Athlete Protect Extras

Benefit Changes from 1 April 2020

This is a corporate product.

At Westfund Health Insurance, we know that providing quality cover that is both easy to understand and use is important.

Our annual review of our products has facilitated a number of changes to your Athlete Protect Extras cover. These changes will come into effect from 1 April 2020 and are outlined below.

It is important that you read and understand this information as it pertains to your benefit coverage. For further information, please don’t hesitate to call us on 1300 937 838 or via email to enquiries@westfund.com.au.

Dental Benefits

Current Benefit New Benefit How this affects you
Benefits for certain dental treatments vary depending whether the treatment is performed by a General or Specialist Dentist.  
Benefits for dental treatment will be the same regardless whether the treatment is performed by a General or Specialist Dentist.  
This will simplify dental entitlements for our members; making it easier to understand the benefits you’re entitled to.  
Some per item benefits that were previously performed by a Specialist Dentist may now receive a lower benefit whereas some item numbers that were performed by a General Dentist may now receive a higher benefit.  
Services covered under the Major Dental limit include Crowns, Bridges, Veneers and Implants.
A 2 month waiting period applies for Oral Surgery, Endodontics and Periodontics.
Additional dental services will now come under the Major Dental limit. These include Dentures, Oral Surgery, Endodontics and Periodontics.
A 12 month waiting period will now apply to Oral Surgery, Endodontics and Periodontics.
Any members who have already served existing waiting periods will not be required to serve any additional waiting period.
Dental Top Up is only available on General Dental and Dentures when completed by a General Dentist. Dental Top Up will now be available on General Dental and Dentures completed by a General or Specialist Dentist. All General Dental and Dentures items are eligible for Dental Top Up regardless if the treatment is performed by a General or Specialist Dentist.

Westfund will provide a transitional period up to 1 October 2020, for pre-scheduled treatment for Dentures, Oral Surgery, Endodontics and Periodontics, please contact Westfund with your applicable dental quote prior to 1 April 2020.

Provider of Choice

Benefit increases to our Dental Provider of Choice (POC) network and Westfund Dental Centre. Westfund has also committed to further expand our POC network including dental, optical and physiotherapy services. The Sunglasses Benefit is now available through selected Optical POC providers.

Podiatry

Additional items for podiatry services have been made available for members to claim including surgical treatment items.

Health Aids & Appliances

To help clarify benefits available on your policy, Westfund has renamed Non-Surgically Implanted Prostheses to Health Aids & Appliances.

Current Benefit New Benefit How this affects you
Devices for Sleep Apnoea and diagnosed snoring include CPAP Machines, EPAP Treatment and Oral Appliances for diagnosed snoring.  Additional items have been added to the Devices for Sleep Apnoea and diagnosed snoring benefit. These include BiPAP, BPAP and APAP Machines. This allows for a broader range of devices to be claimable to assist members who have sleep apnoea or diagnosed snoring.
A benefit of $35 per member, per calendar year is available for Peak Flow Meters. A benefit of $200 per member, per calendar year is available for Nebulisers. No recommendation from a Medicare Registered Practitioner is required to claim these devices. These two devices will now be claimable under a $200 per member, per calendar year benefit for Respiratory Aids. Additional items will also be available under Respiratory Aids including spacer and mucus clearing devices. A lifetime recommendation from a Medicare Registered Practitioner will be required to claim these devices. This will allow a broader range of devices to be claimable to assist with chronic diseases such as asthma, cystic fibrosis and chronic bronchitis.   Recommendation from a Medicare Registered Practitioner will be required and is valid for the lifetime of your policy.
No recommendation from a Medicare Registered Practitioner is required to claim for Compression Garments. Recommendation from a Medicare Registered Practitioner will be required to claim Compression Garments. Recommendation from a Medicare Registered Practitioner will be required when claiming Compression Garments and is valid for the lifetime of your policy.

Recommendation from a Medicare Registered Practitioner will no longer be required when a Health Aid or Appliance is purchased through a Medicare Registered Practitioner. The Practitioner’s name and provider number needs to be included on the receipt.

Antenatal Classes

Current Benefit New Benefit How this affects you
A lifetime limit of $120 per policy was available for antenatal classes and pre/ postnatal consultations The $120 benefit will now be available per policy, per calendar year. This will allow families to claim more frequently for Antenatal Classes and pre/ postnatal consultations including lactation consultations and post-partum assessments.

Westfund will now include Registered Nurses as a recognised provider for Antenatal Classes. This allows for a broader range of claimable services that may be performed by a Registered Nurse.

Travel Benefit

Current Benefit New Benefit How this affects you
No current benefit for travel expenses.     For outpatient medical services, a Travel Benefit of up to $70 per trip is available, with an overall limit of $210 per policy, per calendar year. The Travel Benefit is available for return trips exceeding 150 kilometres. This new benefit assists our rural and regional members with the additional expenses of travelling to receive outpatient medical services such as specialist appointments.