Delivering a Healthy WA

Department of Veterans' Affairs Management Unit

Frequently Asked Questions

Eligibility

I am a veteran, am I covered for hospital treatment?

  • Yes, if you have a gold or white card issued by the Department of Veterans’ Affairs (DVA).

Can I be treated as a DVA patient if I have applied for entitlement, but have not received my card yet?

  • There are circumstances in which DVA would cover consultations and diagnostic procedures associated with a claim and the veteran does not have a valid card.  Under Military Compensation some veterans are eligible to receive treatment at DVA's expense before their claim is finalised if there is a strong indication that the claim will be accepted. These treatment services are usually organised directly by DVA with the hospital or treating specialist. In most cases, the patients will bring a letter confirming that DVA will financially cover the treatment.

Can an interstate Entitled Person (EP) access public hospital services in WA

  • Yes, on presentation of the DVA Gold or White Card and the approval process applies if required.

Can Veterans from other countries access treatment in WA?

  • Yes, after approval by the Australian DVA and provision of an Australian DVA Health Card.

Entitlements and benefits

What is the difference between gold and white card entitlements?

  • A Gold card entitles the holder to treatment for ALL conditions. 
  • A White card 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 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 DVA Management Unit 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 HCARe 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.

Table 1. DVA Approval Process

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.

Transfer from public to private hospital

What happens if I want to be transferred from a public hospital to a private hospital?

  • Transfers to a private hospital for either clinical or social reasons are allowed provided they are clinically appropriate. The discharging public hospital should coordinate the transfer to ensure that a bed is available at the admitting private hospital.
  • If you attend an Emergency Department of a public hospital and express a preference for an admission to a DVA-contracted private hospital at the time of admission, you may be transferred after being stabilised. If a suitable bed is not readily available then a transfer may only be considered if it is clinically appropriate. If a major clinical intervention has occurred, it may be more medically appropriate for you to remain in the admitting public hospital.

Can an EP be transferred to all private hospitals in WA?

  • Yes, if the transfer is clinically appropriate.  It should be noted that transfers to a Tier 2 or 3 facility requires prior financial approval from DVA.

What is a Tier 1, 2 or 3 facility?

  • The DVA contracts with Day Procedure Centres (DPCs), public and private hospitals under a Tier 1 arrangement for hospital care of Entitled Persons.
  • Tier 1 hospitals (including mental health facilities) and DPCs are facilities where admission of Entitled Persons does not require prior approval from DVA.  All WA public hospitals are Tier 1 facilities.
  • Tier 2 hospitals are contracted private facilities where all Entitled Person admissions require prior financial authorisation from DVA. These facilities are used when treatment cannot be provided within a reasonable time in the Tier 1 facilities. Currently there are no private hospitals contracted under these arrangements in WA.
  • All other private hospitals are categorised as “non-contracted private hospitals” or Tier 3 private hospitals. Admission of Entitled Persons to Tier 3 facilities requires prior financial authorisation from DVA and would only be given if the treatment is not available or cannot be provided within a reasonable time in the Tier 1 and Tier 2 facilities

Contracted Private Hospitals (grouped by state)
Day Procedure Centres (grouped by state)
Mental Health Facilities (grouped by state)


Patient charges

As an EP, would I be charged a patient contribution or co-payment?

  • Yes, you will be charged a:
    • Nursing Home Type patient contribution if you are not an ex- Prisoner of War (POW).  If you are an ex-POW, DVA will cover the contribution
    • Co- payment (under the Pharmaceutical Benefits Scheme Reform Program, participating hospitals may charge a patient co-payment for pharmaceuticals provided to admitted patients on discharge or as a non-admitted patient). Please contact DVA on 1300 550 457 (metro) or 1800 550 457 (non-metro) to confirm your eligibility.

Are there any other charges that I should be aware of?

  • Yes, and you will be responsible for paying these accounts and you cannot seek reimbursement from the DVA:
    • The hospital may charge you for meals of boarders if you require company whilst an admitted patient.
    • Charges will apply to personal/non-medical services such as television, telephone calls, newspapers, laundry costs and parking.

WA-DVA Hospital Services Arrangement

What is the WA-DVA Hospital Services Arrangement (HSA) all about?

  • The HSA is an agreement between Western Australia (WA) and the Commonwealth Department of Veterans’ Affairs (DVA) for the provision of a comprehensive range of admitted and non-admitted patient services to entitled Veterans and their beneficiaries by WA publicly funded hospitals. The Department of Health is responsible for the implementation of the HSA on behalf of the State.

Are Commonwealth-funded services part of the HSA?

  • No, services such as Veterans’ Home Care Packages (VHCP), Home and Community Care (HACC), and Assessments conducted by the Aged Care Assessment Teams (ACAT) are not part of the HSA.

As an Entitled Person, am I eligible to access VHCP, HACC, ACAT and other Commonwealth-funded services?

  • Yes.

How can I access Commonwealth-funded services?

  • Hospital staff will determine or refer you to the appropriate service according to your need/s.

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