Continuity of Cover

If you transfer to Westfund from another registered health fund we will guarantee continuity of cover for the benefits included in your previous cover. This applies only to the benefits you were entitled to under your previous cover, as long as they are included in your new Westfund cover.

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
Accident-related 1 Day
Psychiatric, Rehabilitation and Palliative Care 2 Months
Obstetric-related services (single membership must upgrade to family 2 months prior to expected day of birth) 12 months
Treatment of a pre-existing condition 12 Months
All other services 2 Months

The following waiting periods apply to benefits payable for General Treatment:

Extras Waiting Periods
Emergency Ambulance Transport, Accident Benefit 1 Day
Non-emergency Ambulance Transport, General Dental, Optical, Chiropractic, Osteopathy, Physiotherapy, Exercise Physiology, Complementary Therapies, Prescriptions/Vaccinations/Injections, Prevention and Health Management (excluding antenatal classes) 2 Months
Specialist Dental, Major Dental, Orthodontia, Dental Top-Up, Antenatal Classes, Non-Surgically Implanted Prostheses, Sunglasses, Surgical Treatment by a Podiatrist 12 Months
Accommodation Benefit, Advanced Surgery Benefit 24 Months
Forced Retrenchment, Protected Industrial Action 36 Months
Hearing Aids 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.