Why not contact us?
P: 1300 306 289
F: (03) 9899 4234
When Do Benefits Cease?
Benefits are not payable on any services rendered subsequent to a member’s last financial paid to date, the date on which a membership is cancelled or when a membership is in suspension.
When Are Benefits Not Payable?
Benefits are not payable when:
- claims are over 2 years from the date of service;
- the provider is not recognised in a private practice or for Natural Therapies the provider is not recognised by the Australian Regional Health Group (ARHG) or HICAPS;
- the service forms any part of a payment from Workers’ Compensation, Third Party or any other liability provision. Navy Health reserves the right to seek full reimbursement on any benefits paid in these circumstances;
- the procedure does not have an assigned Commonwealth Medical Benefits Schedule item number;
- the claim is within a specified waiting or replacement period or annual/sub limits have been reached;
- Access Gap providers submit medical claims 2 years after the date of service, unless approved by Medicare Australia for benefits;
- services performed, or products from outside of Australia;
- cosmetic surgery;
- during a period of suspension or when membership is in arrears.
Navy Health will not pay benefits on any services, treatments or products received outside of Australia. As a consequence, we strongly advise all members consider Navy Health Travel Insurance when travelling overseas to cover emergency expenses when outside of Australia.