Navy Health Review
Overview
Navy Health was established over 60 years to provide health cover to the Royal Australian Navy and their families. They are now operating as a private health fund but still retain their strong ties with the Australian Defence Force and continue to provide cover to the Navy, Air Force, and Army community.
The fund runs on a financial year and is part of Members Own, a group of like-minded, non-profit mutual health funds that invest their dividends back into their members through higher benefits and paid claims.
Navy Health Key Facts
Founded: 1955
For-Profit or Not-For-Profit?: Not-For-Profit
Private Hospital Agreements Nationwide: 282
Day Hospital Agreements Nationwide: 262
Health Deal Represented? No
Headquarters: Surrey Hills, VIC
Navy Health Hospital Cover
Navy Health has 3 hospital policies that cover all ages and needs. Here is a list of the hospital covers that are currently available:
- Saver Hospital
- Core Hospital
- Premium Gold Hospital
Navy Health Extras Cover
Extras Cover takes care of the everyday healthcare service expenses that are not generally covered under Medicare such as dental services, prescription glasses, and physiotherapy. Here is a list of the current extras covers available:
- Budget Extras
- Healthy Living Extras
- Premium Extras
Navy Health Combined Cover
Navy Health has 1 combined cover available:
- Saver Plus
Navy Health Waiting Periods
Navy Health recognises the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:
Hospital Waiting Periods
- Ambulance services: 2 months
- Accidental Injury: None
- New Conditions: 2 Months
- Pregnancy and birth-related services: 12 months
- Pre-existing conditions: 12 months
- Rehabilitation & Palliative care: 2 months
- Weight Loss Surgery: 12 months
How Do You Claim Extras With Navy Health?
Navy Health’s claiming options are quick and easy. Here are the 4 ways that you can do this:
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
Via a mobile app: You can lodge a claim using the Navy Health App by submitting a photo of your receipt.
Online: You can log onto their online member services and lodge your claim by providing the details on your receipt.
Mail: You can lodge your claim by posting relevant accounts and receipts to:
Navy Health
PO BOX 172 Box Hill,
Victoria
Navy Health Gap Cover
Navy Health’s gap cover is called Access Gap Cover. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense. Access Gap can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.
Gap Cover Ratings By State
To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme.
Medical Services with No Gaps: The percentage of claims that were fully refunded.
Medical Services with No or Known Gaps: The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.
The information below outlines the percentages of services covered under no-gap and known-gap.
Gap Cover by State
Navy Health medical services with No Gap: 82.6%
Industry Average: 79.1%
Navy Health medical Services with No or Known Gap: 94.5%
Industry Average: 90.5%
Navy Health medical services with No Gap: 90.4%
Industry Average: 89.5%
Navy Health medical Services with No or Known Gap: 97%
Industry Average: 95.7%
Navy Health medical services with No Gap: 91.9%
Industry Average: 86.7%
Navy Health medical Services with No or Known Gap: 98.6%
Industry Average: 95.1%
Navy Health medical services with No Gap: 91.8%
Industry Average: 89.2%
Navy Health medical Services with No or Known Gap: 97.6%
Industry Average: 94.5%
Navy Health medical services with No Gap: 93.3%
Industry Average: 89.5%
Navy Health medical Services with No or Known Gap: 99.3%
Industry Average: 96.6%
Navy Health medical services with No Gap: 88.3%
Industry Average: 84.4%
Navy Health medical Services with No or Known Gap: 97.2%
Industry Average: 96.2%
Navy Health medical services with No Gap: 92.6%
Industry Average: 90.2%
Navy Health medical Services with No or Known Gap: 98.1%
Industry Average: 96.7%
Navy Health medical services with No Gap: 86.9%
Industry Average: 84.2%
Navy Health medical Services with No or Known Gap: 94%
Industry Average: 93.8%
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