Question 1

How do I switch to Westfund?

Accepted Answer

Switching is easy, you can do it in just three short steps:

Get a personalised quote to meet your needs.
Join online by answering a few quick questions.
That's it! We’ll cancel your old policy for you and handle all the paperwork. All you’ll need to do is cancel your direct debit with your previous fund, if you have set this up. Find out more.

Need more information? You can call us on 1300 937 838 to set up your Westfund membership.

Question 2

What is a Transfer Certificate?

Accepted Answer

A Transfer Certificate, also known as a Clearance Certificate, serves as a record of your health insurance coverage. The Certificate confirms the following details:

Type of cover (e.g. Hospital, Extras)
Level of cover
Join date
Cancellation date
Lifetime Health Cover (LHC)
A history of your recent claims
Savings Provision Entitlement
Mental Health exemption waiver
Age-Based Discount

Question 3

What's the cooling off period?

Accepted Answer

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.

Question 4

Who is eligible for a concession card discount?

Accepted Answer

Members who live in NSW or ACT and have valid concession card details listed on their membership are entitled to a 1% discount on their hospital cover.

Members must have a Hospital cover (excluding Overseas cover). If you’re on a combined Hospital and Extras cover, the discount only applies to the hospital portion.
NSW/ACT residential address must be listed on the membership.
All adults on the membership must be on a valid concession card – that means for a couple or family membership, both the main member and their partner must be on a valid card.

The concession card discount can’t be backdated, so it’s important to make sure your details are up to date. If your details change, just head to Members Online to update them. Alternatively, you can call our friendly team on 1300 937 838 and we can update them for you.

Question 5

Who is a dependant?

Accepted Answer

There's plenty of jargon involved with private health insurance - this can even include different terminology around the types of people who are covered. One example is dependants - what does 'dependant' mean for us?

To be eligible on a parent or guardian/s policy, a dependant can be:

aged up to 31 years, without a partner or;
a dependant with a disability over 31 who participates in the National Disability Insurance Scheme (NDIS).

Family cover

If you've got family cover, your dependant/s can be covered up to the age of 25 regardless of whether they're a student or not.

Extended cover

Once your dependant turns 25 and you want them to remain on your cover, you will need to upgrade to extended cover available on eligible cover. This will cover your dependant up to 31.

Disability dependant cover

Once your dependant turns 31, is a participant in the National Disability Insurance Scheme (NDIS) and holds an active NDIS plan, you can upgrade to family disability dependant cover on eligible cover. Visit the NDIS website for more information on eligibility. Visit the NDIS website for more information on eligibility.

It is important to note that Westfund's definition of a dependant differs to the Australian Taxation Office's definition.

An active NDIS plan will be issued to an eligible person with a disability, containing an expiry date. During this time, they will be eligible for disability coverage. If the plan is reviewed, members must provide an updated end date once it is approved. If the plan expires the dependant with a disability is no longer eligible to be covered under the disability cover type.

Common questions

Question 6

What is the Provider of Choice Network and why should I use it?

Accepted Answer

We want to encourage our members to make full use of your benefits and have regular check-ups and preventative treatments. That’s why we’re proud to have a strong network of dental and physio providers who work with us to help lower or eliminate out-of-pocket costs on selected treatments.

Question 7

What are my benefits/waits when transferring from another fund?

Accepted Answer

Transferring between health insurers can be confusing - moving to a different fund and different policy means that there are some things to consider and be aware of.

One of the most commonly discussed topics is what moving to Westfund means in terms of waiting periods and benefits.

Portability rules protect people who want to change to another private health insurance policy with their current insurer or another insurer.

If you're transferring from another health fund, provided there’s been no break in coverage when leaving your previous fund, good news - you won't need to re-serve any waiting periods that you have already served.

Waiting periods will apply for:

Any benefits or services under your Westfund policy which weren’t included in your previous cover.
Waiting periods not fully served under your previous cover. If you've partially served waiting periods, you'll only need to serve the remainder of the waiting period before being able to claim; the waiting periods won't start again when you move to Westfund.
Any benefits or services provided under your previous cover where the benefit provided by your new Westfund policy is higher. This means that if your Westfund policy has any new services, high benefits and/or higher annual limits that weren't on your previous policy, you'll need to serve any applicable waiting periods. This also applies if you decrease the excess on your hospital cover.

When transferring from another health insurer, we'll ask your previous fund to provide us with a copy of your Transfer Certificate, which outlines which waiting periods you've served and what benefits you had available/used on your previous cover

Want to know more?

The Commonwealth Ombudsman provides comprehensive information for anyone transferring between health funds - read more here.

Question 8

How do I know what my policy covers me for?

Accepted Answer

If you need to find out what you’re covered for, check your policy summary - it contains everything you need to know, including:

• Key features of your product
• Treatments included, excluded or restricted on your policy
• Any excesses that apply (if applicable)
• Waiting periods
• Details about your Ambulance cover

You can view your Policy Summary on Members Online or on our app.

Still not sure? We’re here to help. Give our team a call on 1300 937 838 and we’ll be able to check for you. Don’t have time to call? Email us.

Question 9

Where can I find my Policy Summary and other membership details?

Accepted Answer

You can view your Policy Summary on Members Online or on our app. Other membership details you can view on either of our online services is your premium amount, cover type, card details and who is on your membership.

Switching to Westfund

How to switch

Understanding your cover