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Factsheet IS15 - Health Care Eligibility for Service Pensioners

Purpose

This Factsheet explains which service pension recipients under the Veterans’ Entitlements Act 1986 (VEA) are eligible for the Gold Card.

For information on eligibility for the Gold Card other than that related to service pension, refer to Factsheet HSV59.

What is the Gold Card?

The “Gold Card” is the Repatriation Health Card For All Conditions.  Your Gold Card gives you access to a wide range of public and private health care services, for the treatment of all your medical conditions.  This treatment is provided at the expense of the Department of Veterans’ Affairs (DVA).

For information regarding the types of health services, refer to Factsheet HSV60 Using the DVA Health Card – All Conditions (Gold) or DVA Health Card Totally & Permanently Incapacitated (Gold).

Who is eligible?

Service pensioners are eligible for the Gold Card if:

  • they are an Australian veteran or mariner and:
  • are receiving the maximum rate of service pension;
  • are permanently blind in both eyes; or
  • satisfy the treatment benefits income and assets test; or
  • the rate of their disability pension is 50% of the general rate or higher; or
  • they have an impairment from one or more service injuries or diseases that constitutes at least 30 impairment points under the Military Rehabilitation and Compensation Act 2004.

What is the Treatment Benefits Income/Assets Reduction Limit?

You satisfy the treatment benefits income and assets test if  your income/assets do not exceed the limits set out below. If either your income or assets exceed the limits set out below, you will lose eligibility for the Gold Card.  However, ‘period of grace’ provisions may apply to you (refer to the section below).

The rates quoted in this Factsheet are current from 20 September 2019 to 31 December 2019.

The current income and asset limits are:

Income per fortnight
Singles $433.20
Couples (combined) $754.40
Income (transitional) per fortnight
Singles $498.00
Couples (combined) $866.00
For each child (transitional only), increase by: $24.60
Assets - Homeowners Value
Singles $306,500
Couples (combined) $469,000
Assets - Non-homeowners Value
Singles $517,000
Couples (combined) $679,500

What if my income or assets increase above the cut off limits?

If you are paid service pension under the income test and your income goes over the treatment benefits limit you may be able to retain your Gold Card for a period of up to 13 weeks under the ’period of grace’ provisions.

The ‘period of grace’ provisions enable you to retain your Gold Card for 13 weeks subject to the following rules:

  • if as a result of the increase in your income the rate of your service pension is reduced by no more than 150% of the income limit set out above, eligibility for the Gold Card continues for the full 13 weeks and then is lost
  • if within the 13 week period your income reduces again to below the treatment benefits income limit, the period of grace provisions cease to apply and your eligibility for treatment benefits continues
  • if your income rises at any time during the 13 week period and results in a reduction in the rate of your service pension by more than 150% of the income limit set out above, eligibility for treatment benefits ceases immediately.

The ‘period of grace’ provisions do not apply for treatment benefits lost in the following circumstances:

  • where your pension is being paid under the income test and there is an increase in your assets which results in your pension becoming payable under the assets test
  • where you are being paid under the assets test and there is:
    • an increase in assets; or
    • a decrease in assets resulting in the pension becoming payable under the income test.

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.

If at any time you lose eligibility for the Gold Card, you will be notified in writing and your Gold Card will be recalled.

Do I retain my Gold Card during bereavement period?

A Gold Card holder's income/assets may exceed the reduction limit when their partner dies.  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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20 September 2019