Choosing the cover that’s right for you and your family is important.
Our easy-to-understand reference tables below help you quickly assess the benefits, inclusions and exclusions for each cover.
Remember, we’re always here to help.
Simply call 1300 WESTFUND or email us so we can discuss your options with you.
| Gold | Silver Plus Assure | Silver Plus Nurture | Silver | Bronze | Basic | Waiting Period | |
|---|---|---|---|---|---|---|---|
| More on Gold | More on Silver Plus Assure | More on Silver Plus Nurture | More on Silver | More on Bronze | More on Basic | ||
| Rehabilitation |  |
|
|
|
R |
R |
2 months |
| Hospital psychiatric services | |
R |
R |
R |
R |
R |
2 months |
| Palliative care | |
|
|
|
R |
R |
2 months |
| Brain and nervous system | |
|
|
|
|
R |
12 months |
| Eye (not cataracts) | |
|
|
|
|
R |
12 months |
| Ear, nose and throat | |
|
|
|
|
R |
12 months |
| Tonsils, adenoids and grommets | |
|
|
|
|
R |
12 months |
| Bone, joint and muscle | |
|
|
|
|
R |
12 months |
| Joint reconstructions | |
|
|
|
|
R |
12 months |
| Kidney and bladder | |
|
|
|
|
R |
12 months |
| Male reproductive system | |
|
|
|
|
R |
12 months |
| Digestive system | |
|
|
|
|
R |
12 months |
| Hernia and appendix | |
|
|
|
|
R |
12 months |
| Gastrointestinal endoscopy | |
|
|
|
|
R |
12 months |
| Gynaecology | |
|
|
|
|
R |
12 months |
| Miscarriage and termination of pregnancy | |
|
|
|
|
R |
12 months |
| Chemotherapy, radiotherapy and immunotherapy for cancer | |
|
|
|
|
R |
12 months |
| Pain Management | |
|
|
|
|
R |
12 months |
| Skin | |
|
|
|
|
R |
12 months |
| Breast surgery (medically necessary) | |
|
|
|
|
R |
12 months |
| Diabetes Management (excluding insulin pumps) | |
|
|
|
|
R |
12 months |
| Heart and vascular system | |
|
|
|
 |
R |
12 months |
| Lung and chest | |
|
|
|
|
R |
12 months |
| Blood | |
|
|
|
|
R |
12 months |
| Back, neck and spine | |
|
|
|
|
R |
12 months |
| Plastic and reconstructive surgery (medically necessary) | |
|
|
|
|
R |
12 months |
| Dental surgery | |
|
|
|
|
R |
12 months |
| Podiatric surgery (provided by a registered podiatric surgeon) | |
|
|
|
|
R |
12 months |
| Implantation of hearing devices | |
|
|
|
|
R |
12 months |
| Cataracts | |
|
|
|
|
R |
12 months |
| Joint replacements | |
|
|
|
|
R |
12 months |
| Dialysis for chronic kidney failure | |
|
|
|
|
|
12 months |
| Pregnancy and birth | |
|
|
|
|
R |
12 months |
| Assisted reproductive services | |
|
|
|
|
R |
12 months |
| Weight loss surgery | |
|
|
|
|
|
12 months |
| Insulin pumps | |
|
|
|
|
R |
12 months |
| Pain management with device | |
|
|
|
|
R |
12 months |
| Sleep studies | |
|
|
|
|
R |
12 months |
Covered – Benefits are paid towards hospital and medical services. R Restricted – Minimum benefits are paid towards hospital and medical services. Excluded – No benefits are paid towards hospital and medical services.
Basic Hospital – Hospital and medical services are restricted to public hospitals only.
| Gold | Silver Plus Assure | Silver Plus Nurture | Silver | Bronze | Basic | |
|---|---|---|---|---|---|---|
| Ambulance Cover | |
|
|
|
|
|
| Access Gap agreement | |
|
|
|
|
|
| Excess available including excess waivers for Day Surgery, Dependants and Accidents |
Nil $250 $500 $750 |
Nil $250 $500 $750 |
Nil $250 $500 $750 |
Nil $250 $500 $750 |
Nil $250 $500 $750 |
$500 $750 |
| Accommodation/Travel Benefit | $600 per policy $150 per night for accommodation expenses. A Travel benefit for in/out patient specialist medical services exceeding 150 km round trip. |
$400 per policy $100 per night for accommodation expenses. A Travel benefit for in/out patient specialist medical services exceeding 150 km round trip. |
$320 per policy $80 per night for accommodation expenses. A Travel benefit for in/out patient specialist medical services exceeding 150 km round trip. |
|
|
|
| Advanced Surgery Benefit (per hospitalisation) |
$400 per night, up to $4,800 |
|
|
|
|
|
| Accident Benefit (per hospitalisation) |
$200 per night | $100 per night | $100 per night | $100 per night | $100 per night | |
| Forced Retrenchment / Protected Industrial Action | Waiver of premiums up to six months | Waiver of premiums up to six months | Waiver of premiums up to six months | Waiver of premiums up to six months | Waiver of premiums up to six months | Waiver of premiums up to six months |
Limits are per calendar year unless otherwise stated. Before selected your health cover please review the Policy Summaries. This has full details on important terms and conditions, waiting periods, pre existing conditions and benefits.
Accommodation & Travel, Advanced Surgery and Accident benefits are in addition to Hospital and Medical entitlements.
| Ultimate Pro Extras | Ultimate Extras | Esteem Extras | Advantage Pro Extras | Advantage Extras | Essential Pro Extras | Essential Extras | |
|---|---|---|---|---|---|---|---|
| More on Ultimate Pro | More on Ultimate | More on Esteem | More on Advantage Pro | More on Advantage | More on Essential Pro | More on Essential | |
| General Dental | No Annual Limit | No Annual Limit | $1,600 per person | No Annual Limit | No Annual Limit | $400 S $800 F, C, SP | $400 S $800 F, C, SP |
| Major Dental | $1,800 per person | $1,500 per person | $1,275 per person | $1,125 per person | $1,020* lifetime limit |
| |
| Orthodontia (Lifetime Limit) | Up to $4,000 per person | Up to $3,250 per person |
| Up to $2,500 per person | Up to $2,500 per person |
|
|
| Optical | $400 per person | $350 per person | $250 per person | $250 per person | $250 per person | $250 per person | $180^ per person |
| Chiropractic | $1,250 S $2,500 F,C,SP | $400 S $800 F,C,SP | $600 per person | $300 S $600 F,C,SP | $300 S $600 F,C,SP | $500 S $1000 F,C,SP | $400^ per person combined with Optical and Preventative and Health Management |
| Physiotherapy | $1,250 S $2,500 F,C,SP | $520 S $1,040 F,C,SP | $420 S $840 F,C,SP | $300 S $600 F,C,SP | |||
| Complementary Therapies | $1,000 S $2,000 F,C,SP | $750 S $1,500 F,C,SP | $400 per person | $500 S $1,000 F,C,SP | $500 S $1,000 F,C,SP | ||
| Prescriptions | $100 up to $800 per person | $75 up to $600 per person | $50 up to $500 per person combined with Preventative and Health Management | $50 up to $400 per person | $50 up to $400 per person | $50 up to $400 per person |
|
| Laser Eye Surgery | $2,000 Lifetime limit per person |
|
|
|
|
|
|
| Sunglasses | $100 per person | $75 per person | $50 per person | $50 per person | $50 per person | $50 per person | $50 per person |
| Preventative and Health Management |
|
|
|
|
|
|
^ |
| Non Surgically Implanted Prostheses (see below) |
|
|
|
|
|
|
|
| Ambulance |
|
|
|
|
|
|
|
F = Family, SP = Single Parent Family, C = Couple, S = Single
* Lifetime limit for surgical extraction of wisdom teeth by oral surgeon.
^ Optical grouped with Chiropractic, Physiotherapy, Complementary Therapies and Preventative and Health Management with $180 optical sub-limit applying.
Eligibility and benefits for Non-Surgically Implanted Prostheses vary between covers, refer to the relevant Policy Summaries for full benefit information.
| Blood Pressure Monitor | CPAP Machine | FM Systems |
| Nebuliser | TENS Machine | Orthotics |
| Mammary Prostheses/Brassieres | INR Monitor | Hearing Aids |
| Wigs | Oral Device for Diagnosed Snoring | Mobility Aids |
| Blood Glucose Monitor | EPAP Treatment | Oxygen and Accessories |
| Compression Garments | Burns Suits | Oximeter |
| Peak Flow Meter | CPAP Mask | Low Vision Aids |
| Orthopaedic Boots | CPAP Accessories | Repairs to Devices |
| Braces | TENS Accessories | Artificial Limbs |
Limits are per calendar year unless otherwise specified. Not all benefits are shown in the table. For Terms and Conditions for benefit information, waiting periods, item limits and sub-limits please review the Policy Summary.
