’s prior financial authorisation.
Tier 3 hospitals
In exceptional circumstances only, you can be admitted or receive treatment at a hospital or day surgery facility which does not have an arrangement or agreement with DVA. DVA prior financial authorisation is required for any Tier 3 hospital admission.
If I am admitted to hospital as a DVA patient, what will DVA pay for?
If you are admitted to a DVA tier 1 or tier 2 hospital (with prior financial authorisation) as a DVA patient you will be admitted as a private patient and have access to the doctor/specialist of your choice. Your accommodation in hospital will be in a shared ward (normally 2 to 4 beds) and DVA will cover your hospital and treatment costs.
What doesn't DVA cover?
DVA does not pay for:
- Private room fees (where not deemed medically necessary); and
- Personal/non-medical services such as installation of TV, telephone calls, newspapers, laundry costs etc.
Where DVA has an arrangement or agreement with a hospital, a private room fee will only be funded by DVA if your treating doctor/specialist and the hospital deem this is medically necessary. You can of course arrange privately with the hospital to be accommodated in a private room (if available), in which case you will be asked to sign an agreement to fund the difference between what DVA pays and the private room rate (this can be between $50 and $150/day).
When does a hospital admission require DVA's prior financial authorisation?
DVA’s Prior Financial Authorisation must be sought by your treating doctor/specialist/hospital for some services and treatment in hospital, regardless of the Tier status of the hospital. These services include:
- Psychiatric treatment;
- Respite Care;
- Convalescent Care;
- Dental Services;
- Procedures that do not have a Commonwealth Medicare Benefits Schedule (CMBS) item number, including cosmetic surgery;
- Treatment involving drugs that do not have marketing approval for that treatment; and
- Other specific treatment nominated by DVA from time to time.
If I choose to enter a private hospital under private health insurance, would DVA cover me for any GAP payments?
No. If you choose to enter a private hospital under an arrangement with a private health fund, payment for the hospital accommodation and medical treatment is the responsibility of the health fund, you and, in some circumstances, Medicare.
Should I cancel my private health insurance?
The decision on whether to maintain or take out private health insurance is for each person to decide according to individual preferences and circumstances. You may find it useful to discuss your situation with your doctor or a family member.
A doctor who treated me as a DVA patient at the hospital has sent me a bill. What should I do?
Return the account to the doctor or the hospital with a note that you are a DVA patient. Do not send the bill to Medicare or your private health insurance.
Who do I contact if I have an issue with a hospital or the treatment I have received in hospital?
DVA is extremely interested in your feedback regarding your hospital treatment and experiences, whether they be positive or negative.
In all Veteran Partnering private hospitals, a position has been developed, known as the Veteran Liaison Officer (VLO). The VLO will normally be involved in your admission or discharge process and should be your first point of contact if you have a query regarding your stay at the hospital. A similar person may exist in some metropolitan or large regional public hospitals.
If you are unable to resolve an issue with a hospital to your satisfaction, please contact your nearest DVA Office and ask to speak with the Contract Manager of the hospital in question. DVA will endeavour to assist you to resolve your issues. If at the end of this process, you are still unhappy with the results, you should refer your issue to the Victorian Health Services Commission this will be different in each state.