Premium Increase and Benefit Changes 2021

Why are my premiums changing?

We get it – no one likes paying more. However, as health care costs and usage continue to rise, it’s our job to balance premiums with our ability to deliver the same quality cover and outstanding service that you’ve come to expect from us. 

As a member-owned fund, increasing premiums is never our first choice but we need to ensure we’re maintaining our commitments to our members and their access to quality and timely healthcare.

We’ve answered some of the most commonly asked questions about the changes to the cost of your premiums. We want you to be happy with your cover and to understand any changes and how they apply to you.

If you want to discuss your cover with us, get in touch and we'll be happy to help.

Common questions

My premium just increased in October – why is it increasing again so soon?

Many health funds delayed the planned April 2020 rate increase for six months to help offset the impact of the COVID-19 pandemic. That’s why premiums increased in October 2020.

Unfortunately, this was close to the regular annual premium increase in April.

Even though COVID-19 is still present in Australia, it has not impacted the increases we see in hospital and medical costs.

In fact, despite the COVID-19 restrictions, for the 12 months to September 2020, Australian health funds paid a record $22 billion in benefits on behalf of their members for 90.3 million subsidised hospital and extras services.

Source - Private Healthcare Australia.

I rarely claim but my premium is increasing. Why?

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.

Why do premiums need to increase during the COVID-19 pandemic?

We have continued to provide support and to pay claims for our members throughout COVID-19.

Our support has included:

  • paused premium increases,
  • access to financial hardship support,
  • access to Telehealth services,
  • an expanded suite of Health and Wellbeing programs.

As a not-for-profit health insurer, our focus is on providing higher than average benefits back to our members, ensuring we deliver the best value for money we can.

When does the increase take effect? When will I know my new premium?

Premium increases are effective as of 1 April 2021. Payments made on or after this date will be calculated at the new rate.

We notified members in early February of their new premium by direct correspondence. How you received this information depends on your correspondence preference – if you opted in for email, keep an eye on your inbox. Otherwise, your notification would have been sent via post.

Why is my premium increasing more than the average figure?

The widely reported ‘headline rate’ is an average of all health funds’ increase percentage, Australia wide.

We take any changes to premiums seriously, and assess any changes on a product-by-product basis. As your premium relates to your specific cover, it may differ to the Westfund or national average.

Why don’t extras benefits go up when the premiums go up?

As we are not-for-profit and invested in the satisfaction of our members, we’re always looking for ways to improve benefits and services.

We review our benefits regularly to make sure we are offering good value, especially on the services our members want most. Don’t just take our word for it - you can see how our benefits compare to other health funds on the Federal Government’s comparison tool.

This is an independent Australian Government comparison site which also provides more information about private health insurance, including premium costs.

What is rate protection? How far ahead can I pre-pay?

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 2021.

Your membership can be paid up to 1 October 2022.

Are all products having a premium increase?

All products except Advantage Pro Extras and Essential Extras are having a premium increase on 1 April 2021.

Our members claiming the Australian Government Rebate on private health insurance will notice an increase to their premium due to the change in the Rebate Adjustment Factor (RAF).

Is my direct debit/payroll payment automatically adjusted?

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 2021 to ensure your policy remains up to date.

I can’t afford this increase. What are my options?

We don’t want members who are experiencing financial distress right now to be burdened with additional concerns about premium payments.

Please don’t hesitate to get in touch. We’re here to discuss any possible impacts of this premium increase and any options available, including:

  • 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