The Veteran Card – All Conditions, commonly called the Gold Card, provides eligible holders with clinically necessary treatment for all medical conditions within Australia under DVA arrangements. It may also provide access to prescription medicines, health-related services and certain concessions or discounts.
It differs from the Veteran Card – Specific Conditions, commonly called the White Card. The White Card generally covers accepted service-related conditions and may also cover treatment for mental health conditions, cancer or pulmonary tuberculosis where the eligibility requirements are met.
Who may qualify for a DVA Gold Card?
DVA Gold Card eligibility can arise through several pathways. It should not be assumed from a diagnosis, accepted condition or impairment score alone.
A veteran may qualify because of particular service, an eligible compensation entitlement or the assessed effects of service-related conditions. Relevant pathways include qualifying service for a veteran aged over 70, former prisoner-of-war status, eligibility for certain disability payments, eligibility for the Special Rate Disability Pension or Additional Disablement Amount, or an assessment of at least 60 impairment points under the improved Military Rehabilitation and Compensation Act 2004 (MRCA). Certain war widows or widowers, dependants and eligible civilians may also qualify.
Some Service Pension recipients may qualify under separate criteria. These may include being permanently blind in both eyes, satisfying the applicable treatment-benefits income and assets test, receiving a Disability Compensation Payment assessed at 50% of the general rate or higher, or having service-related impairment assessed at 30 or more impairment points under the MRCA.
The appropriate starting point is DVA’s current eligibility decision and card correspondence. The physical or digital DVA health card can also be checked through MyService or the MyGov wallet.
What does a DVA Gold Card cover?
The Gold Card generally covers clinically necessary treatment for all medical conditions within Australia, including conditions that are not related to the cardholder’s service. Coverage may include treatment listed on the Medicare Benefits Schedule, approved allied health services and pharmaceutical items available through the Pharmaceutical Benefits Scheme or Repatriation Pharmaceutical Benefits Scheme.
However, asking what does a DVA Gold Card cover involves more than confirming the type of card held. The particular treatment must still satisfy DVA’s clinical and administrative requirements.
Services not listed on the Medicare Benefits Schedule, some allied health treatment, non-listed medicines and certain services costing more than the relevant DVA fee may require prior approval. Some treatments also require a valid referral or must be delivered through DVA’s treatment-cycle arrangements.
A Gold Card therefore does not mean that every treatment, product or provider is automatically covered. Before treatment begins, it is sensible to ask whether the provider accepts Veteran Cards, can claim through DVA and requires a referral or prior approval. Providers accepting a Veteran Card payment cannot charge the cardholder a gap fee for that treatment.
The difference between Gold and White Cards
The type of DVA health card determines the scope of treatment ordinarily funded by DVA. A Gold Card covers clinically necessary treatment for all medical conditions within Australia, subject to DVA’s treatment rules. A White Card generally covers treatment for the accepted or otherwise specified conditions recorded against the cardholder’s entitlement.
White Card holders may also be entitled to non-liability health care for mental health conditions and, depending on their service, treatment for cancer or pulmonary tuberculosis without first establishing that those conditions were caused by service.
The conditions covered by a White Card can be reviewed through the Cards section in MyService. This can help avoid assuming that a particular condition or treatment is covered when it has not been accepted or otherwise included.
What to check if the wrong card was issued
If you believe the wrong DVA card Australia entitlement was issued, check the underlying decisions rather than relying only on the colour or description of the card.
The issue may be that a condition has not been accepted, the impairment assessment is incomplete, a relevant payment or service category has not been recognised, or the eligibility requirements for a Gold Card have not yet been met. For some Service Pension recipients, changes in income or assets may also affect ongoing Gold Card eligibility.
The decision and card correspondence should identify the entitlement granted. Any review should focus on the underlying eligibility criteria and evidence rather than simply requesting a different card.
Reviewing a Veteran Card decision
A DVA card Australia entitlement can affect access to treatment, medicines and other support. It is therefore important to understand both the card issued and the conditions or services it covers.
KSC Law can review a Veteran Card decision, the underlying compensation or impairment assessment and the available evidence. We can identify whether further information may be required and explain the review pathway applying to the individual matter.