Providing Treatment to DVA Clients

Who is eligible to receive treatment

To help you identify our clients, we issue Veteran Cards to our veterans, their widowed partners or dependants.

We will pay many of the healthcare costs for people who have a Veteran Card. We will only cover healthcare costs for the person whose name is on the card.

We issue 3 types of Veteran Cards that entitle the holder to different levels of healthcare treatment:

• Veteran Card – All Conditions – provides clinically necessary treatment for all medical conditions within Australia.
• Veteran Card – Specific Conditions – provides clinically necessary treatment for accepted service-related conditions (plus Non-Liability Health Care)
• Veteran Card – Pharmaceuticals Only – provides access to concessions for prescriptions, wound care products and nutritional supplements.

Checking what type of Veteran Card a client has

There are 2 ways you can establish what type of Veteran Card a DVA client holds:

• They can show you the physical card, or
• DVA clients can access digital versions of their Veteran Card through the myGov wallet in the myGov app, and through the online portal MyService.

The myGov app has some additional security features to confirm the card is genuine and valid. You can find out more in the myGov community resources.

The digital Veteran Cards provide the same information that is currently available on the physical card and can be used in the same way.

Treating a Veteran Card – All Conditions holder

Generally, Veteran Card – All Conditions holders can access all healthcare services listed on the Medicare Benefits Schedule (MBS) or DVA fee schedules for all health conditions, regardless if they are service related or not. The MBS and DVA fee schedule time and service limits still apply to Veteran Card – All Conditions holders.

A person who has a Veteran Card – All Conditions:

• can access the Repatriation Pharmaceutical Benefits Scheme; and
• can access transport assistance.

Visit the Travel for Treatment web page for further information.

Treating a Veteran Card – Specific Conditions holder

A Veteran Card – Specific Conditions holder may be a current or former member of the Australian Defence Force (ADF) or Allied Veteran living in Australia.

For Veteran  Card – Specific Conditions holders, DVA will pay the healthcare costs for the specified health conditions listed on their card, these are conditions that have been determined to be service-related.

Veterans with continuous full-time service in the ADF or certain types of reserve service can also access mental health treatment under Non-Liability Health Care (NLHC) arrangements. In addition, some veterans may be eligible for treatment of cancer (malignant neoplasm) and pulmonary tuberculosis, depending on their service type and timing under NLHC arrangements. These will be listed on their card as Non-Liability Healthcare all mental health or malignancy. When treating a Veteran Card – Specific Conditions holder you are required, under the applicable DVA Notes for Providers and DVA fee schedules, to check the treatment is for a condition listed on their card.

To check a person’s accepted condition/s or NLHC you can:

• have the client present their Veteran Card – Specific Conditions in MyService, with the Conditions Listed opened to display the conditions covered; or
• have the client present written confirmation from DVA of their accepted conditions or acceptance of conditions eligible for treatment.

Some Veteran Card – Specific Conditions holders may access transport assistance when travelling for treatment for a condition that is listed on their card.

Visit the Travel for Treatment web page for further information.

What type of treatment can I provide

Veteran Card – All Conditions and Veteran Card – Specific Conditions generally cover:

• medical and surgical care
• medical consultations and procedures that the MBS covers
• medical services and surgical procedures the MBS lists and which a healthcare professional performs in public and private hospitals and day surgery facilities
• medical specialist services the MBS lists
• medication reviews
• allied health services
• optical services
• dental services
• community nursing
• veterans home care
• rehabilitation aids and appliances
• pathology and x-rays
• nuclear medicine imaging
• ultrasound and computerised tomography

Sometimes we may not fund medical services that the MBS or DVA fee schedules do not list or where the service is outside the limits provided in the MBS or DVA fee schedules’ descriptors. You will need us to approve these services before you provide them.

Treating a Veteran Card – Pharmaceuticals Only holder

A Veteran Card – Pharmaceuticals Only holder may be a Commonwealth or allied veteran who:

• has qualifying service from the First World War or Second World War
• is aged 70 years or over
• has been a resident in Australia for 10 years or more

A Veteran Card – Pharmaceuticals Only holder will pay less for medicines under the Repatriation Pharmaceuticals Benefits Scheme (RPBS).

The RPBS contains:

• all items that the general public can access
• extra items that Veteran Card – Pharmaceuticals Only holders can access

Tools to assist with assessing eligibility for DVA-funded health care

The following tools can assist you to assess a DVA client’s eligibility for DVA-funded health care:

• Assessing Eligibility for DVA-funded Health Care – Quick Guide — a document which is designed to be printed out or saved as a quick reference guide
• Assessing Eligibility for DVA-funded Health Care – Flowchart — a simple single page flowchart
• Assessing Eligibility for DVA-Funded Health Care – Case Examples — a document which provides some practical examples of common health care treatments which DVA is able and unable to fund.
• Assessing Eligibility for DVA-funded Health Care – Online Guide — an interactive tool which guides a health care provider through a set of questions relating to eligibility for DVA-funded treatment.

NOTE: These tools are for guidance use only and using them does not provide a formal decision by DVA.

If you still require assistance

If you still require assistance or support, please contact DVA on 1800 550 457 (option 3, option 1).

Help DVA clients connect with heath care services through healthdirect

You can now indicate that you accept DVA Veteran Cards through the National Health Services Directory (NHSD), which powers healthdirect’s Service Finder, an online tool for Australians to find health services.

If your service is already listed, you can update your details by searching for your practice on Service Finder, select ‘Suggest an edit’, and submit your changes via the online form.

If your service is not yet listed, you are encouraged to register. This helps veterans and families of veterans find appropriate care more easily.

Indicating you accept Veteran Cards does not create any new obligations. It simply reflects your current practice and improves visibility for the veteran community.

How you can claim for your service

Before we can pay you for providing healthcare, you will first need to become a provider with us.

There are steps you can take to invoice us.

Use a health card image

If you want to use a health card image in advertising, complete a D9208 application form.

Email the form with a mock-up image of the publication the health card will be in to publications@dva.gov.au