Athlete Silver Plus Hospital

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 Silver Plus Hospital 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.

Excess waivers

Current excess waivers New excess waivers How this affects you
No excess is payable for private or public hospitals, if you are admitted as a private patient due to an accident, same-day procedures or for dependants.

Excess of $500 is payable once per adult member, per calendar year.
No excess payable for private hospitals, if you are admitted as a private patient due to an accident or for a same-day procedures. No excess payable for admissions to a private or public hospital for dependants.

Excess of $500 is payable once per adult member, per calendar year.
Adult members will be required to pay their excess when admitted to a public hospital as a private patient for all hospitalisations.

This change has no impact on your current hospital inclusions.

If you have scheduled or are undergoing treatment at a public hospital following 1 April 2020, Westfund has implemented transitional arrangements that may be relevant to you.
Jump to transitional arrangements explained

Members are required to pay an excess when:

Admitted to Private Hospital

Admitted forSame-day
procedure
AccidentAll other admissions
Main Member or Spouse / Partnerxx
Dependantsxxx

Admitted to Public Hospital

Admitted forSame-day
procedure
AccidentAll other admissions
Main Member or Spouse / Partner
Dependantsxxx

Removal of the Accident Benefit

Current Benefit From 1 April 2020 How this affects you
A benefit of $200 per night for admissions due to an accident. To comply with Australian Government legislation, this benefit will be removed. This benefit will no longer be available for admissions due to an accident. This will have no impact on your current hospital and medical entitlements.

Savings from the removal of this benefit have been reinvested into the Accommodation and Travel Benefit.

Accommodation and Travel Benefit

Current Benefit New Benefit How this affect you
No current benefits for Accommodation and Travel expenses.  An uncapped per calendar year Accommodation and Travel Benefit is now available. Benefits for Accommodation expenses are paid for the night before admission to hospital, the nights during and the night of discharge. Nights 1-4 will be paid at $80 per night and nights 5 and onward will be paid at $30 per night. A Travel Benefit of up to $70 per admission is available for inpatient medical services. The Accommodation and Travel Benefit is available for return trips exceeding 150 kilometres. The new Accommodation and Travel Benefit further assists our rural and regional members with the additional expenses of travelling to receive medical treatment in hospital.

Transitional Arrangements Explained

Westfund will apply transitional measures for a period of six months following the change of the hospital excess waiver. From 1 April 2020, the following transitional arrangements will apply for the removal of excess waivers. Examples of transitional measures are provided below;

  • Treatment commenced: For patients admitted prior to the effective date of the excess waiver change but discharged on or after 1 April 2020, the excess waiver will apply.
  • Pre-bookings: For patients with a booking received by the hospital prior to 1 April 2020, including bookings notified by the doctor or where the patient has completed the necessary forms, but where admission occurs within six months of the date of excess waiver removal, the excess waiver will apply.
  • Course of treatment: For all patients undertaking a course of treatment (e.g. chemotherapy, dialysis, psychiatric, rehabilitation), the excess waiver applies for the duration of the course of treatment or a continuous period of up to 6 months from the excess waiver change, whichever occurs first.
  • Emergency admissions: For emergency admissions the excess waiver will apply for a continuous period of at least 6 months.

If you believe you meet one of the above criteria please contact Westfund on 1300 937 838 or enquiries@westfund.com.au with all relevant information relating to your hospitalisation.