What is the difference between gold and white card entitlements?
A Gold card (external site) entitles the holder to treatment for ALL conditions.
A White card (external site) entitles the holder to treatment for SPECIFIC war or conflict-related conditions and conditions such as malignant cancer, pulmonary tuberculosis and post-traumatic stress disorder whether service related or not. Vietnam veterans are covered for anxiety and/or depression.
Gold cardholders and eligible White cardholders are referred to as "Entitled Persons" (EP).
I have an Orange Card, what entitlements do I have?
The Orange card (external site) entitles you to pharmaceutical benefits under the Repatriation Pharmaceutical Benefits Scheme. It is not a treatment card (like Gold and White) and cannot be used to access hospital treatment services.
If the DVA file or card number details are not available at admission, what should hospitals do?
Hospitals should obtain the details during the course of admission from either the patient or the next of kin and then record the details in the inpatient record.
Is white card authorisation still required?
From December 2007, hospitals are no longer required to seek authorisation from DVA before treating white cardholders except for non-MBS procedures or treatments such as cosmetic surgery or in vitro fertilisation. Instead, the Revenue Strategy and Support section will submit the relevant records to the DVA for retrospective confirmation of treatment eligibility. The account type must be “VA” or the equivalent values in data capturing systems to be included in the submission to DVA.
When is DVA financial approval required and how do we obtain it?
The table below specifies the circumstances when financial approval from DVA is required for both Gold and White cardholders. Make sure you have the patient’s name, DVA card colour and file number, and information about the required treatment, procedure or service.
| Items |
How to obtain approval |
- Procedures not listed in the Medical Benefits Schedule (MBS)
- Treatments occasionally nominated in writing by DVA such as cosmetic surgery or in vitro fertilisation
- Surgically implanted prosthesis costing more than $25,000
- Aids, equipment and home modification more than $500
- Patient transfers from public hospital to a Non DVA Tier 1 private facility.For a list of DVA Tier 1 facilities, please follow this link: DVA Tier 1 Facilities (external site)
|
- Contact the DVA Provider line on 1800 550 457
- Select the option relating to Medical, Hospital or Prior Approval from the series of prompts. The DVAA will require information to establish eligibility on a case-by-case basis, depending on the nature of treatment or procedure. There may be instances where DVA would require hospitals to fax or email the information to DVA.If this is the case, please email health.approval@dva.gov.au
- If approval is not granted, the patient should be admitted under another financial election or account type.
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| Pharmaceuticals under the Special Access Scheme (not registered for use in Australia) or drugs not normally provided to other patients |
Contact the Veterans’ Affairs Pharmacy Advisory Centre (VAPAC) on 1800 552 580 |
| Inter-hospital transport and commercial flight; and where the appointment is unrelated to the current episode of care |
Contact the DVA Transport section on 1800 550 455 |
| When in doubt, call DVA |
Contact the DVA Provider line on 1800 550 457 |
What are the benefits of being admitted as a DVA patient?
- Choice of publicly funded hospital, with a minimum shared ward accommodation;
- Choice of doctor provided the doctor has admitting rights to the hospital;
- Free hospitalisation - costs of accommodation, medical and diagnostic services, prostheses, aids and equipment are charged to the DVA;
- Free pharmaceuticals whilst admitted, on discharge and as non-admitted patients (some hospitals may charge a patient co-payment);
- Aids, equipment and home modification
- Nursing home type contribution for ex-Prisoners of War and Victoria Cross Recipients is charged to the DVA;
- Inter-hospital transport; and
- Transport at discharge.
As an EP, can I choose to be treated as a public patient?
Yes, although you are encouraged to use your Gold or White Card entitlements as this provides access to other benefits not available to public patients.
Can I use private health insurance with my DVA entitlements at the same time?
No. If you wish to be admitted as a private patient in a publicly funded hospital using your private health insurance, you should take note that:
- you are entitled to a choice of hospital and doctor provided the doctor has admitting rights to private patients at that hospital;
- the financial arrangement for the costs of all hospital services will be between you and the insurer; and any gap payments will be your personal responsibility and cannot be claimed from the DVA.