Cover is for the member only and therefore would need to be adjusted to the family rate if dependants or a partner were to be added. A single membership should be adjusted to the family rate at least two months prior to the expected date of birth of a child if cover for the child is required at birth.
Cover is for the member with a spouse/partner plus; any unmarried children until they attain the age of 22 years or enter into de facto relationship; any unmarried children between the age of 22 and 25 years who are full time students attending an education facility within Australia.
A dependant is no longer eligible for cover under a parent’s membership is able to take out membership in their own right. If the new cover is started within thirty (30) days at an equivalent level, no additional waiting periods will apply.
For more information please call 1300 306 289.
Single Parent Family or Military Family with one serving adult
Cover is for one adult and dependants. For a military family with one serving adult, the serving person is the membership owner but cannot make a claim on the membership.
Dependant(s) Only or Military Family with two serving adults
Cover is for children only. The members (adults) are not entitled to claim benefits on a Dependant(s) Only cover.
When does membership commence?
Membership will only be accepted from the date when the first contribution is received, or on the date on which the application form is received by Navy Health, whichever is the latest. Backdating of membership is not permitted.
How can I change my membership?
Any changes to the status of membership (i.e. level of cover, adding or deleting dependants) cannot be undertaken without Navy Health receiving written notification of the change.
Likewise, the change cannot be taken as being actioned without the member receiving written acknowledgement from Navy Health.
The application forms supplied by Navy Health can be used for that purpose or the member can use the Navy Health website.
The easiest method of changing details is via Online Member Services. Here you can change/verify your details without needing to contact Navy Health directly.
Upward (increased entitlement) changes in the level of cover will result in the member and any persons covered undergoing new waiting periods. Whilst these waiting periods are in force, benefits will still be payable as they would normally have been under the previous level of cover.
Higher benefits are not payable for ailments or conditions in evidence at the time of transfer (regardless of whether or not they have been diagnosed) until a waiting period of 12 months has been served.
Higher level maternity (and the management of) and IVF procedures benefits will not be payable for a period of 12 months after transfer.
For transfers within the extras products, the waiting periods for higher benefits are those listed for new members. At all times the benefits paid under a previous level of cover are considered when determining residual benefit entitlements.
When are contributions payable?
Payment of contributions are always in advance. Direct debit payments can be made on a fortnightly, monthly, six monthly or yearly basis.
A 2% discount has been applied for members choosing to pay half yearly and a 4% discount has been calculated for those members choosing to pay annually.
For General Treatment (Extras) the Navy Health benefit year is July 1 to June 30. For hospital products with an excess, the benefit period is a rolling calendar year (i.e. the excess is payable once per person, in full, up to the family maximum, in any rolling 12 month period).
When does membership cease?
A membership will cease on a date advised and paid to by the member or automatically when contribution payments are more than one month in arrears.
If a non-student dependant takes up any extras cover within 30 days of being ineligible to continue under a parent’s membership, Navy Health will allow the dependant to retain the hospital cover provided under the existing family membership until they attain 25 years of age, marry, or enter into a de facto relationship.
Continuity of hospital cover, at an equivalent level of cover to that carried over from a parent’s membership will be provided when the dependant seeks cover in their own right provided the parent’s membership is still current and cover is activated within 30 days of being ineligible for inclusion under a parent’s membership.
A dependant can take up membership in their own right at any time after being ineligible to continue under their parent’s cover, however some waiting periods may apply unless membership is taken up within 30 days. The new membership will take effect from the day after they lose their eligibility on their parent’s membership.
Cooling Off Period
Members can choose not to proceed with their Navy Health cover and request to have any premiums reimbursed. This reimbursement is on the provision that the member expresses their request in writing, within 30 days of their cover commencing and that no claims have been lodged or are pending during the 30 day cooling off period.
Suspension of Membership
Navy Health at its absolute discretion may allow, within a clearly defined limited set of circumstances, for a member to suspend their membership for an agreed period.
Where the suspension has been approved in writing by the insurer, members will be advised of the conditions relating to waiting periods and pre-existing condition rules which may be applied upon reinstatement of membership.
The agreed suspension period is not subject to change without written notification to and written confirmation from Navy Health. For more information please go to Suspending Your Cover.
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