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Factsheet HSV59 - Eligibility for the DVA Health Card - All Conditions or Totally & Permanently Incapacitated (Gold Card)

Purpose

This Factsheet describes who is eligible for the DVA Health Card - All Conditions or Totally & Permanently Incapacitated (Gold Card) and what circumstances can affect your eligibility under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA).

Sample photo of the DVA Health Card — For All Conditions (Gold Card)   Sample photo of the DVA Health Card — For All Conditions (Gold Card) TPI

Using the Gold Card

For information on the services and treatment you can access with your Gold Card, see Factsheet HSV60 Using the DVA Health Card - All Conditions (Gold) or Totally & Permanently Incapacitated (Gold)

Who can obtain a Gold Card?

Australian Veterans

A Gold Card is issued to veterans of the Australian Defence Force (ADF) who:

  • are aged 70 years or over, and have qualifying service under section 7A of the VEA.  This includes members who have rendered a period of service classified as warlike on or after 1 July 2004, and which is covered under the MRCA for compensation purposes; or
  • are ex-prisoners of war; or
  • served in Japan between 16 August 1945 and 30 January 1946, or served in Japan as part of the British Commonwealth Occupation Force at any time between 31 January 1946 and 28 April 1952; or
  • were participants in the British nuclear test program in Australia (for information on the the specific eligibility criteria, see Factsheet DP83 British Nuclear Test Participants and Members of the British COmmonwealth Occupation Force.)

Veterans Receiving Disability Pension under the VEA

Veterans who don’t fit into the above categories but who receive the disability pension are also eligible to receive the Gold Card, if:

  • the rate of their disability pension is 100% of the general rate or higher; or
  • the rate of their disability pensions is 50% of the general rate or higher and they also receive any amount of service pension (including partner service pension); or
  • their disability pension includes an additional amount under section 27 of the VEA for specific service-related amputations or blindness in one eye; or
  • they were granted the disability pension for pulmonary tuberculosis before 2 November 1978.

Veterans Receiving an Age or Invalidity Service Pension

Some veterans who receive an age or invalidity service pension are eligible to receive the Gold Card, if they also:

  • satisfy the treatment benefits eligibility income and assets test; or
  • are permanently blind in both eyes; or
  • receive any amount of service pension and have an impairment from one or more service injuries or diseases that constitutes at least 30 impairment points under the MRCA.

Members with Conditions Accepted under MRCA

Former members of the ADF, cadets and reservists who have conditions for which liability has been accepted under the MRCA are eligible for a Gold Card if they:

  • have permanent impairment from accepted conditions assessed at or above 60 points; or
  • have a permanent impairment from accepted conditions assessed at 30 points or above, and the person is receiving any amount of Service Pension; or
  • meet the criteria for the Special Rate Disability Pension (SRDP) even if they have not chosen that pension.

For more information on the overview of MRCA and MRCA eligibility, refer to Factsheet MRC01 Overview of the Military Rehabilitation and Compensation Act 2004 (MRCA)

Commonwealth and Allied Veterans

Some veterans of Commonwealth or allied forces with qualifying service are eligible for a Gold Card if they are:

  • a veteran who served with a Commonwealth or allied force during World War 2 or in specified operations areas after World War 2 and were domiciled in Australia immediately prior to enlistment in the Commonwealth or allied force; or
  • a mariner who served on a Commonwealth or allied ship during World War 2, if they or their dependants were residing in Australia for at least 12 months immediately prior to the commencement of their service on that ship.

*Note:  Eligibility for individuals who served with a Commonwealth or allied force requires that they have been 'domiciled' in Australia immediately prior to enlistment.  Until 1 July 2010, individuals who were under 21 years of age were automatically determined to have been domiciled in the same country as their father (or mother, where their father was deceased).  On 1 July 2010, this age was lowered to 18, allowing individuals older than this to take their own domicile.

Australian Civilians

A Gold Card is issued to Australian mariners who:

  • served in Australia's merchant navy, between 3 September 1939 and 29 October 1945, who are aged 70 years or over, and have qualifiying service from that conflict; or
  • served in Australia's merchant navy between 3 September 1939 and 29 October 1945 and are ex-prisoners of war.

A Gold Card is issued to Australian civilian British nuclear test participants who:

  • were directly involved in the nuclear tests, including Commonwealth employees and contractors providing services associated with the nuclear tests; or
  • were not directly involved in the nuclear tests but entered a nuclear test area at a relevant time.

For information on the specific eligibility criteria, see Factsheet DP83 British Nuclear Test Participants and Members of the British Commonwealth Occupation Force.

Dependants of Veterans

Certain dependants of veterans are also eligible for a Gold Card if they are:

  • a war widow or widower in receipt of the war widow's or widower’s pension;
  • from 1 July 2008 a war widow whose partner was in receipt of Temporary Special Rate and Intermediate Rate Pensions at the time of their death;
  • a dependent child of a deceased veteran whose death has been accepted as war-caused, who is under 16 or between the ages of 16 and 25 and undergoing full-time education;
  • a child of a deceased veteran whose death was not war-caused and who had operational service, if the child is not being cared for by the remaining parent;
  • an invalid son or daughter of a deceased veteran whose death has been accepted as war-caused, who had treatment entitlement before 6 June 1985*;
  • a widowed mother or widowed step-mother who was dependent on an unmarried deceased veteran whose death has been accepted as war-caused, who had treatment entitlement before 6 June 1985*; or
  • a wholly dependent partner or dependent child of a member who is eligible for compensation for the member’s death under the MRCA.

*Note: No new treatment eligibility grants for categories marked with * have been possible since 18 October 1985.

When a veteran, former member, cadet or reservist passes away, that person’s Gold Card is not transferred to the surviving partner or any other dependant. Partners and other dependants who fall into the categories above would receive their own Gold Card if their claim is successful.

Can I lose eligibility for the Gold Card?

It is possible to lose eligibility for the Gold Card if your eligibility depends on anything that may change, such as payments, impairment ratings, age or living arrangements.

If your eligibility for the Gold Card depends on something that cannot change, such as your past service, your widow(er) status, blindness or amputations, then it is not possible to lose eligibility for the Gold Card.

Losing the Gold Card due to a change in financial circumstances

You may lose eligibility for the Gold Card if you were granted the Gold Card because you met any of the below criteria, but your financial circumstances have now changed and you no longer meet the relevant income and assets test:

  • you receive the disability pension at a rate of 50% of the general rate or higher and you also received any amount of service pension;
  • you have an impairment from one or more service injuries or diseases that constitutes at least 30 impairment points under the MRCA and have received an age or invalidity service pension; or
  • you receive an age or invalidity service pension and also satisfied the treatment benefits eligibility income and assets test.       

To find out the current treatment benefits income and assets limits, see Factsheet IS15 Health Care Eligibility for Service Pensioners.

Losing the Gold Card due to a change in disabilities

You may lose eligibility for the Gold Card due to a change in your disabilities if:

You were granted the Gold Card because you were in receipt of the disability pension at a rate of… but then a change in your disabilities resulted in your disability pension being reduced to…
50% of the General Rate or higher (including 100% or higher) below 50% of the General Rate
100% of the General Rate or higher between 50% and 100% of the General Rate and you are not in receipt of the service pension
 

Losing the Gold Card when you are a dependant of a deceased veteran

You may lose eligibility for the Gold Card if:

  • you were granted it because you are a child of a deceased veteran; and
  • your age, living circumstances, disability or study status changes.

If you are a dependant of a deceased veteran and are concerned about your Gold Card eligibility, contact DVA for more information.

What happens if I lose eligibility?

If at any time you lose eligibility for the Gold Card, you will be notified in writing and your Gold Card will be recalled. However, if you lost eligibility for the Gold Card due to a change in your financial circumstances, there are some circumstances in which you may be able to temporarily retain your Gold Card.

Period of Grace

Where you have lost your eligibility for the Gold Card because you have ceased to satisfy the treatment benefits eligibility income and assets test, a ‘period of grace’ of up to 13 weeks may be granted if your income does not exceed the set limits by more than 50%. During the period of grace you are able to retain your Gold Card. However, if, during the 13 weeks, your income:

  • reduces below the limits within the 13-week period, your eligibility for Gold Card is re-established; or
  • rises above the limit by more than 50%, your Gold Card is cancelled immediately.

You are not eligible for the ‘period of grace’ if:

  • you are being paid service pension under the income test, and your assets increase so that you are eligible to be paid under the assets test instead; or
  • you are being paid service pension under the assets test; and
  • your assets reduce so that you are eligible to be paid under the income test; or
  • your assets increase.

For more information on the income test refer to Factsheet IS87 Income Test Overview and for more information on the assets test refer to Factsheet IS88 Asset Test Overview.

Bereavement Period

A Gold Card holder's income/assets may increase when their partner dies, and may result in them exceeding the treatment benefits income and asset limits or becoming ineligible for the service pension. In this case, the person retains the Gold Card during the 98 days bereavement period. Gold Card eligibility is lost at the end of the bereavement period.

More Information

DVA General Enquiries

Phone: 1800 555 254 *

Email: GeneralEnquiries@dva.gov.au

DVA Website: www.dva.gov.au

Factsheet Website: www.dva.gov.au/factsheets

* Calls from mobile phones and pay phones may incur additional charges.

Related Factsheets

Disclaimer

The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA.

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8 January 2019