Military, DVA and Defence health patients – what’s the difference?

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You might find yourself coming across patients that are currently serving military members or have previously been so. 

 They can be insured in very different ways, so it’s helpful to know the difference.  

Currently serving military members

Uniformed Army, Navy and Air Force members are entitled to free health care which is paid entirely by the Department of Defence. They are not entitled to Medicare.  

 Health care services in the military, known as ADF Garrison Health Services, is currently contracted to a special department of BUPA. BUPA are responsible for both primary and specialist health care, including paying anaesthetic fees. 

Military members requiring surgery require approval from BUPA prior. They are issued with a Defence Approval Number (DAN). The DAN, plus the members Eligible Person ID, which is their employee number, are required to make a claim with BUPA. 

 BUPA asks all specialists to register with their program in order to receive referrals for Defence members. However, there is no requirement for anaesthetists to register. BUPA will pay AMA rates for anaesthetic services, but if you register with them, they will pay you significantly less ($59.68 per unit as at 15/8/2023). You can use ASA or MBS item numbers. 

 Claims made to BUPA need to be done manually and require close monitoring for timely payment.  

Department of veteran affairs (DVA)

Patients who have previously served in the Australian Defence Force, known as Veterans, may be eligible for ongoing medical care. This varies depending on the patient’s circumstances. Some patients will have what’s known as a DVA Gold Card, which means all their healthcare is covered by the DVA. Others will have a DVA White Card, which means they are only covered for specific conditions. 

DVA sets the rates for medical care to Veterans and it is illegal to charge them any out of pocket expenses. As a guide, rebates are approximately in line with MediBank Private rebates. You can only claim for MBS item numbers. 

Defence health and navy health

Defence Health and Navy Health are not-for-profit Private Health Insurance funds. Current and former serving military members, and their extended families, are eligible to join these funds. 

Defence Health rebates are in line with AHSA rebates and a $500 gap is permitted without affecting the rebate. 

 You may see the codes AHB, DEF or DHF used for Defence Health patients. NHB is Navy Health’s code. Like all Private Health Funds, only MBS item numbers are eligible for rebates. 

Solo Practice Management is here to maximise your income in the complex field of private anaesthetics. Rely on us to make sure you’re claiming every dollar you can! To enquire about how we can help your private practice, head here. 

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