Health insurance for Defence Connections Experience family value

Transcription

1 Health insurance for Defence Connections Experience family value Issued September 2014

2 Contents Introduction 1 Who s eligible to join 2 Why you re better off with private 3 health insurance Types of cover 6 Finding the right type of cover 7 Hospital cover 10 Extras cover 16 Get the lowdown 24 Making the most of the Australian 28 Government s initiatives Important information 30 More ways we treat you like family 31 How to join the family 32 Information in this brochure is current as at 1 September It replaces all earlier versions. Please read it carefully and retain with any other Defence Health documentation.

3 Call us on We re always here to help because that s what family is for. At Defence Health, we put our members before profit. Because our members are more than just a name or number to us. They re just like family. In these pages you ll discover why over 200,000 Australians, all with connections to Defence, have joined our family. And if you decide to join us, you ll discover why they stay. Like any good family, we support each other through good times and bad, and always take the time to listen. To us, family is the most important thing. That s why we are not for profit and all for the benefit of our members. That s why we ll defend your right to the very best cover and protection. If you want great value health insurance from an insurer that cares about your wellbeing and always provides excellent service, you re in the right place. Read on and if you have any questions we re just a phone call away. Because that s what families are for. Defence Connections 1

4 Who s eligible to join Defence connections Past Service All those who have previously served in the ADF (full-time or part-time) and their partners and children ADF supporters Anyone who works or has worked in the Dept of Defence and other Defence-related departments Anyone who works or has worked for a Defence supplier a company or agency contracted to the Department of Defence, where you are or were involved in the supply of goods and services to Defence. Extended families of all above Your mum and dad, sister and brother, grandkids and even your ex-spouse/partner ADF families Full-time ADF and active Reservists, plus their partners and children can all join Defence Health. If you re a member of the permanent ADF you don t need to cover yourself but you can cover your partner and/or child(ren). We ve got a different brochure for ADF families. Visit our website to download it or call us on and we ll send you a copy. 2

5 Visit defencehealth.com.au Why you re better off with private health insurance Manage your health costs Manage the costs of hospital admissions and medical treatment and enjoy money back on extras. Control your care Choose your doctor, specialist and the hospital you re treated in. Skip the queues Avoid public hospital waiting lists and get the treatment you need sooner. Maximise Government incentives Access the Australian Government Rebate on private health insurance which can reduce the premium you pay. Avoid the Lifetime Health Cover loading Take out hospital cover by July 1 after turning 31 and you can avoid paying a Lifetime Health Cover loading. Reduce your taxes Higher income earners can avoid paying the Medicare Levy Surcharge by taking out hospital cover. Money back on extras Get money back when you visit dentists, physios, optometrists and others. Defence Connections 3

6 Why you re better off with Defence Health 4

7 Call us on Special features for our whole family Low management costs Because we have low management expenses, we can keep your premiums lower and return more in benefits. Not-for-profit To us, family is the most important thing. That s why we re not for profit and all for the benefit of our members. Comprehensive ambulance cover Every policy includes 100% cover for treatments provided by state-appointed ambulance services across Australia. And there s no limit on the number of times you can use the service when needed. One of the largest hospital networks We have agreements with over 500 hospitals around the country. This significantly reduces your out-of-pocket expenses. So no matter where you are, your closest private hospital will almost certainly be contracted to us. Great optical benefits Members with extras cover can get no-gap glasses from our optical partners, Specsavers and VSP Vision Care. Our extensive optical network reaches far and wide with over 600 providers around the country. No waiting when you switch If you switch from another insurer with an equivalent level of cover, we recognise any waiting periods you ve already served. So you can make claims right away. Simple claiming You can claim your extras on the spot, online, or on your mobile with our free app. Over 60 years of service We were created to support the families of those who defend our country. After 60 years, as Defence has grown, our family has also grown. And now we embrace everyone with a Defence connection. Supporting the Defence community We support the Defence community through sponsorships of Defence community groups and organisations like Defence Families of Australia and Defence Special Needs Support Group. Funding for medical research We established the Defence Health Foundation in 2010 to fund medical research aimed at helping ADF serving and ex-serving personnel and their families. Just another way we support the Defence community. Special features for full time ADF and active Reservists Exclusive ADF packages with national pricing These packages offer targeted benefits specially for ADF families. Special prices on mix and match range All ADF and active Reservists get special pricing for our mix and match hospital and extras covers, just in case the ADF packages don t meet your needs. Suspension of health cover ADF personnel can suspend their cover for up to 24 months when they are sent overseas on an accompanied posting. Active Reservists on continuous full-time service (CFTS) for more than 28 days can also suspend their cover for the full duration of the service. Transition discount for discharging ADF Discharging full-time ADF personnel, who aren t becoming active Reservists, receive a 10% discount on mix and match hospital or hospital and extras in their first year, as long as it s paid for by direct debit. No waiting periods for discharging ADF All waiting periods are waived for those who join within two months of discharging from the full-time ADF. Excellent service We never forget we re dealing with your health and wellbeing. We listen to you, and offer the protection you want. Our members are more than a name or a number: they re just like family. Defence Connections 5

8 Types of cover We offer a range of hospital covers and extras covers that can be mixed and matched to meet your needs. Mix and match Hospital cover Hospital cover helps lower or remove your costs when you re a private patient in hospital. We have three levels of hospital cover, Premier, Value and Essentials. The level you choose determines the number and types of procedures and services you re covered for. The higher your level of cover, the more you ll be covered for. Extras cover Extras cover helps lower or remove your costs when you visit health and wellbeing providers whose fees aren t covered by Medicare. They include dentists, chiropractors, physiotherapists, a range of alternative therapists and much more. We have three levels of extras cover Premier, Value and Essentials. The higher your level of cover, the more services you ll be covered for and the lower your out-of-pocket expenses will be. 6

9 Visit defencehealth.com.au Finding the right cover for you See if you can identify yourself in our guide below. Or you can read about all our covers in the pages ahead. Where you re at Young, fit and healthy singles and couples No kids, none planned any time soon Need and wants I just need basic cover I don t want to pay for services I don t need I want low cost cover I want to avoid government penalties I want well priced cover with more than the basics I want good benefits Recommended product Essentials Hospital (Pg 14) + Essentials Extras (Pg 22) Value Hospital (Pg 13) + Value Extras (Pg 20) Planning a family We want cover for pregnancy and assisted reproductive services We need cover that can protect a growing family Premier Hospital (Pg 12) + Value Extras (Pg 20) Young family on a tight budget We don t want to spend too much The health and wellbeing of our family is important but we re willing to have a few exclusions on unlikely treatments to keep premiums affordable Value Hospital (Pg 13) + Value Extras (Pg 20) Established family We need cover for a wide range of services We are looking for value for money Premier Hospital (Pg 12) + Value Extras (Pg 20) My health and the health of my family is not worth risking I want the best cover for total peace of mind Being in control of my health is vital to me My family s wellbeing is my priority Premier Hospital (Pg 12) + Premier Extras (Pg 18) Older and wiser I want to be well covered just in case We want to get the treatment we need as soon as we need it Premier Hospital (Pg 12) + Premier Extras (Pg 18) Get a quote Go to defencehealth.com.au or call us on Defence Connections 7

10 Favourite features about our health insurance Excess options that lower your premium We ll reduce your premium if you choose to pay an excess when you go to hospital. The higher your excess, the lower your premium. Reduce your out-of-pocket expenses Agreement private hospitals Be treated in one of our agreement private hospitals to significantly reduce your out-of-pocket expenses. We have agreements with over 500 hospitals around the country that ensure the majority of hospital charges are covered when you re admitted either for day procedures or overnight. For a full list of agreement hospitals, visit defencehealth.com.au. Access Gap If your Doctor agrees to participate in our Access Gap scheme you can reduce or eliminate your medical out of pocket expenses. You can find doctors who participate at defencehealth.com.au. This scheme works on the basis that Defence Health will pay your doctor more on the condition they agree to charge you a no gap or capped gap fee. No-gap fees on diagnostic services We ve negotiated no-gap agreements with a number of diagnostic service providers such as radiologists and pathologists. If you receive their services in hospital, there s no cost to you. They send their bill directly to us and we take care of it for you. Family favourites No excess for children If you have a policy that covers your family, you ll never have to pay the hospital excess for your children. Cover for older kids We ll cover kids on your policy until they re 21. And if they re single and studying fulltime, we ll cover them until they re 25. Young Adult Support Plan If your older kids are single and not studying fulltime, they can remain on your family hospital policy until they re 25 if they take out their own Value Extras cover. Health programs Members with Value Hospital or Premier Hospital have access to a number of programs and services that help you look after your health and wellbeing. Hospital substitute treatments If your doctor agrees, you could avoid the hassle and inconvenience of going to hospital for certain treatments. Depending on where you live, we can arrange for health care providers to deliver services such as wound management, intravenous therapy, and ambulatory sleep studies. Home nursing Where your doctor is able to substitute hospital admission with home nursing, we ll pay for a registered nurse to care for you in your home. Midwifery We ll pay for a registered midwife in private practice to attend the delivery of your baby. Midwifery benefits are not payable if a doctor is required to intervene in the delivery. Benefits will be payable for the doctor s in-hospital treatment instead. Chronic care Our chronic disease management programs provide telephone-based support for members who have had an eligible hospital admission relating to heart disease or type 2 diabetes. Our program coordinators work with treating practitioners to support existing treatment and aid recovery. No waiting periods for newborns We know there is a lot to think about when you re having a baby and sometimes, in all the excitement, it is easy to forget your health insurance. So as long as you contact us before your baby is 2 months old, we ll add them to your cover with no waiting periods. We even allow backdating of the policy to the day of your baby s birth so treatments within those first two months are covered. 8

11 Call us on Defence Connections 9

12 Mix and match hospital cover Choose from three levels of hospital cover that can help take the pain out of hospital visits: Premier Hospital, Value Hospital and Essentials Hospital. We ve designed each level of cover to provide protection to meet different needs. And they can be added to your choice of three extras covers for more complete protection. Finding the right hospital cover Premier Hospital If your family s wellbeing is your priority and you want total peace of mind then Premier Hospital is for you. Premier Hospital provides comprehensive cover in all agreement hospitals throughout Australia. That means treatment where and when you need it. Premier Hospital has no exclusions on any Medicareapproved treatment which means no costly surprises. You also get 100% ambulance cover for treatment provided by a state-appointed ambulance service across Australia, including emergency services, non-emergency dispatch, mobile intensive care and air and sea ambulance services. Value Hospital If you are happy to exclude some procedures that you might not need Value Hospital is for you. Value Hospital is priced for families who know the importance of health and wellbeing but are trying to keep things a little more affordable. Value Hospital provides comprehensive cover for most treatments but you don t have to pay for things you are less likely to need. Included in Value Hospital cover is ambulance treatment 100% cover for treatment provided by a state-appointed ambulance service across Australia, including emergency services, non-emergency dispatch, mobile intensive care and air and sea ambulance services. Essentials Hospital If you re only interested in covering things a young and healthy person might need, and want to avoid Government penalties for not having hospital cover, then Essentials Hospital could be for you. Essentials Hospital cover is low-cost because it only covers you for a limited number of services most commonly used by young and healthy people. And you can cancel your ambulance membership as Essentials Hospital also covers 100% of treatment provided by a state-appointed ambulance service across Australia, including emergency services, non-emergency dispatch, mobile intensive care and air and sea ambulance services. Get a quote Go to defencehealth.com.au or call us on

13 Call us on Compare our hospital cover Which services are covered? Premier Hospital Value Hospital Essentials Hospital Accidental injury Removal of tonsils Removal of adenoids Removal of appendix Surgical extraction of teeth Hernia repairs Joint investigations and minor repairs Joint reconstructions Colonoscopy Gastroscopy Rehabilitation Palliative care Psychiatric treatment Cancer treatment Stroke treatment Brain surgery Pregnancy and pregnancy related services Heart related procedures Assisted reproductive services and infertility treatments Cataracts, Glaucoma and laser eye surgery Dialysis for renal failure Obesity related treatment (eg. gastric banding) Joint replacements All other services recognised by Medicare Treatment not recognised by Medicare incl. most cosmetic surgery Chronic care programs Hospital substitute programs Midwifery (confinement and delivery) $1,500 $750 Home nursing Maximum Per day $1,800 $90 $750 $70 Included Excluded Restricted You will be covered as a private patient in a public hospital shared room. If you are treated anywhere else you will be significantly out-of-pocket. Defence Connections 11

14 Premier Hospital Premier hospital is designed to give you peace of mind and no worries. Comprehensive hospital cover gives you our best protection. It covers everything Medicare does, including pregnancy and assisted reproductive services. So if you and your family s wellbeing is a priority then Premier Hospital is for you. Favourite features Comprehensive ambulance cover Comprehensive hospital cover No excess for kids Your kids stay covered to age 21. And if they re single and studying fulltime to age 25 No exclusions on any Medicare-approved treatment Get hospital treatment in your home for treatments such as wound management, and intravenous therapy Comprehensive ambulance cover 100% cover for treatment by state-appointed ambulance services across Australia. This includes emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance transport. And there s no limit or cap on your cover. Your hospital cover Excess options You can reduce your premium by electing to pay an excess if you go to hospital. Your excess options are $0, $200 or $400 per adult. The excess applies once per adult per financial year on all same day and overnight admissions. Your hospital cover gives you Choice of doctor and hospital No exclusions on any Medicare-approved treatment 100% of agreement hospital charges (subject to your excess), including: Shared or private room Theatre fees, including labour ward Intensive care, critical care and high dependency unit Most drugs supplied in hospital 100% of public hospital charges (subject to your excess) Up to 100% of doctors fees if your doctor chooses to use Access Gap Up to 100% for prostheses on the Australian Government Prostheses List Health programs which include up to $1500 for midwife delivery services, and up to $90 per day for home nursing ($1800 max) Treatment in a non-agreement private hospital will incur significant out-of-pocket expenses. What s covered Joint reconstructions and replacements Colonoscopies and arthroscopies Heart and artery related services Pregnancy related services Assisted reproductive services (e.g. IVF and GIFT) Joint replacements Psychiatric and rehabilitation services And all other Medicare-approved treatments What s restricted No hospital services are restricted What s excluded Services where Medicare pays no benefit (e.g. most cosmetic surgery) When you join Defence Health or upgrade your existing cover, you may have a waiting period before you can claim benefits. Most waiting periods are 2 months but some, such as pre-existing conditions, are 12 months or more. To see all waiting periods and get more information about making the most of your hospital and medical cover and what your hospital cover will not pay for go to Pg 24. Get a quote Go to defencehealth.com.au or call us on

15 Visit defencehealth.com.au Value Hospital Value Hospital is designed for families who know the importance of health and wellbeing but are trying to keep things a little more affordable. If you are happy to exclude some procedures you might not need then Value Hospital is for you. Favourite features Comprehensive ambulance cover Hospital cover for a broad range of services with some exclusions No excess for kids Your kids stay covered to age 21. And if they re single and studying fulltime to age 25 Excludes selected hospital services to help keep the cost down Get hospital treatment in your home for treatments such as wound management, and intravenous therapy Comprehensive ambulance cover 100% cover for treatment by state-appointed ambulance services across Australia. This includes emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance transport. And there s no limit or cap on your cover. Your hospital cover Excess choices You can choose from a $200 or a $400 excess per adult on your premium if you go to hospital. The excess applies once per adult per financial year on all same day and overnight admissions. Your hospital cover gives you For the services listed under What s covered you get: Choice of doctor and hospital 100% of agreement hospital charges (subject to your excess), including: Shared or private room Theatre fees, including labour ward Intensive care, critical care and high dependency unit Most drugs supplied in hospital 100% of public hospital charges (subject to your excess) Up to 100% of doctors fees if your doctor chooses to use Access Gap Up to 100% for prostheses on the Australian Government Prostheses List for services covered Health programs which include up to $750 for midwife delivery services, and up to $70 per day for home nursing ($750 max) Treatment in a non-agreement private hospital will incur significant out-of-pocket expenses What s covered Joint investigations (arthroscopies), minor joint repairs and reconstructions Colonoscopies Gastroscopies Heart and artery related services Pregnancy related services Cancer treatments And all other Medicare-approved treatments that are not listed below What s restricted Psychiatric services You will be covered as a private patient in a public hospital shared room. If you are treated anywhere else you will be significantly out-of-pocket. What s excluded Assisted reproductive services (e.g. IVF and GIFT) Renal dialysis Obesity related treatment (eg. gastric banding) Joint replacements and revisions Cataracts, glaucoma and laser eye surgery Services where Medicare pays no benefit (e.g. most cosmetic surgery) When you join Defence Health or upgrade your existing cover, you may have a waiting period before you can claim benefits. Most waiting periods are 2 months but some, such as pre-existing conditions, are 12 months or more. To see all waiting periods and get more information about making the most of your hospital and medical cover and what your hospital cover will not pay for go to Pg 24. Defence Connections 13

16 Essentials Hospital Essentials Hospital is basic hospital cover for young, healthy singles and couples. It covers a limited range of hospital treatments and helps you avoid Government penalties. Favourite features Comprehensive ambulance cover Cover for a limited range of hospital services that a young and healthy person is most likely to need Choice of doctor and hospital for treatment of the ten procedures covered. Exempts you from Government penalties such as the Medicare Levy Surcharge and Lifetime Health Cover loadings Great choice for your first health cover or if you re not planning on kids any time soon Comprehensive ambulance cover 100% cover for treatment by state-appointed ambulance services across Australia. This includes emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance transport. And there s no limit or cap on your cover. Your hospital cover $200 excess per person The excess applies once per adult per financial year on all same day and overnight procedures. Your hospital cover gives you For the limited range of services listed under What s covered you get: Choice of doctor and hospital 100% of agreement hospital charges (subject to your excess), including: Shared or private room Theatre fees Intensive care, critical care and high dependency unit Most drugs supplied in hospital 100% of public hospital charges (subject to your excess) Up to 100% of doctors fees if your doctor chooses to use Access Gap Up to 100% for prostheses on the Australian Government Prostheses List for services covered Hospital in the Home program for services like wound management and intravenous therapy, through selected hospitals Treatment in a non-agreement private hospital will incur significant out-of-pocket expenses. What s covered Accidental injuries Removal of tonsils Removal of adenoids Removal of appendix Surgical tooth extraction Hernia repairs Joint investigations (arthroscopies) and, minor joint repairs Joint reconstructions Colonoscopies Gastroscopies What s restricted Psychiatric services Rehabilitation services Palliative care You will be covered as a private patient in a public hospital shared room. If you are treated anywhere else you will be significantly out-of-pocket. What s excluded All other hospital treatments When you join Defence Health or upgrade your existing cover, you may have a waiting period before you can claim benefits. Most waiting periods are 2 months but some, such as pre-existing conditions, are 12 months or more. To see all waiting periods and get more information about making the most of your hospital and medical cover and what your hospital cover will not pay for go to Pg

17 Visit defencehealth.com.au Defence Connections 15

18 Mix and match extras cover Three levels of extras cover to make looking after your health and wellbeing more affordable: Premier Extras, Value Extras and Essentials Extras. Each can lower or even remove your costs when you visit health and wellbeing providers like the dentist, chiropractor, physiotherapist and a range of alternative therapists. You re free to choose who treats you, and if you visit one of our many optical partners, you ll receive even greater benefits. And they can be added to your choice of three hospital covers for more complete protection. Plus, all our extras include 100% cover for state-appointed ambulance services. Premier Extras Our Premier Extras cover gives you comprehensive cover on a wide range of services with our highest individual annual limits. If you have frequent or planned treatment, especially for complex dental services, then Premier Extras will give you the most money back. Plus there s no annual limit on general dental and no lifetime limit on orthodontic treatment. Premier Extras gives you 100% back on all initial consultations. You also get 100% back on glasses (up to $300 per person) at our optical partners or it covers laser eye surgery to help you become glasses free. Essentials Extras Don t want to pay for services you don t need? If you re only looking for basic cover at a low cost price, then Essentials Extras is for you. Essentials Extras is ideal for young and healthy people who just want cover for the basics including general dental, preventative dental, surgical extractions, physiotherapy, chiropractic/osteopathic, alternative therapies and travel vaccinations. And you ll get 100% back on glasses (up to $170 per person) at our optical partners. To help you decide which cover is best for you, take a closer look at what each level offers. Remember, the higher your level of cover, the more services you ll be covered for and the greater your benefits can be. Get a quote Go to defencehealth.com.au or call us on Value Extras If you want to be covered for a wide range of services at a more affordable price, then Value Extras is for you. Value Extras is great value for money and perfect for those that want cover for more than just the basics. You ll get 100% back on glasses (up to $255 per person) at our optical partners. There s no annual limit on general dental and no lifetime limit on orthodontic treatment. Our Optical Network We ve joined forces with Specsavers and VSP Vision Care to deliver better optical cover for our members. Our optical network is available to all our members with extras cover and provides better optical benefits and an extensive range of no-gap glasses. VSP Vision Care is a network of 500 independent optometrists. VSP Vision Care providers are conveniently located close to where you live or work. Specsavers is already a household name with more than 280 optical stores around Australia. You can still get benefits back at any optical store you choose. But if you do use the optical network you will receive better value optical benefits, coupled with a wide selection of stylish, fashionable frames. Visit specsavers.com.au or vsp-australia.com.au to find your nearest optical network provider. 16

19 Visit defencehealth.com.au Compare our extras cover Service Premier Extras Value Extras Essentials Extras per person limit per person limit per person limit Ambulance treatment Unlimited Unlimited Unlimited Preventative dental Unlimited Unlimited General dental Unlimited Unlimited Major dental $1100 $850 $500 Preventative dental, general dental and surgical extractions only Orthodontics $1000 $800 Optical $300 $255 $170 Physiotherapy (including hydrotherapy) $800 $550 Chiropractic/Osteopathy $550 $450 $350 Antenatal and postnatal services $500 $200 Pharmacy and vaccinations $600 $500 Travel vaccinations $100 Alternative therapies Exercise physiology $400 $300 $200 Psychology $500 $400 Podiatry/chiropody $400 $300 Occupational therapy $600 $500 Speech therapy $600 $500 Eye therapy $600 $500 Dietician $350 $250 Audiology $350 $200 Medically prescribed devices, aids and supports $1500 $1000 School accidents $800 $600 Laser refractive eye surgery (claimable once every 2 years) $1500 Not covered Defence Connections 17

20 Premier extras cover Premier Extras provides comprehensive cover for a wide range of services with our highest individual annual limits. Favourite features No annual limit on general dental treatment, up to $1000 back on orthodontics and no lifetime limit, and up to $1100 back on major dental per person 100% up to $300 per person at our optical partners 100% back on initial consultations Generous benefits for a wide range of alternative therapies Cover for laser refractive eye surgery with up to $1500 back per person every 2 financial years Up to $1500 back per person per year on health appliances such as hearing aids, blood glucose monitors and CPAP machines 100% cover for state-appointed ambulance services Dental Some dental items are limited in the number of times they can be claimed in a year. Some items are not payable in combination with others. And some may not attract a benefit at all. General dental Annual limit Unlimited Periodic oral exam (012) Up to $48 Removal of calculus (114) Up to $85 Bitewing x-ray (022) Up to $35 Adhesive filling to one surface Up to $100 of a rear tooth (531) Mouthguard (151) Up to $105 Major dental Annual limit $1100 per person Surgical tooth removal (323) Up to $200 Root canal obturation (417) Up to $150 Veneer indirect (583) Up to $650 Full crown veneer indirect (615) Up to $1000 Endosseous implant (688) Up to $1100 Course of non-surgical periodontal Up to $600 treatment (281) Orthodontics Complete course of orthodontic treatment (881) Annual limit $1000 per person Up to $1000 Unlike other funds there is no lifetime limit. You get $1000 every financial year until your treatment is complete. Passive removable appliance (811) Up to $175 Ambulance Treatment Annual limit Unlimited 100% cover for treatment provided by a state-appointed ambulance service in Australia including emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance services. Optical Annual limit $300 per person Optical network partners 100% Our optical network providers have extensive ranges of no-gap glasses. Visit specsavers.com.au or vsp-australia.com.au for locations. Specsavers VSP Vision Care Single vision glasses 2 pairs no-gap 1 pair no-gap Bi/Multifocal glasses 1 pair no-gap 1 pair no-gap Frames Discounted Discounted Contacts (in store) 10% off 15% off Non-preferred providers Single vision lenses Up to $100 Ground single vision lenses Up to $105 Bifocal lenses Up to $115 Multifocal lenses Up to $175 Frames Up to $125 Contact lenses Up to $200 A sight-correcting script must accompany the claim. Physiotherapy (including hydrotherapy) Annual limit $800 per person Initial consultation 100% Subsequent consultation Up to $50 Group therapy sessions and classes Up to $20 Chiropractic/Osteopathy Annual limit $550 per person up to $1100 per policy Initial consultation 100% Subsequent consultation Up to $42 Chiropractic xrays (max 2) Up to $60 Alternative therapies & exercise physiology Annual limit $400 per person up to $800 per policy Per consultation Up to $38 Where the provider is recognised by the Australian Regional Health Group the following alternative therapies are payable: acupuncture, homeopathy, aromatherapy, myotherapy, naturopathy, remedial massage, remedial therapy, Chinese herbal medicine and western herbal medicine. No benefit payable for any prescribed medications, herbal or dietary preparations. Antenatal & postnatal services Annual limit $500 per person Antenatal course Up to $500 Antenatal consultations/classes Up to $50 Postnatal consultations/classes Up to $50 By a midwife or physiotherapist in private practice only. Treatment that has been claimed through Medicare cannot be covered.

21 Call us on Psychology Annual limit $500 per person Initial consultation 100% Subsequent consultation Up to $100 Group therapy Up to $40 Couple/family therapy Up to $60 Treatment claimed through Medicare cannot be covered. Speech therapy Annual limit $600 per person Initial consultation 100% Subsequent consultation Up to $55 Group therapy Up to $30 Occupational therapy Annual limit $600 per person Initial consultation 100% Subsequent consultation Up to $55 Group therapy Up to $30 Podiatry/chiropody Annual limit $400 per person Initial consultation 100% Subsequent consultation Up to $42 Audiology Annual limit $350 per person Initial consultation 100% Subsequent consultation Up to $60 Eye therapy Annual limit $600 per person Initial consultation 100% Subsequent consultation Up to $45 Laser refractive eye surgery Annual limit $1500 per person every 2 years Up to $1500 per person is payable for LASIK or PRK eye surgery in a recognised day surgery centre. Dietitian Annual limit $350 per person Initial consultation 100% Subsequent consultation Up to $40 Pharmacy and vaccinations Medically prescribed devices & supports 36 Annual limit $600 per person Per prescription or vaccination Up to $120 The benefit is payable on non-pbs pharmaceuticals and is the prescription amount less the current PBS amount. School accidents No waiting period Annual limit $800 per person Up to $800 per person for health care gap costs resulting from a school accident to your child excluding Medicare services. Annual limit $1500 per person 36 month waiting period per person Hearing aids* Up to $ month waiting period per person CPAP machine* for sleep apnoea Up to $1250 Blood glucose monitor* Up to $500 Foot orthotics Up to $300 custom-made or fitted by a podiatrist, chiropodist or orthotist Orthopaedic shoes Up to $300 custom-made or fitted by specialist shoemaker Splints and braces Up to $300 splints, knee/leg/spinal/lumbar/sacral/wrist/ ankle braces and surgical corsets only Mobility aids* Up to $1000 wheelchairs, crutches, walking frames, walking sticks, rolling walkers, seat riser cushions, reaches and adjustable canes only Non-cosmetic prostheses Up to $1250 Wig following a medical condition Up to $300 External breast prostheses for following Up to $300 a mastectomy Artificial eye* Up to $1250 per policy Blood pressure monitor* Up to $300 TENS machine* Up to $300 Nebuliser and spacer for breathing Up to $300 conditions Compression garments for purpose-made garments that aid burn management, post-surgical recovery, lymphoedema treatment and deep vein thrombosis prevention per item Up to $300 2 month waiting period per person Non-sight correcting Irlen lenses Up to $100 EpiPen Up to $150 Hearing aids and foot orthoses repair Up to $100 Rental of appliances Up to $200 including oxygen cylinders, soft collars, toilet seat risers, shower chairs, Continuous Passive Movement machines or any other appliance listed above * Replacement or additional items are not claimable within 3 years of previous purchase Defence Connections 19

22 Value extras cover Value Extras covers a wide range of extras with great annual limits at a value for money price. Favourite features No annual limit on general dental treatment, up to $800 back on orthodontics with no lifetime limit, and up to $850 back on major dental per person 100% up to $255 per person at our optical partners Cover for physiotherapy, chiropractic, osteopathy, psychology, speech/eye/occupational therapy, dietetics, audiology and podiatry Generous benefits for a wide range of alternative therapies Up to $1000 back per person per year on health appliances such as blood glucose monitors, foot orthotics, EpiPens and nebulisers 100% cover for state-appointed ambulance services Dental Some dental items are limited in the number of times they can be claimed in a year. Some items are not payable in combination with others. And some may not attract a benefit at all. General dental Annual limit Unlimited Periodic oral exam (012) Up to $39 Removal of calculus (114) Up to $68 Bitewing x-ray (022) Up to $28 Adhesive filling to one surface Up to $80 of a rear tooth (531) Mouthguard (151) Up to $84 Major dental Annual limit $850 per person Surgical tooth removal (323) Up to $150 Root canal obturation (417) Up to $113 Veneer indirect (583) Up to $488 Full crown veneer indirect (615) Up to $750 Endosseous implant (688) Up to $850 Orthodontics Complete course of orthodontic treatment (881) Annual limit $800 per person Up to $800 Unlike other funds there is no lifetime limit. You get $800 every financial year until your treatment is complete. Passive removable appliance (811) Up to $140 Optical Annual limit $255 per person Optical network partners 100% Our optical network providers have extensive ranges of no-gap glasses. Visit specsavers.com.au or vsp-australia.com.au for locations. Specsavers VSP Vision Care Single vision glasses 2 pairs no-gap 1 pair no-gap Bi/Multifocal glasses 1 pair no-gap 1 pair no-gap Frames Discounted Discounted Contacts (in store) 10% off 15% off Non-preferred providers Single vision lenses Up to $90 Ground single vision lenses Up to $95 Bifocal lenses Up to $105 Multifocal lenses Up to $155 Frames Up to $95 Contact lenses Up to $180 A sight-correcting script must accompany the claim. Physiotherapy (including hydrotherapy) Annual limit $550 per person Initial consultation Up to $48 Subsequent consultation Up to $40 Group therapy sessions and classes Up to $15 Chiropractic/Osteopathy Annual limit $450 per person up to $900 per policy Initial consultation Up to $43 Subsequent consultation Up to $33 Chiropractic xrays (max 2) Up to $40 Alternative therapies & exercise physiology Annual limit $300 per person up to $600 per policy Per consultation Up to $30 Where the provider is recognised by the Australian Regional Health Group the following alternative therapies are payable: acupuncture, homeopathy, aromatherapy, myotherapy, naturopathy, remedial massage, remedial therapy, Chinese herbal medicine and western herbal medicine. No benefit payable for any prescribed medications, herbal or dietary preparations. Antenatal & postnatal services Ambulance Treatment Annual limit $200 per person Annual limit Unlimited 100% cover for treatment provided by a state-appointed ambulance service in Australia including emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance services. Antenatal course Up to $200 Antenatal consultations/classes Up to $20 Postnatal consultations/classes Up to $20 By a midwife or physiotherapist in private practice only. Treatment that has been claimed through Medicare cannot be covered.

23 Visit defencehealth.com.au Psychology School accidents Annual limit $400 per person No waiting period Annual limit $600 per person Initial consultation Up to $75 Subsequent consultation Up to $65 Group therapy Up to $20 Couple/family therapy Up to $25 Treatment claimed through Medicare cannot be covered. Up to $600 per person for health care gap costs resulting from a school accident to your child excluding Medicare services. Medically prescribed devices & supports Speech therapy Annual limit $500 per person 36 Annual limit $1000 per person 36 month waiting period per person Hearing aids* Up to $1000 Initial consultation Up to $70 Subsequent consultation Up to $40 Group therapy Up to $20 Occupational therapy Pharmacy and vaccinations Annual limit $500 per person Initial consultation Up to $65 Subsequent consultation Up to $35 Group therapy Up to $20 Podiatry/chiropody Annual limit $300 per person Initial consultation Up to $43 Subsequent consultation Up to $33 Audiology Annual limit $200 per person Initial consultation Up to $60 Subsequent consultation Up to $35 Eye therapy Annual limit $500 per person Initial consultation Up to $60 Subsequent consultation Up to $35 Dietitian Annual limit $250 per person Initial consultation Up to $35 Subsequent consultation Up to $25 Annual limit $500 per person Per prescription or vaccination Up to $100 The benefit is payable on non-pbs pharmaceuticals and is the prescription amount less the current PBS amount. 12 month waiting period per person CPAP machine* for sleep apnoea Up to $1000 Blood glucose monitor* Up to $400 Foot orthotics Up to $250 custom-made or fitted by a podiatrist, chiropodist or orthotist Orthopaedic shoes Up to $250 custom-made by specialist shoemaker Splints and braces Up to $250 splints, knee/leg/spinal/lumbar/sacral/ wrist/ankle braces and surgical corsets only Mobility aids Up to $1000 wheelchairs, crutches, walking frames, walking sticks, rolling walkers, seat riser cushions, reaches and adjustable canes only Non-cosmetic prostheses Up to $1000 Wig following a medical condition Up to $250 External breast prostheses for Up to $250 following a mastectomy Artificial eye* Up to $1000 per policy Blood pressure monitor* Up to $250 TENS machine* Up to $250 Nebuliser* and spacer for breathing Up to $250 conditions per item Compression garments Up to $250 for purpose-made garments that aid burn management, post-surgical recovery, lymphoedema treatment and deep vein thrombosis prevention 2 month waiting period per person Non-sight correcting Irlen lenses Up to $90 EpiPen Up to $100 Hearing aids and foot orthoses repair Up to $100 Rental of appliances Up to $150 including oxygen cylinders, soft collars, toilet seat risers, shower chairs, Continuous Passive Movement machines or any other appliance listed above *Replacement or additional items are not claimable within 3 years of previous purchase Defence Connections 21

24 Essentials extras cover Essentials Extras is budget-friendly cover on the extras services most people use. Favourite features Up to $500 back on general dental, preventative dental and surgical extractions Cover for essential services like physiotherapy, chiropractic, osteopathy and alternative therapies 100% up to $170 per person at our optical partners Money back for a wide range of alternative therapies Money back for travel vaccinations 100% cover for state-appointed ambulance services Dental general and surgical extractions Annual limit $500 per person Some dental items are limited in the number of times they can be claimed in a year. Some items are not payable in combination with others. And some may not attract a benefit at all. General and preventative dental Periodic oral exam (012) Up to $34 Removal of calculus (114) Up to $60 Bitewing x-ray (022) Up to $23 Adhesive filling to one surface Up to $65 of a rear tooth (531) Mouthguard (151) Up to $69 Surgical extractions Surgical tooth removal (323) Up to $130 Optical Annual limit $170 per person Optical network partners 100% Our optical network providers have extensive ranges of no-gap glasses. Visit specsavers.com.au or vsp-australia.com.au for locations. Specsavers VSP Vision Care Single vision glasses 2 pairs no-gap 1 pair no-gap Bi/Multifocal glasses 1 pair no-gap 1 pair no-gap Frames Discounted Discounted Contacts (in store) 10% off 15% off Non-preferred providers Single vision lenses Up to $80 Ground single vision lenses Up to $95 Bifocal lenses Up to $105 Multifocal lenses Up to $120 Frames Up to $95 Contact lenses Up to $120 A sight-correcting script must accompany the claim. Physiotherapy (including hydrotherapy), Chiropractic/Osteopathy Annual limit $350 per person up to $700 per policy Initial consultation Up to $35 Subsequent consultation Up to $26 Group therapy sessions Up to $10 and classes Alternative therapies & exercise physiology Ambulance Treatment Annual limit $200 per person up to $400 per policy Annual limit Unlimited 100% cover for treatment provided by a state-appointed ambulance service in Australia including emergency services, non-emergency dispatch, mobile intensive care, air and sea ambulance services. Per consultation Up to $20 Where the provider is recognised by the Australian Regional Health Group the following alternative therapies are payable: acupuncture, homeopathy, aromatherapy, myotherapy, naturopathy, remedial massage, remedial therapy, Chinese herbal medicine and western herbal medicine. No benefit payable for any prescribed medications, herbal or dietary preparations. Travel vaccinations Annual limit $100 per person Per travel vaccination prescription Up to $50 The benefit is payable on non-pbs travel vaccinations and is the prescription amount less the current PBS amount. 22

25 Call Visit us defencehealth.com.au on Join now and start being treated like family Whether you re taking out health cover for the first time or switching from another insurer, joining Defence Health is simple: call Monday to Friday 8.30am 5pm or go to defencehealth.com.au Defence Connections 23

26 Get the lowdown We know health insurance can be a lot to get your head around. This section should help clarify some important information for you. If you have any questions, we re just a phone call away. What you need to know about joining Defence Health Waiting periods When you join Defence Health or upgrade your existing cover, you may have a waiting period before you can claim benefits. Waiting periods apply when: You are taking up health insurance for the first time or have had a break in cover of two or more months You transfer from another fund before completing equivalent waiting periods You upgrade to a higher level of cover at Defence Health, including by reducing or removing an excess Hospital waiting periods: 12 months for pre-existing conditions (excluding psychiatric, rehabilitation and palliative care) 12 months for pregnancy related treatment 2 months for psychiatric, rehabilitation and palliative care 2 months for all other hospital services Cover for an accident is immediate where it is not claimable from another source such as workers compensation or third party insurance Extras waiting periods: 12 months for major dental and orthodontic treatment 12 months for laser refractive eye surgery 12 months for most devices, aids and appliances 36 months for hearing aids 2 months for all other services Pre-existing conditions A pre-existing condition is an illness, ailment or condition where signs or symptoms existed in the six months prior to you joining or upgrading to a higher level of cover. If you need treatment in the first 12 months of joining for a condition that could be pre-existing, we may ask your doctor to complete a medical report. This will help our appointed medical advisor to assess if your condition was pre-existing. You should speak to us before going into hospital. Cooling off period If you change your mind within 30 days of taking out cover, and have not made a claim, we ll cancel your membership and refund any premiums you ve paid. All you have to do is give us a call or write to us. How to join? If you are taking out health insurance for the first time, waiting periods will apply. If you are switching from another health insurer, Defence Health recognises the waiting periods you have served with the previous insurer. It is easy to join Defence Health: Give us a call on and we ll set up your membership in about 10 minutes Join online at defencehealth.com.au Switching from another fund There is no waiting period if you transfer from another fund on the same level of cover. If you transfer to Defence Health within two months of leaving another fund, any waiting periods already served under your previous cover for equivalent benefits will be honoured. If you transfer to a higher level of cover at Defence Health than you were on at your previous fund, you will need to serve the applicable waiting period (for the higher level of benefit) at Defence Health. You will still be entitled to the benefits of the lesser cover for the duration of the waiting period. 24

27 Call us on Defence Connections 25

28 Making the most of your hospital cover Where you re treated affects your benefits We have agreements with more than 500 hospitals in Australia. By choosing to be treated in an agreement private hospital, you can significantly reduce your expenses. If you choose a hospital that does not have an agreement with Defence Health, you may have significant out-of-pocket expenses. Our agreement hospital listing is one of the largest in Australia. Search the list at defencehealth.com.au Reduce your medical costs with Access Gap Your doctor, surgeon, anaesthetist, pathologist and radiologist will all charge for their services separately. Between Medicare and Defence Health we will cover 100% of the Medicare Benefits Schedule (MBS) fee for the in-hospital services covered by your policy. But some doctors charge above the MBS fee and this can result in significant out-of-pocket medical costs. Defence Health can help reduce or eliminate these extra medical costs if your doctor agrees to use our Access Gap scheme. Always ask your doctor what they will charge and if they will participate in our Access Gap scheme to reduce or eliminate the medical costs. You can search for doctors who may participate in our Access Gap scheme at defencehealth.com.au Claiming hospital benefits In most cases, we will settle your account directly with the hospital when you are discharged. If you have an excess or are still serving a waiting period, the hospital will require you to pay the additional charge either at admission or on discharge. What s not covered Situations where you will not be covered include: Hospital services listed as an exclusion 26 Treatment received while serving a waiting period Treatment provided at an emergency department of a hospital Treatment for which a Medicare benefit is not payable (apart from rehabilitation, psychiatric treatments and palliative care) Treatment not clinically necessary such as cosmetic surgery Your hospital cover does not provide benefits when you are treated in doctors rooms or require specialist tests as an outpatient Doctors fees in excess of the MBS fee, unless covered by Access Gap Pharmaceuticals provided on discharge or unrelated to the reason for hospitalisation Exceptionally expensive drugs Personal items such as newspapers, toiletries or TV Accommodation in an aged care facility Services claimable from another source such as workers compensation or third party insurance Hospital stays beyond 35 days that are not supported by an acute care certificate (this will incur out of pocket expenses) Surgery by a non-accredited podiatric surgeon (when provided by an accredited podiatric surgeon, hospital benefits will be paid according to your cover and a limited benefit is payable for the podiatric surgeon s fees) Midwifery fees if a doctor is required to intervene in the delivery (but benefits will be payable for the doctor s in-hospital treatment). Restrictions For hospital services that are restricted on your level of cover you will be covered as a private patient in a public hospital shared room. If you are treated anywhere else you will be significantly out-of-pocket. Please call us before you commence any hospital treatment to ensure you are covered. Excess If your hospital cover has an excess, each adult on your policy is required to pay it when admitted to a public or private hospital, whether it s a same day procedure or overnight admission. However, thanks to our excess cap, no more than twice per financial year. And remember there s no excess for kids. Accidental injury benefit Essentials Hospital provides you with a benefit for injuries you get in an accident that occurred after joining this cover. An accident means an unplanned or unforeseen event leading to bodily injuries caused solely and directly by external means and requiring urgent treatment from a registered practitioner. To be covered you must provide documented proof from your registered practitioner that you sought treatment within 48 hours of the accident. If treatment in hospital is needed as an admitted patient, you will need to be admitted within 90 days of the initial treatment. After this 90-day period, any hospital treatment will be paid as per the level of benefits on your cover (that is, some benefits may be excluded or restricted). Exclusions If you need treatment for procedures not covered by your policy, you won t receive any benefits from us.

29 Visit defencehealth.com.au Making the most of your extras cover Knowing your annual limits Most of the goods or services claimable under extras cover have annual per person limits. Some categories may include policy maximums. Once the annual limit has been reached, no further benefits are payable in that year. Limits are re-set on 1 July each year. Benefit payments will resume for treatment received after the beginning of the next financial year. You can easily monitor your available limits via the Member Area of our website. Claiming extras benefits We recognise all those extras providers who are registered with their professional body and in the case of approved alternative therapies, those recognised by ARHG. Many health care providers (like dentists, optometrists and physiotherapists) can swipe your membership card on-thespot through an electronic terminal. The benefit payable is automatically credited to them and you then settle any outstanding amount. A list of providers who offer on-the-spot claiming is available on our website. If your provider doesn t offer on-the-spot claiming you can claim using one of the following convenient options: For the simplest process claim via your smartphone through our Mobile Claiming App For the fastest refund claim online through the secure Member Area of our website Or complete a claim form then: it with your receipts to [email protected] Fax it and your receipts to Post it and your original accounts or receipts to us: Defence Health, PO Box 7518, Melbourne, Victoria, 3004 Claim forms can be downloaded from our website or you can call us and we ll send you one. Claiming conditions The most common claiming conditions are: All services must be provided by an approved practitioner in private practice Claims must be lodged within 2 years of receiving the service Benefits are only payable on goods and services purchased in Australia Benefits are only payable where Medicare benefits are not payable Benefits are not payable when they can be claimed from another source If you are unsure whether a practitioner is registered with us, just give us a call. Full claiming conditions are available online. Get a quote Go to defencehealth.com.au or call us on Defence Connections 27

30 Making the most of the Australian Government s initiatives The Australian Government has a number of initiatives in place to encourage people to take out private health insurance. There are benefits for taking out cover and penalties if you don t. The better you understand these initiatives the better off you could be so let s take a closer look. Australian Government Rebate Reduces the amount you have to pay for health insurance The Australian Government Rebate on private health insurance may reduce the amount you pay for private health insurance. The rebate amount is based on the age of the oldest person covered by the policy (the older the better) and your annual earnings (the lower the better). Most people choose to take the Australian Government rebate in the form of a premium reduction. Alternatively, you could choose to claim the rebate as a tax offset when you lodge your tax return. If you choose to take the rebate as a premium reduction, tell us which rebate tier you fall within and we ll automatically apply the relevant rebate to your premium. And don t worry if you choose the wrong rebate tier. If you receive too much, or too little, it will be reconciled by the ATO when you submit your tax return. How is the rebate calculated? The Government indexes the rebate on 1 April each year using a calculation which represents the difference between the Consumer Price Index and the industry weighted average premium increase. This means that the percentage of Government rebate as a proportion of your premium will diminish over time. If you have a Lifetime Health Cover loading, the rebate won t apply to this component of your premium. Medicare Levy Surcharge More tax for high income earners without hospital cover The Medicare Levy Surcharge (MLS) is an additional tax on higher income earners who don t have hospital cover for themselves and their family. The surcharge is in addition to the Medicare Levy of 2.0% that applies to most taxpayers. No MLS is payable if you take out any of Defence Health s ADF packages or any other Defence Health hospital cover. Permanent or full-time ADF personnel should note that although you do not need private health cover yourself, if your combined family income is above the base tier threshold your family will need to take out private hospital cover to avoid the MLS. Singles Income thresholds* Up to $90,000 $90,001 to $105,000 $105,001 to $140,000 More than $140,000 Income tiers Base Tier Tier 1 Tier 2 Tier 3 Rebate Under 65 years old % % 9.680% 0% Aged years % % % 0% Aged 70 years and older % % % 0% Medicare Levy Surcharge if no hospital cover All age groups 0% 1% 1.25% 1.5% *Income thresholds are determined by the Australian Taxation Office and are indexed annually on 1 July. The ATO has specific rules for calculating your Income for Rebate and Medicare Levy Surcharge purposes. For more information, please go to 28

31 Call us on Single parents and couples are considered families. For families with children, the thresholds are increased by $1,500 for each child after the first. Income thresholds increase at the start of each financial year. Age ranges relate to the oldest person covered on the policy. *Income thresholds are determined by the Australian Taxation Office and are indexed annually on 1 July. The ATO has specific rules for calculating your Income for Medicare Levy Surcharge purposes. For more information, please go to Lifetime Health Cover Everyone needs to consider the impact of Lifetime Health Cover If you are 30 or over, and you are not serving full time in the ADF, you will need to consider the impact of Lifetime Health Cover legislation. It is designed to encourage people to take out hospital cover earlier in life and to penalise people who don t. If you take out hospital cover later than the 1 July following your 31st birthday, you will pay a loading of 2% on your premium for each year you are aged over 30. And it won t be removed until you have maintained hospital cover for a continuous 10-year period. For example, a person who first takes out hospital cover at age 40 will pay 20% more in premiums each year than someone who takes out hospital cover at age 30. The longer you leave it, the higher the loading. The maximum loading is 70%. To cover small gaps, such as switching from one insurer to another or discharging from the ADF, you are permitted to be without hospital cover for up to two years and 364 days during your lifetime. If you are without hospital cover longer than that, you will attract a loading of 2% on the first day of your third year, and every year after that. The Australian Government Rebate on private health insurance cannot be applied to the loading amount. Special provisions for discharging ADF Permanent ADF members are considered to have hospital cover whilst serving. If you ve just left the full-time ADF, then you are no longer exempt from the impact of Lifetime Health Cover. If you discharge after your 31st birthday, you can take out hospital cover without a loading, unless you already had a loading when you enlisted. However, if you don t take out hospital cover on discharge, you ll start using the two years and 364 days you are permitted to be without hospital cover. If you discharge from the ADF before your 31st birthday, then the normal Lifetime Health Cover conditions apply. Couples and families Combined income thresholds* Up to $180,000 $180,001 to $210,000 $210,001 to $280,000 More than $280,000 Income tiers Base Tier Tier 1 Tier 2 Tier 3 Rebate Under 65 years old % % 9.680% 0% Aged years % % % 0% Aged 70 years and older % % % 0% Medicare Levy Surcharge if no hospital cover All age groups 0% 1% 1.25% 1.5% Single parents and couples are considered families. For families with children, the thresholds are increased by $1,500 for each child after the first. Income thresholds increase at the start of each financial year. Age ranges relate to the oldest person covered on the policy. *Income thresholds are determined by the Australian Taxation Office and are indexed annually on 1 July. The ATO has specific rules for calculating your Income for Rebate and Medicare Levy Surcharge purposes. For more information, please go to Defence Connections 29

32 Important information Privacy statement Defence Health has a legal obligation to comply with the Commonwealth Privacy Act 1988 and the Australian Privacy Principles. The Defence Health privacy statement informs you about how your personal information will be collected, held, used and disclosed, how you may gain access and seek correction of that information, and how you may complain about possible breaches of privacy. A copy of the full current statement is available on our website. We will always endeavour to collect your personal information directly from you, but in some circumstances, for instance where you are a dependant on the policy, we will collect your personal information from the policy holder. We will generally collect and use your information to approve your transactions/claims, to provide services you have requested and to inform you of products, benefits and services we think may be of interest to you. We may use or disclose your personal information for another purpose, but only if we have your prior consent, or we are required to do so to fulfil our obligations as a private health insurer, or for any other reasonably expected purpose related to the provision of your health benefits. For example, we may disclose your information to other service providers we have arrangements with or who provide services to us, or where otherwise permitted or required by law. Policy holders will have access to certain personal information about dependants on the policy. Policy holders have an obligation to make dependants aged 16 years and over aware that they may contact us if they do not wish us to share their personal information with the policy holder or others on the policy. If you do not provide the information requested or do not consent to us requesting it from third parties, we may be unable to provide our health benefit services to you. Code of Conduct Defence Health follows the Private Health Insurance Code of Conduct. Under the Code, Defence Health will: Provide information to you in plain language Ensure that policy documentation is full and complete Ensure that all our staff who provide information on health insurance are appropriately trained and able to provide clear explanations Ensure information exchanged between you and us is protected in accordance with privacy principles Provide you with easy access to our internal issues and complaints handling system and advise you of your rights to take an issue to the Private Health Insurance Ombudsman, and Continue to improve our standards of practice and service. A copy of the Code can be downloaded from our website. Compliments or complaints We value your feedback. Compliments or complaints can be made through any of our contact channels. Our complaints handling procedures are based on Australian and International Standards to ensure we deal with your concerns efficiently and consistently. If we are unable to satisfy you, you can contact the Private Health Insurance Ombudsman on The Ombudsman provides free information and assistance to resolve disputes. Defence Health Fund Rules Your cover will be provided and benefits paid in accordance with the Fund Rules of Defence Health Limited. You can download a copy of the latest Fund Rules from our website or ask us to send you one. 30

33 Visit defencehealth.com.au More ways we treat you like family Travel insurance Your health insurance does not cover you for medical expenses incurred overseas. To cover yourself when travelling outside Australia, you need travel insurance. Defence Health Travel Insurance provides value for money and covers you for medical expenses, and also for lost luggage, cancellation costs, hire car excesses and many other things. The policy covers most activities and you have the option of adding specialty cover for cruises, snow skiing and adventure experiences. Special features All permanent ADF personnel, active Reservists and Defence Health members receive our special members pricing ADF personnel posted overseas can use Defence Health Travel insurance to cover yourself and your family from your overseas posting to your travel destination If you re in the ADF and your leave is cancelled because of operational needs, you can claim for lost deposits and bookings To get a quote for your next trip and to find out more information about the benefits and conditions of the policy, please visit defencehealth.com.au Term Life insurance Designed for full-time serving ADF and active Reservists Defence Health Term Life covers you when deployed to warlike operations as long as your policy is in force before you re told you re being deployed. It provides a lump sum payout for death in addition to any military compensation. And, you can add optional Critical Conditions cover with a lump sum payment if you re diagnosed with a range of serious conditions such as cancer, or if you suffer a stroke or a heart attack. Personal Accident insurance We also offer D-Pax Personal Accident Insurance for Defence personnel. It provides lump sum payments for injuries, permanent disabilities, fractures, burns or accidental death. For an additional premium it has an optional extension for cover in a warzone, with reduced benefits, that can be taken at the time of deployment and then removed upon your return. Disclosure AGA Assistance Australia Pty Ltd ABN AFSL trading as Allianz Global Assistance issues and manages Defence Health Travel Insurance for the insurer Allianz Australia Insurance Limited ABN AFSL Suncorp Life & Superannuation Limited (ABN , AFSL ) is the issuer of Defence Health Term Life insurance. AIG Australia Limited (ABN , AFSL ) is the issuer of D-Pax Personal Accident Insurance. Defence Health receives commission payments from the product issuers of Defence Health and other insurance products in the range of 10% to 20% of the premiums you pay to the insurer (excluding GST). The information on Travel, Term Life and D-Pax insurance in this brochure is of a general nature and does not take into account your personal objectives, financial situation or needs. Defence Health is not the issuer of these products and does not warrant that they are suitable for you. You may wish to obtain Personal Advice. You should consider the relevant Product Disclosure Statement (PDS) in deciding whether to acquire these products. A PDS can be obtained by calling or by downloading it from the Defence Health website. Defence Connections 31

34 Join now and start being treated like family Whether you re taking out health cover for the first time or switching from another insurer, joining Defence Health is simple: call Monday to Friday 8.30am 5pm or go to defencehealth.com.au 32

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36 Contact Us Phone Monday to Friday 8:30 am to 5:00 pm Web defencehealth.com.au /DefenceHealth Fax Post PO Box 7518 Melbourne, Victoria 3004 Level 4, 380 St Kilda Road Melbourne, Victoria 3004 Defence Health Limited ABN AFSL DH0932/0947/09-14