Westfund Health Insurance

Westfund is a member-owned health fund – Full policy review and comparison

If you’re looking for a private health fund to offer peace of mind and help you take better care of yourself, Westfund Health can help. Established in 1929, Westfund is a member-owned health fund, which means all its profits are returned to members in the form of cheaper premiums and better products.

With an aim of providing quality cover at an affordable price, Westfund Health offers the following plans to its members: Hospital and Extras Cover, Hospital Only Cover, Extras Only Cover, Overseas Cover and Ambulance Cover.

Westfund Health Insurance option

There’s certainly no shortage of health cover options available from Westfund Health, with cover ranging from standalone hospital or extras cover through to combined policies. Whether you want the most basic and affordable level of cover, a mid-range option or comprehensive protection, Westfund Health has options designed to suit you.

• Hospital and Extras Cover
• Hospital Only Cover
• Extras Only Cover
• Overseas Cover
• Ambulance Cover

Are there any additional benefits?

Westfund's Member Advantages program rewards its customers for maintaining their policies with the following bonuses:

• After serving your waiting period: Receive up to an additional $200 per night if you are hospitalised following an accident.
• After 1 year: Receive $75 towards sunglasses from any Westfund Care Centre.
• After 2 years: Get $150 per night accommodation expenses up to $600 per year as well as an additional $400 per-night benefit for advanced surgical procedures.
• After 3 years: Enjoy the flexibility of being able to suspend your premiums for up to six months if you’re made redundant.
• After 5 years: Get up to $2,000 for hearing aids and enjoy eligibility for any special premium discounts that may arise.

General exclusions and waiting periods

There are certain circumstances under which Westfund Health will not pay your claim, including if:

• It is for a procedure or treatment excluded from your policy
• It is for services rendered by a provider who is not recognised by Westfund or not in private practice
• It is for services received more than 24 months prior to you lodging your claim
• You have received treatment from your business partner, spouse, de facto or relative
• It is for services received by the dependents of your dependents
• It is for benefits that are claimable from another source, for example Medicare or workers’ compensation insurance
• It is for services or health care goods provided outside Australia
• It is for a service for which Medicare does not pay a benefit, for example cosmetic surgery.

Just as with any other health fund, you’ll also need to consider the waiting periods you will need to serve when you join Westfund Health. For example, you’ll only have to serve a one-day waiting period for accident and ambulance cover, while all other hospitalisations (excluding obstetrics and pre-existing conditions) require you to serve a two-month waiting period. Other treatments, for example major dental work and obstetrics, require you to sit out a 12-month waiting period.

Westfund Health Insurance excess

Many health insurers require you to pay an excess when you are admitted to hospital. This is the amount that you contribute to the cost of your hospital treatment and is typically paid when you are admitted. Whether or not you need to pay an excess depends on the Westfund policy and level of cover you choose. You may also be required to pay an excess if you have transferred from another health fund that requires you to pay an excess, and if a waiting period still applies to your policy.

Making a claim

If you need to make an extras claim, you can simply swipe your Westfund membership card at any provider that offers on-the-spot electronic claiming. Where this is not an option, you can download a claim form from the Westfund website, fill it out, sign it and return it to the health fund via email, mail or fax. A handy online claims portal is also available through the members area of the Westfund Health website.

In terms of hospital claims, most hospitals will send the bill directly to your health fund. However, in other cases you can lodge a claim via the Westfund website.

Frequently asked questions about Westfund

Question: Does Westfund Health have any branches I can visit?

• Answer: Yes, Westfund operates branches in Lithgow, Mudgee, Bathurst, Orange, Dubbo, Wollongong, Moranbah, Emerald, Maroochydore, Townsville, Mackay and Rockhampton.

Question: How can I join Westfund Health?

• Answer: It’s simple to sign up for a Westfund Health membership online, however you can also phone or email Westfund to run through your cover options before you make your final decision.

Question: Does a waiting period apply to pre-existing conditions?

• Answer: Yes, you’ll need to serve a 12-month waiting period before you can receive any benefits related to the treatment of pre-existing conditions.

Question: Am I eligible for the private health insurance rebate?

• Answer: Whether or not you are entitled to the Australian Government Rebate on private health insurance is determined by your income level. To find out whether you qualify you can examine the income tiers on the ATO website.

Compare health insurance policies online and find the right cover

Westfund Health offers an extensive range of benefits to its members, so consider the cover it offers when you’re looking for a private health fund. Just make sure to compare Westfund Health with other private health funds before you make the all-important decision of where to get cover.