What are DVA health card arrangements?
The health card arrangements are the main way the Department of Veterans’ Affairs (DVA), on behalf of the Australian Government, provides convenient access to health and other care services for veterans, war widows and eligible dependents. Our arrangements are based on providing access to clinically appropriate and required treatment, which is evidence-based. The Australian Government provides more than $5 billion in funding in health treatment, services and support to veterans and their families every year.
The DVA health card allows card holders a streamlined administrative process, whereby the health card holder only has to present their card when receiving treatment and not worry about seeking reimbursement or obtaining receipts and invoices for payment.
How do the health card arrangements work?
The health card arrangements are based on providing access to clinically appropriate and required treatment, which is evidence-based.
For medical and pharmaceutical services, although DVA arrangements are based on Medicare arrangements, DVA provides access to a broader range of health services than is available to the general population through Medicare. DVA’s scheduled fees (or payments) to doctors and other medial providers for medical services are higher than the Medicare fee.
For subsidised pharmaceuticals, the Repatriation Pharmaceutical Benefits Scheme (RPBS) provides DVA clients with access to a wider range of pharmaceuticals and wound dressings than are available to the general population.
For other services, such as the Rehabilitation Appliances Program (RAP), DVA maintains its own schedules and fee arrangements. The RAP is a veteran-specific service for Gold and White card holders (for accepted conditions) to give access to appliances which might aid recovery, assist in managing illness or injury or enable the client to remain in their own home.
What about health care providers?
Most providers in Australia accept DVA health cards. Providers who accept health cards are registered by the Australian Government and, as a requirement of accepting the cards, agree to accept DVA’s scheduled fee as full payment for the services. No health provider should charge a DVA health card holder a gap fee.
DVA encourages health card holders to ask providers whether they accept the DVA health card prior to making any arrangements for treatment.
What do the health card arrangements cover?
DVA health cards provide access to a broad range of treatments and services, including private or public hospital treatment, theatre fees, intensive care, GP services, referred specialist services, allied health services, dental services, optical services and ambulance cover. Health card holders are also covered for a wide range of rehabilitation devices and appliances, pharmaceutical needs and travel for treatment.
What type of health cards are there?
There are 3 categories of DVA health cards. They include Gold, White and Orange.
Gold card - ‘DVA health card - For all conditions’
A Gold card entitles the holder to DVA funding for services for all clinically necessary health care needs, and all health conditions, whether they are related to war service or not. The card holder may be a veteran or the widow/widower or dependant of a veteran. Only the person named on the card is covered.
White card - ‘DVA health card - For specific conditions’
A White card entitles the holder to care and treatment for:
- accepted injuries or conditions that are war caused or service related;
- malignant cancer, pulmonary tuberculosis, posttraumatic stress disorder, anxiety and/or depression whether war caused or not; and
- the symptoms of unidentifiable conditions that arise within 15 years of service (other than peacetime service).
Services covered by a White card are the same as those for a Gold card but must be for treatment of war caused or service related accepted conditions. The card also entitles the holder to transport related to treatment and access to the Repatriation Pharmaceutical Benefits Scheme (RPBS) for their accepted conditions.
Orange card - ‘DVA health card – For pharmaceuticals only’
The Orange card enables the holder to access the range of items available under the Repatriation Pharmaceutical Benefits Scheme (RPBS). The Orange card is for pharmaceuticals only, and cannot be used for any medical or other health care treatment.
Have there been any changes to DVA health card arrangements?
No. One of the Government’s key priorities is to provide the best possible services in a cost effective and fair way. This involves regular assessments of the services that can be accessed through the health card arrangements, to assess how well the services are being delivered.
This takes into account issues such as changing clinical practice and advances in technology, to ensure that services better meet our clients’ needs.
There has recently been some relatively minor changes to optometry, where clinical evidence supported a change that saw card holders over 65 years old move to annual consultations.
In 2014, a comprehensive review of the RAP schedule was undertaken and a new category of dementia items in this area was included.
In 2013, a comprehensive review was undertaken of the dental services. This led to greater flexibility taking into account technological advances within the dental industry.
It is important to note that through prior approval arrangements, DVA can provide access to services which are not generally covered. This is only in circumstances where the services are clinically appropriate and required, and appropriate evidence is provided, usually by the treating practitioner.
Do DVA health card holders require private health insurance?
If you are a Gold card holder you are covered for all medically required treatment within Australia. DVA funds healthcare services for entitled veterans and war widow/widowers under the Repatriation Medical Benefits Schedule which is based on services available through the Medicare Benefits Schedule.
It should be noted that health card holders remain free to choose whether to use their Gold card or be treated as a private patient utilising private health insurance or as a Medicare patient. You may choose to continue to hold private health insurance for coverage of alternative and complementary therapies such as remedial massage, homeopathy, hypnotherapy and hypnosis.
When travelling overseas, the Department does encourage Gold card holders to consider travel insurance as DVA can only fund medical treatment for accepted disabilities.
White card holders should consider private health insurance for treatment of conditions not accepted through their White card.
It should be noted that health card holders remain free to choose whether to use their Gold card or be treated as a private or Medicare patient as they see fit.
How is DVA working with the Department of Defence to address continuity of care?
DVA and Defence work closely to improve the care and support provided to transitioning ADF members. A Memorandum of Understanding (MoU) between the departments for the Cooperative Delivery of Care and Support to Eligible Persons has been in place since February 2013. Under the MoU, the Support for Wounded Injured or Ill Program, now in its third phase, is focussing on efficient sharing and use of information held by both departments to improve care and support. Numerous improvements in the way information is shared have already been implemented and planning is underway to identify and progress additional initiatives aimed at further improving connectivity.
For separating members of the ADF, DVA honours the rehabilitation determination made by a delegate of the Chief of the Defence Force and will usually continue the rehabilitation program already commenced by the person. Ideally, this also entails continuing with the same rehabilitation service provider, wherever possible.
It is worth noting that it is common for members to relocate considerable distances when transitioning out of the ADF. This presents a challenge because the member needs a new specialist they are comfortable with, and the new doctor may provide a different care plan.
How do DVA’s travel for treatment arrangements work?
DVA operates travel for treatment arrangements. The Department facilitates well over one million car trips and several thousand domestic flights for clients every year. DVA has a strong focus on monitoring the quality and responsiveness of the travel for treatment arrangements and appreciates clients advising us when the system doesn’t quite work for them.
In order to support clients individual needs, DVA has the following arrangements in place:
For VEA clients, transport bookings can be made by call DVA during business hours (Metro callers: 1300 550 455, Regional callers: 1800 550 455) or 24 hours a day, 7 days a week through DVA’s MyAccount. In these circumstances, the health card holder is usually informed of who the transport provider is and can contact them directly if needed. If the provider fails to attend and the health card holder is unaware of the provider, the health card holder can organise their own transport and then claim reimbursement.
MRCA/SRCA clients normally make their own travel for treatment appointments. Travel costs are then claimed by lodging a claim online using MyAccount, or by fax, email or post. In circumstances where a client is unable to manage their travel arrangements for clinical reasons, the Department can provide assistance. Clients can request assistance with travel for treatment by calling the Department during business hours (Metro callers: 133 254, Regional callers: 1800 555 254).
Veterans' Health Cards
DVA issues health cards to eligible veterans and former members of Australia's defence force, their widows/widowers and dependants. There are different eligibility requirements for each type of card.
The Gold Card - ‘Repatriation Health Card - For All Conditions’ gives you access to a wide range of public and private health care services, for the treatment, at the department’s expense, of all your health care conditions whether war or service related or not.
- Factsheet HSV60 - Using the DVA health card - all conditions (gold)
- Factsheet HSV59 - Eligibility for the DVA Health Card All Conditions (Gold) or Totally & Permanently Incapacitated (Gold)
The White Card - ‘Repatriation Health Card - For Specific Conditions’ gives access to a wide range of public and private health care services for the treatment, at the department’s expense, of your disabilities and conditions accepted as war or service related.
Veterans of the Australian Defence Force may also receive treatment for the following conditions whether service related or not:
- cancer (malignant neoplasia)
- pulmonary tuberculosis
- post traumatic stress disorder
- anxiety and/or depression
- symptoms of unidentifiable conditions, until diagnosed, where a claim is lodged within 15 years of eligible service (being other than peacetime service). This is subject to certain additional requirements.
The Orange Card - ‘Repatriation Pharmaceutical Benefits Card’ gives access to subsidised pharmaceuticals and medicines under the Repatriation Pharmaceutical Benefits Scheme (RPBS). The Orange Card is issued to Commonwealth and allied veterans and mariners who meet the eligibility criteria.
This card is for PHARMACEUTICALS ONLY and cannot be used for any medical or other health care treatment.
Commonwealth Seniors Health Card
The Commonwealth Seniors Health Card is available to eligible veterans, partners, war widows and widowers who do not receive an income support pension from DVA or a pension or benefit from Centrelink and who meet an annual adjusted taxable income test.
Lost, stolen or damaged cards
If your Gold, White or Orange card is lost, stolen or damaged you must contact DVA immediately so it can be cancelled and a new card issued.
It may take up to four weeks for a new card to be issued. DVA will provide a letter of authority for this period if you need one, or your health provider may phone DVA for information about your eligibility and entitlements.
Transport to medical appointments
If you hold a Gold or White Card you may be eligible for reimbursement of travel expenses for approved medical treatment. For further information please see the DVA website transport page.
How do I obtain a Health Card?
For more information about receiving a Health Card contact your nearest DVA office.
Repatriation Pharmaceuticals Benefit Scheme
The Repatriation Pharmaceuticals Benefit Scheme (RPBS) provides a wide range of pharmaceuticals and dressings at a concessional rate for the treatment of eligible veterans, war widows/widowers, and their dependants.
Veterans’ Pharmaceutical Reimbursement Scheme
The Veterans’ Pharmaceutical Reimbursement Scheme (VPRS) is an annual reimbursement for eligible veterans for out–of-pocket costs associated with the concessional pharmaceutical co-payment. You will be paid this reimbursement automatically if you are eligible. You do not have to claim for it.
The second annual payment under the Scheme was made in the last week of March 2014 for out-of-pocket costs incurred in 2013. Future payments will be made in March of each year for the previous calendar year.