For more information about your policy conditions, refer to Membership Terms and Conditions.

Transferring from another fund.

If you transfer to Westfund from another registered health fund we will guarantee continuity of cover for the benefits included in your previous cover. More information.

Waiting Periods

Benefits are not payable in respect of services provided during a waiting period.
The following waiting periods apply to benefits payable for Hospital Treatment:

Hospital Waiting Periods
Hospital Waiting Periods
Accident-related hospitalisation 1 day
Hospital Psychiatric Services, Rehabilitation and Palliative Care
A Member who has held a Policy with Hospital cover for at least 2 months and upgrades to a Policy which includes psychiatric treatment may elect to waive the 2 month Waiting Period that applies to psychiatric treatment upon upgrade. This waiver can only be accessed once in a Member’s lifetime.
2 Months
Pregnancy and Birth 12 Months
Accommodation Benefit 12 Months
Inpatient Travel Benefit 12 Months
Treatment of a pre-existing condition 12 Months
Chronic Disease Management Programs 12 Months
All other services (not listed above) 2 Months

The following waiting periods apply to benefits payable for Extras:

Extras Waiting Periods
Extras Waiting Periods
Emergency Ambulance Transport 1 Day
Non-emergency Ambulance Transport, General Dental, Optical (excluding Laser Eye Surgery), Chiropractic, Osteopathy, Physiotherapy, Exercise Physiology, Complementary Therapies, Prescriptions/Vaccinations/Injections, Sunglasses, Prevention and Health Management (excluding antenatal classes) 2 Months
Major Dental, Orthodontia, Dental Top-Up, Antenatal Classes, Health Aids & Appliances (excluding Hearing Aids), Surgical Treatment by a Podiatrist, Outpatient Travel Benefit 12 Months
Hearing Aids, Laser Eye Surgery 36 Months

The following Waiting Periods apply to Benefits payable for Member Advantages:

Member Advantages Waiting Periods
Member Advantages
Forced Retrenchment Suspension 36 Months
Protected Industrial Action Suspension 36 Months

The Commonwealth Ombudsman also provides general information about waiting periods.

Policy Conditions

Before you select your health plan please review the policy summary which can be found at the top of each product page. This has full details on the important Terms and Conditions, waiting periods and benefits available.

What is a pre-existing condition?

A pre-existing condition is an illness or condition for which, in the opinion of a medical practitioner appointed by Westfund, signs and symptoms existed during 6 months before the date you joined Westfund or upgraded to a higher level of cover. A 12 month waiting period applies to all new members for hospital costs relating to the treatment of pre-existing conditions.

Should you wish to claim a benefit for hospital treatment before this period ends, you will need to ask your certified medical practitioner to complete the Medical Practitioner Certificate regarding ‘Pre-Existing Ailments’ form. This certificate helps Westfund determine the level of health insurance benefits that will apply when hospitalisation is required for members who have been with Westfund for less than 12 months. Once this period is over you are entitled to the full benefits available under your policy.

Cooling off period

If you’ve just joined Westfund or changed to a different level of cover, you have a 30 day review period from the date your policy starts.

During this period, if you don’t want the cover or want to change it, you can. We’ll either refund your premium or transfer you to a different level of cover. If you choose a higher level of cover, you’ll have to pay the additional premium from the start date of your cover. Any waiting periods associated with the higher level of cover will also apply.

This review period does not apply if a claim has been paid during the 30-day cooling off period.