It’s a privilege to support our members to invest in their health. Last financial year, we paid almost $220 million in claims for our members – an increase of 15 per cent from 2019/20 and we expect that number to continue to rise. That’s why we need to review benefits and our range of covers annually.

It’s important you read through all of the changes in the changes to your Westfund benefits communication that you received in February. This communication outlines all the changes that apply to you. 

Changes to the name of your cover

From 1 April 2022 or 1 August 2022, you'll see the name of your Hospital cover or Extras cover change. We want to help our members find a level of cover that suits them and this starts by ensuring the name of your cover matches the benefits you can claim. 

  • Bronze Hospital name will change to Bronze Plus Hospital
  • Bronze 250 Hospital name will change to Bronze Plus 250 Hospital
  • Bronze 500 Hospital name will change to Bronze Plus 500 Hospital
  • Bronze 750 Hospital name will change to Bronze Plus 750 Hospital.

Hospital cover name changes and product migrations from 1 August

  • Members on Gold 750 Hospital will be moving to Gold Complete 750 Hospital. Don't worry, your benefits and cover haven't changed. You'll notice that from now on, all of your documentation and online interactions will refer to your cover as Gold Complete 750 Hospital
  • Members on Gold 250 Hospital, you’ll see the name of your cover change to Gold 500 Hospital
  • Members on Basic 500 Hospital, you’ll see the name of your cover change to Basic 750 Hospital.


Transitional measures are in place for members on Gold 250 Hospital and Basic 500 Hospital. Please refer to 'Transitional Measures' further down for more information about how these changes will apply to you. 

Extras cover name changes from 1 April

  • Advantage Extras name will change to Mid Extras
  • Advantage Pro Extras name will change to High Extras
  • Essential Extras name will change to Starter Extras
  • Esteem Extras name will change to High Extras Over 50s.

Changes to Hospital cover

We're making some changes. These are outlined below.

We’ve introduced our Cancer Support Complete program to support members who’ve had a cancer diagnosis and require help navigating their treatment. Cancer Support Complete is a digital health program delivered by a team of experienced nurses and allied health oncology professionals to provide high quality, personalised cancer support from the comfort of home. You can find out more about Cancer Support Complete here.

Transitional Measures

We’ve changed your excess amount.

If you’re on our Gold 250 Hospital or Basic 500 Hospital cover, your excess will increase from 1 August. If you've planned or are undergoing treatment following 1 August 2022, we have some transitional measures that may be relevant to you. If you have any questions about this change, please get in touch with us on 1300 937 838 or email [email protected].

Current cover Current excess amount New excess amount from 1 August 
Gold 250 Hospital Your excess of $250 is payable once per adult member per
calendar year.

An excess of $500 will apply to your cover and is
payable once per adult member per calendar year. Remember, you don’t need to pay any excess for private hospital admissions, if you’re admitted as a private patient due to an accident or for any dependants on your membership.

Basic 500 Hospital

Your excess of $500 is payable once per member per
calendar year.

An excess of $750 will apply to your cover and is
payable once per member per calendar year to a maximum of $1,500 per cover.
Situation  Excess Increase
If your treatment has commenced (you’re admitted to hospital before 1 August 2022) Not applicable.
If you’re receiving a course of treatment  If you’re currently receiving a course of treatment (e.g. chemotherapy, dialysis, psychiatric or rehabilitation) your current excess will apply for the duration of the course of this treatment or a continuous period of up to six months from 1 August 2022 (when your new excess applies), whichever occurs first.
If you have booked your treatment before 1 August 2022 If the hospital has received your booking before 1 August 2022, your current excess will apply to that admission. We've outlined below how your current excess may apply to your upcoming hospital admission:
  • The hospital has received the completed necessary forms for your admission or has been notified by your doctor about your admission
  • Your hospital admission is between 1 August 2022 and 31 January 2023.
If you’re being admitted after 1 August 2022 If you’re admitted after 1 August 2022 and no other pre-arrangements have been confirmed prior, your new excess will apply.


We will honour any upcoming admissions that have been booked before 1 August 2022, as long as you have advised us or have had an Online Eligibility Check (OEC) completed by the hospital before 1 August 2022.

Changes to Extras cover

We're making some changes. These are outlined below.

Changes to our Fund Rules
Our Fund Rules are a framework that help us define member benefits, claiming conditions and terms and conditions of your membership with Westfund.

Pharmacy
We’ve added some additional points to help you understand your pharmacy benefits.
• To be able to be claimed, a pharmaceutical item must be a Schedule 4 or Schedule 8 item (relating to the Poisons Standard) and also not be supplied under the Special Access Scheme.
• In some instances, a letter is required from a Medicare-registered practitioner to support your claim. We’re removing this annual condition and a letter will now only be required for the duration of your membership.
Learn more

Vitamins
We’ve clarified the wording in our Fund Rules relating to your claimable benefits for vitamins.
• New conditions clarify that to be claimable, a vitamin must not be a Schedule 4 or Schedule 8 item (relating to the Poisons Standard). These items may be claimed under pharmaceutical benefits.
• Vitamins also exclude items supplied under the Pharmaceutical Benefits Scheme (PBS).
Learn more

We’re changing the ‘Optical Bonus’ for members who visit a Westfund Eye Care Centre

Your current cover - now
The Optical Bonus ranges between $10-$80 per member per calendar year, accruing to $20-$160 if you don't make an optical claim at any provider in the year previous.

Your cover from 1 April
We’ll give you between $15-$100 (depending on your level of cover - please refer to your correspondence history on Members Online or the app) per member each year, on top of your existing optical benefit when you use your benefits at a Westfund Eye Care Centre. For members on Starter Extras, the optical bonus is now included under your Annual Group Limit.

What this means for you
We’re not changing your optical limits or benefit amounts when you attend any registered provider. If you use Westfund Eye Care, you’ll receive an extra amount between $15-$100. Benefits are only payable for prescription glasses/contacts (no tinting, coating or add ons).

We’re removing the overall claiming limit on Other Therapies.

Your current cover - now
You currently have an Annual Group Limit that applies to the Other Therapies component of your Extras cover. This applies to services such as remedial massage, podiatry, acupuncture and psychology.

Your cover from 1 April 
We’ll remove the Annual Group Limit from 1 April, so it will no longer apply (item and sub-limits will apply).

What this means for you
You’ll be able to access more benefits under the Other Therapies component of your cover. There’s no change to your existing item limits and sub-limits.

Expanding access to Counselling services

Your mental health is important and we know that services can often be hard to access. That’s why we’ve added, effective 1 April 2022, counselling services to your Clinical Psychology benefit for eligible members. This means you’ll now be able to claim on services from accredited, Westfund-recognised counsellors.

More information

Why is my excess changing?

Westfund offers different excess options across our Gold, Silver, Bronze and Basic Hospital products. Not all excess options are available on all Hospital products. That's why your excess is changing on your Hospital policy as it is no longer available. 

If you’ve planned or are undergoing treatment following 1 August 2022, we have some transitional measures that may be relevant to you. If you have any questions about this change, please get in touch with us on 1300 937 838 or email [email protected]

Why are you moving me onto a different hospital product?

We want to help our members find a level of cover that suits them and this starts by ensuring the name of your cover matches the benefits you can claim.

While the name and excess level may be changing you are still covered for the same services as you are currently.