A DVA Gold Card covers private hospital care, but the rules around approvals, emergencies and billing are not always clear. Can you use it in an emergency? Do you need approval before surgery? Will you be left with a bill?
This guide explains what is covered, how planned and emergency admissions work, and how to keep the process stress-free. For the full picture of the card, see our DVA Gold Card guide, and to compare cards, our DVA card eligibility page.
Article at a glance
- Yes, with conditions: the hospital usually needs to be contracted with DVA.
- Emergencies first: you are treated, and the hospital sorts approval and billing with DVA afterwards.
- No out-of-pocket cost: contracted hospitals bill DVA directly for clinically necessary care.
- Planned care: needs a referral from a DVA-registered GP or specialist and, often, prior approval.
Can you use the Gold Card in private hospitals?
Yes, with a few conditions. DVA has Hospital Service Agreements with a wide network of contracted private hospitals and day procedure centres, and the current list is on the DVA website. For a planned admission you need a referral from a DVA-registered GP or specialist, and the hospital must be on DVA’s approved list. The key is knowing whether the hospital is contracted with DVA before admission.
What private hospital services are covered?
Through a contracted hospital, your cover includes just about everything you would expect from a private stay:
- Hospital accommodation
- Specialist treatment and surgery
- Diagnostics such as scans and pathology
- Mental health care
- Rehabilitation programs
The hospital bills DVA directly, so there should be no out-of-pocket expenses. The only time you may face a cost is if you request extras with no clinical need, such as a private room upgrade without medical justification.
Accessing emergency care with the Gold Card
Do not wait if you need emergency care. If you present to a private hospital emergency department with your Gold Card, you will be treated, and the hospital seeks retrospective approval from DVA afterwards. If an emergency becomes an extended stay, the hospital coordinates with DVA to confirm funding or arranges a transfer if needed. For non-contracted hospitals, immediate emergency care is still usually covered, though longer stays may require approval or transfer to a contracted facility.
Steps to arrange planned private hospital care
- Get a referral from your GP or specialist, making sure they are DVA-registered.
- Check that the hospital is contracted with DVA, using the list on the DVA website.
- Confirm the hospital will seek prior approval from DVA before your admission.
- On admission, present your Gold Card and sign the Hospital Admission Voucher.
- Do not pay out-of-pocket fees, as billing goes directly to DVA. If you are asked to pay, contact DVA or our expert team.
Limits, approvals and things to know
Holding a Gold Card does not mean every admission is automatically approved. Hospitals sometimes need prior financial authorisation from DVA, which protects you from surprise bills. Approval is often needed where there is uncertainty about eligibility, for respite or convalescent care after discharge, where a procedure is not on the Medicare Benefits Schedule, where non-listed devices or human tissue products are used, for flagged treatments such as cosmetic surgery, or for medicines not on the PBS or RPBS. Emergencies are treated first and confirmed afterwards.
Frequently asked questions
Can I use my Gold Card in a private hospital emergency department?
Yes. You will be treated, and the hospital seeks approval from DVA afterwards. Do not delay emergency care.
Will I be left with a bill?
At a contracted hospital, billing goes directly to DVA for clinically necessary care. Costs only arise for non-clinical extras you request yourself.
Do I need approval before planned surgery?
Often, yes. Confirm the hospital is contracted and will obtain prior approval from DVA before your admission.
Need help arranging hospital care?
Our expert team can help with referrals, prior approvals and liaising with DVA, so the paperwork does not add to the stress.
Related from KSC Law
- DVA card eligibility: Gold, White and Orange
- DVA Gold Card: benefits and eligibility
- DVA White Card: benefits and eligibility