Overview

The fund has almost 100,000 members, with branches across Queensland and New South Wales.

This health fund values giving back to the community, and participates in many local fundraising events and other initiatives, including the annual Westfund Christmas Appeal and a community service called the Vision Screening Program.

Key Points

  • Benefits and perks through the Member Advantages Program.

  • Eye care clinics across regional NSW and QLD provided at no extra cost to members.

  • Online portal to process claims. 

Westfund is not on our panel but you can compare from a range of Australia's leading insurers.

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Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, usually where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, appropriate health cover can help you avoid paying the Medicare Levy Surcharge.

Westfund Health Insurance has a range of hospital-only covers, from Basic to Gold, to suit all budgets and needs.

Their excess options range from $0 through to $750 per calendar year.

If you are looking to compare Westfund health insurance, our team at Compare Club can help.

Basic Hospital

This basic cover provides restricted cover on a few popular services, and is typically taken up by healthy singles and couples on a budget.

Key inclusions:

  •  Unlimited emergency ambulance transport

  • All items except weight-loss and dialysis are covered in a public hospital but with potentially large out of pocket expenses if you are treated in a private hospital.

Bronze Hospital

This entry-level cover provides cover for common treatments, including dental surgery, and is typically taken up by healthy singles and couples on a budget.

Key inclusions: 

  • Unlimited emergency ambulance transport

  • Dental surgery

  • Ears, nose and throat

Silver Hospital

Only pay for what you need with mid-level hospital cover that's suitable for established families and couples.

Key inclusions:

  • Implantation of hearing devices

  • Joint reconstructionsInsulin pumps

  • Medically necessary plastic and reconstructive surgery

Silver Plus Assure Hospital

Higher-level hospital cover suitable for older adults, that covers services likely to be needed later in life.

Key inclusions:

  • Cataracts

  • Dialysis for chronic kidney failure

  • Chemotherapy, radiotherapy, and immunotherapy for cancer

Gold Complete Hospital

This is Westfund's most comprehensive hospital cover, with no exclusions or restrictions. It's a popular option for those wanting to start a family or just want top-tier coverage. This cover is only available when packaged with extras cover.

Key inclusions:

  • Weight loss surgery

  • Pregnancy and birth

  • Assisted reproductive services

Ambulance cover

All Westfund Health Insurance cover options include emergency ambulance transportation.

If you don't want to take out hospital or extras cover, you can purchase emergency ambulance cover on its own.

Note: Emergency ambulance costs for Queensland and Tasmanian residents are covered by their state schemes.

Extras cover

Westfund’s extras reset on January 1 every year.

From dental, to optical, to chiro, and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with the health fund.

Take time to work out what you need and what you're prepared to pay.

If this feels a bit overwhelming, you can speak to one of our experts who can talk you through what is and isn't included in each extras policy.

Westfund Health Insurance offers five extras cover options.

You can purchase a policy on its own or combine it with hospital cover.

Essential Extras

Basic cover for the price-conscious, suitable for healthy young singles, couples, and families.

Key inclusions:

  • Dental

  • Optical

  • Physio 

Advantage Extras

Mid-level cover with competitive rebates and benefits for key services such as optical, dental, physio and chiropractic, plus additional services like orthodontics. This cover is only available when packaged with hospital cover.

 Key inclusions:

  • Optical

  • Chiropractic, physiotherapy and exercise physiology

  • Clinical psychology

Esteem Extras

High-level extras that’s designed for mature singles and couples. This cover has larger limits per person for optical, dental, physio and more.

 Key inclusions:

  • Hearing aids

  • Devices for sleep apnoea

  • Gym membership cover

Advantage Pro Extras

High-level extras that’s designed for growing families, with no annual limit for general dental and has larger limits for optical, physio and more. 

 Key inclusions:

  • Orthodontics

  • Home nursing

  • Psychology

Ultimate Extras

This is the top-tier extras cover with generous limits on a comprehensive range of benefits.

Suitable for those who proactively want to cover the full range of treatments.

 Key inclusions:

  • No annual limit on dental

  • Top up feature of $300 for singles and $600 for families who have gap fees on dental

  • Optical

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Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all health funds apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait. Waiting periods may carry over from your previous health fund, although extra benefits may have longer waiting periods.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

  • 12 months for treatment of a pre-existing condition, pregnancy and birth, hospital accommodation boarding at a hospital or nearby motel by the patient or one Member covered by the same Westfund Policy and inpatient travel available for round trips exceeding 150kms from the member’s home locality to the locality of the hospital

  • 2 months for psychiatric, rehabilitation and palliative care and all other health management and medical services

  • 1 day for accident-related treatment

Extras waiting periods

  • 36 months for  laser eye surgery and hearing aids

  • 12 months for major dental, orthodontic, dental top-up, antenatal classes, health aids & appliances (excluding hearing aids), surgical treatment by a podiatrist and outpatient travel benefits

  • 2 months for optical and health management programs

  • 1 day months for general dental, physio, chiro, pharmacy, podiatry and natural therapies as well as all other health services

Member benefits

Westfund Health Insurance member receive:

  • Discounted member dental services at the Westfund Dental Centre in Lithgow^ and all Westfund Eye Care Centres^^

  • No excess for day surgery, kids or in an accident for private hospital admissions

  • The option to suspend membership for up to six months if you're made redundant or face protected industrial action

  • The option to suspend your membership for up to 24 months due to overseas travel

How to claim

Claim through the Westfund app, email, fax or post. You can also claim on the spot at participating HICAPS providers.

Hospital agreements

Westfund Health Insurance has agreements with many private hospitals and day clinics across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

Westfund Health received 0.9% of complaints in 2021, and has a market share of 0.9%^^^.

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FAQs

1. Is Westfund a not-for-profit fund?

Yes, Westfund is a non-for-profit health fund.

2. Who can apply? Are there restrictions?

Any person over the age of 18 can apply for a Westfund Health Insurance Policy.

Members must comply with the requirements of the fund and give full and complete disclosure on all matters required by Westfund.

3. Is it easy to switch to Westfund?

Westfund isn’t on our panel so it’s best to contact them directly to switch. However, we’re confident the Compare Club teamcan find you a great deal from the insurers on our panel. 

4. Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you generally won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits.

5. Can I change my level of cover?

Yes, you can modify your cover with Westfund directly. If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

6. Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 32.81233.4% (depending on your age and income). To learn what you’re entitled to,read our rebate guide.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You canfind out more here.

8. Up to what age are children covered?

Children and young adults are automatically covered under until they turn 25, but only if they are unmarried or not in a bona fide domestic relationship.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

^Westfund, Westfund Dental Care, accessed 15th December 2021.

^^Westfund, Westfund Eye Care, accessed 15th December 2021.

^^^ Private Health Ombudsman,Westfund Health, accessed 28 February 2022.