Premium increases are a result of various factors that contribute to the rising cost of healthcare each year. Some of these include:

• Advances in medical technology
• Inflation in medical and hospital costs
• Increased community demand for hospital and general treatment services

Health insurance premiums can vary widely based on several factors, including location, level of coverage, and the pricing structure. Premiums may range from affordable options to more comprehensive policies with higher costs. Additionally, government incentives such as Lifetime Health Cover loading (LHC), Age-Based Discounts (ABD), and the Australian Government Rebate can affect your premium. 

Our online quote tool can assist you in comparing different products to ensure you choose the right level of cover for your needs. Alternatively, get in touch with us for assistance.

All private health insurers in Australia operate under the ‘Community Rating’ system – it’s a government requirement.

Community Rating means all consumers are entitled to buy the same product, at the same price and are guaranteed the right to renew their policy. There are some exceptions to this, for example Lifetime Health Cover and Age-Based Discounts.

A health fund cannot refuse to insure you or refuse to sell you any policy you want to buy on the basis of your health or how likely you are to claim.

Basically, regardless of how you use (or don’t use) your cover, we don’t charge you differently based on your health status or age.

Many of our members are feeling the strain of rising living costs, and we’re committed to doing everything possible to minimise premium increases. Our goal is to keep any changes sustainable while ensuring we continue to deliver real value to our members.

Here’s how we’re working to manage costs and protect access to quality healthcare:

Efficient cost management

• Negotiating competitive rates: The Australian Health Service Alliance work with hospitals and doctors to secure fair pricing, delivering the best value for our members.
• Preferred provider networks: Our partnerships with trusted healthcare providers help lower costs without compromising the quality of care.

Investing in preventative health

• Health and wellbeing programs: We support initiatives that promote healthier lifestyles, reducing the need for expensive medical treatments.
• Chronic disease management: By assisting members with chronic conditions, we help prevent costly hospital visits and long-term complications.

Streamlined operations

• Reducing overheads: As a not-for-profit organisation, we reinvest surplus funds to enhance member benefits, improve technology, and optimise efficiency.
• Leveraging digital technology: Our innovative tools simplify claims processing and administrative tasks, saving time and money.

Expanding our membership base

• Sustainable growth: Welcoming new members allows us to distribute costs more evenly, easing pressure on premiums for everyone.

Review your policy in Members Online or the Westfund app

• Make sure your policy still meets your healthcare needs.
• Check the excess on your policy. For example, paying a higher hospital excess can lower your premium.
• If your income has changed, make sure you’re getting the rebate you’re entitled to.

Make the most of our find a provider tool

Find a provider in our network. We’re proud to have a strong network of dental and physiotherapy providers who work with us to help lower or eliminate out-of-pocket costs on selected treatments.

Our handy ‘find a doctor or hospital’ search tool can help you review and choose a specialist based on their bio, location and how often they participate in the Access Gap Cover Scheme. This scheme means specialists have agreed to charge our members no gap or a lower gap for their procedure, helping you reduce your medical out-of-pocket costs.

Know your coverage and out-of-pocket costs before booking your treatment 

When discussing treatment options with your healthcare provider, don't hesitate to ask questions. Open discussions with both your healthcare provider, the hospital and us ensure you're making well-informed choices for your care and budget. To make these conversations easier, we've put together some questions to guide discussions with your treating specialist and hospital. 

Questions to ask your treating specialist:

• What are the item numbers for my procedure or treatment?
• How much will you charge for the procedure?
• Do you participate in the Access Gap Cover Scheme?
• Will I need to pay a gap? If so, how much will it be? Can you provide me a written cost estimate (sometimes known as Informed Financial Consent)?
• When would I need to pay the gap?
• What options are available if I can’t afford the gap?
• Which other medical professionals will be involved in my treatment or recovery?
• How can I find out their fees?

Questions to ask Westfund:

• Is this hospital a Westfund contracted private hospital?
• Are there any out-of-pocket costs for me to pay? 
• Do I have an excess or co-payment on my policy?
• Am I entitled to claim any other benefits in relation to my hospital admission?

Questions to ask your hospital:

• Are there any additional out-of-pocket costs I should expect during my hospital stay? Can you provide me a written cost estimate (sometimes known as Informed Financial Consent)?
• If I need to pay an excess or other out-of-pocket expenses, when will payment be required?

Prioritising Preventative Health Checks

Preventative health checks are an essential part of maintaining your overall wellbeing. They’re not just about catching problems early —they’re also about supporting a healthier, longer life while helping you save on healthcare costs in the long run.

If you hold an eligible Extras cover and have served the two-month waiting period, you may be able to claim a benefit towards the cost of certain Preventative Health Checks. Your Policy Summary will provide detailed information on your level of benefit and any limits that apply.

Preventative Health Checks assist members in detecting chronic conditions like cancer or osteoporosis in their early stages, enabling timely intervention and improving future health outcomes.

What Preventative Health Checks are covered?

Preventative Health Checks include but are not limited to:

• Cancer Screening Checks
• Cardiac Screening Checks
• Chronic Disease Screening Checks
• Musculoskeletal Screening Checks
  
  

Learn more about Preventative Health Checks here.

Giveback for Good Health Package

Westfund’s Member Giveback for Good Health, a major initiative designed to support you with everyday health costs and improve access to care.

We’re reinvesting approximately $7 million* in 2026 through a suite of practical, value-driven measures that deliver real, tangible support to you, our members. This initiative will be available from 1 January 2026 to 31 December 2026. Learn more. 
*Estimated based on utilisation modelling

Make the most of our find a provider tool

Find a provider in our network. We’re proud to have a strong network of dental and physiotherapy providers who work with us to help lower or eliminate out-of-pocket costs on selected treatments.

Our handy ‘find a doctor or hospital’ search tool can help you review and choose a specialist based on their bio, location and how often they participate in the Access Gap Cover Scheme. This scheme means specialists have agreed to charge our members no gap or a lower gap for their procedure, helping you reduce your medical out-of-pocket costs.

Explore digital health programs available with your membership on our Health Co-Op

We’ve brought together some of the best digital healthcare programs and providers who are united by our mission to make great healthcare accessible to all.

We’re focused on connecting our members to evidence-based, high quality and affordable healthcare solutions no matter where they live.

The Westfund Health Co-Op will continue to grow and evolve in line with the needs of our members. We encourage all members to visit the Co-Op, so make sure you keep an eye out for our newest resources.

Westfund Online Services 

We want you to have the best experience possible when it comes to managing your membership, whether that’s in-person in a Care Centre, over the phone or online.

That’s why we offer a range of online services to allow you to manage your membership your way. Members Online and the Westfund app are convenient, easy-to-use tools to help you make the most of your membership.

With our online services, members can enjoy the benefits of:

• Contactless claiming 
  Access your membership card on your phone for fast and convenient claiming. 
  
• Simpler claiming
  Make a claim in a few short steps using our online services.
  
• Check Extras limits
  Quickly and easily check your Extras benefits usage anytime, anywhere.
  
  

Westfund+ app 

Whether you’re keeping up with routine health checks, finding health services near you, or looking for ways to get more from your cover, Westfund+ puts everything you need right at your fingertips. 
•    Annual health check-ups at participating pharmacies
•    Health check reminders when you need them
•    Pro tips to get more out of your cover
•    Explore mental health pathways & connect with Westfund partners 
•    A preventative health plan built for you 
Learn more. 

Refer a Friend and earn up to $500 in eGift cards

Our Refer a Friend program lets you refer up to 5 friends each year, earning you up to $500 in eGift cards (terms and conditions apply).

Premium changes are effective as of 1 April 2026. Payments made on or after this date will be calculated at the new rate.

We let members know in March of their new premium from 1 April 2026 via email or mail (depending on their communication preference). Search for "Changes to your Westfund premium and benefits" or "Changes to your Westfund premium" in your inbox if your preference is email. Please check your junk folder if you don't see the email in your inbox. 

Our members can lock in their current rate by paying their premiums up to 18 months in advance. If you want to do this, you just need to make a payment before 31 March 2026.

• Changing how often you make your payments. By making payments more often, each payment can be more manageable.
• Choosing a cover with an excess. Our excess options on selected covers include Nil, 250, 500 and 750.
• Choosing a Hospital only cover
• Choosing an Extras only cover

Yes – we’ll take care of your payroll or direct debit payments for you. Just a reminder, if you pay via BPAY, you'll need to adjust your payment from 1 April 2026 to ensure your policy remains up to date.