Extras Cover and Waiting Periods
No annual limit

For diagnostic and preventative dental, periodontics, endodontics, fillings and extractions or oral surgery.

Set item benefits depending on service or item number

2 month waiting General Dental
12 month waiting Specialist Dental
No annual limit
$1800 per member per calendar year

To use on major dental treatment like crowns, bridges, implants and veneers.
Dentures are available with no annual limit.

Set item benefits depending on service or item number

12 month waiting period
$1800 per member per calendar year
$500 per calendar year for singles
$1000 per calendar year for couples or families

100% of gap
Use towards eliminating the gap on General Dental and Dentures.
For dental completed by a General Dentist.

12 month waiting period
$500 per calendar year for singles
$1000 per calendar year for couples or families
$4000 lifetime limit

Limit accrues at $800 per member per policy year to use on orthodontics completed by a registered orthodontist with a maximum accrued lifetime benefit of $4000.

General Dentist sub-limit
Sublimit of $640 per member per policy year to use on orthodontics completed by a general dentist with a maximum accrued lifetime benefit of $3200.

12 month waiting period
$4000 lifetime limit
$400 per member per calendar year

100% of fee (up to annual limit) for frames, single vision lenses, bifocal lenses, multifocal lenses, contact lenses.

No benefit towards tinting, coating or add-ons. Benefits also apply for Irlen lenses.

2 month waiting period
$400 per member per calendar year
$1250 per calendar year for singles
$2500 per calendar year for couples or families

Annual limit shared by all members on the policy.

2 month waiting period
Physiotherapy and Exercise Physiology benefits for Ultimate Pro Extras
Group / Class Item Limit Individual Item Limit
Physiotherapy $15 $60
Exercise Physiology $15 $55
$1250 per calendar year for singles
$2500 per calendar year for couples or families
$1250 per calendar year for singles
$2500 per calendar year for couples or families

Annual limit shared by all members on the policy.

2 month waiting period
Chiropractic and Osteopathic benefits for Ultimate Pro Extras
Item Limit
Chiropractic $55
Chiropractic X-ray $80
Osteopathic $55
  • Two chiropractic x-rays per member per calendar year
$1250 per calendar year for singles
$2500 per calendar year for couples or families
$1000 per calendar year for singles
$2000 per calendar year for couples or families
2 month waiting period
12 months for surgical treatment by a Podiatrist
Complementary Therapies Sub-Limits and Rebates for Ultimate Pro Extras
Type Maximum rebate per service Single sub-limits
per calendar year
Family or couple sub-limits
per calendar year
Remedial Massage and Myotherapy $50 $500 $1000
Acupuncture and Chinese Herbalism $50 $500 $1000
Dietetics and Nutrition $65 $500 $1000
Home Nursing $20 (up to 6 hours) $90 (over 6 hours) $500 $1000
Vision (Eye) Therapy $50 $500 $1000
Occupational Therapy $85 $500 $1000
Podiatry
Podiatry Surgical Treatment
$50
100%
$600 $1200
Clinical Psychology $125 $720 $1440
Speech Therapy $80 (initial)
$50 (subsequent)
$500 $1000
$1000 per calendar year for singles
$2000 per calendar year for couples or families
$800 per member per calendar year

$100 per prescription for the amount that exceeds the PBS co-payment for Private, Non-PBS, Non-NHS.

Doctor letter required in some instances (see Membership Terms and Conditions)

2 month waiting period
$800 per member per calendar year
$300 per calendar year for singles
$600 per calendar year for couples or families

100% of fee (up to annual limit) for Fitness Centre, Aquatic Programs, Weight Loss Programs, Virtual Gastric Banding, Diabetes Education, Vitamins, Omega 3 or Probiotics.

Fitness Centre, Weight Loss, Virtual Gastric Banding and Aquatic Programs require a Medicare Registered Practitioner to complete a Health Management Claim Form to confirm the Program is medically necessary.

2 month waiting period
$300 per calendar year for singles
$600 per calendar year for couples or families
Preventative Health Rebates and Annual Group Limits for Ultimate Pro Extras
Type Rebate per service Annual Group Limit (unless otherwise stated)
Preventative Health Tests
(Bone Density Test, Bowel Testing Kit, Calcium Score, Mammogram, Mole Scan, Thin Prep Pap Test)
100% $100 per member
Ear and Eye Preventative Health Checks
(Audiology Test, Corneal Topography, Optical Coherence Tomography, Retinal Photography)
$100 $200 per member
Antenatal Classes and Pre/Postnatal Consultations 100% $120 per policy
Lifetime Limit
Hypnotherapy for Quit Smoking 100% $250 per member
Lifetime Limit
Chronic Disease Association Fees 100% $30 per member
2 month waiting period
12 months for Antenatal
12 month waiting period
36 months for hearing aids
Non Surgically Implanted Prostheses Rebates for Ultimate Pro Extras
Health Aid or Appliance Item limit per member Letter of recommendation required
Artificial Limbs $200 per calendar year Lifetime letter
Braces $200 per calendar year Every 12 months
Compression Garments No
Blood Glucose Monitor $100 per calendar year No
Blood Pressure Monitor $150 per calendar year No
Burn Suits $800 per calendar year Every 12 months
CPAP (sleep apnoea) Machine
EPAP Treatment
Oral Appliance for diagnosed snoring
$750 every 3 years Lifetime letter
CPAP Masks, Accessories and TENS Accessories $100 per calendar year No
INR Monitor $200 every 2 years Lifetime letter
Low Vision Aids $100 per calendar year Every 12 months
Mobility Aids Every 12 months
Mammary Prostheses and Brassieres $400 per calendar year Lifetime letter unless relevant hospitalisation is recorded with Westfund
Nebuliser $200 per calendar year No
Custom Made Orthopaedic Boots $400 per calendar year Every 12 months
Custom Made/Preformed Orthotics $300 per calendar year Every 12 months
Oximeter
Oxygen and Accessories
$750 per calendar year Lifetime letter
Peak Flow Meter $35 per calendar year No
Repairs to Devices $100 per calendar year Every 12 months unless initial purchase of the device is recorded with Westfund
TENS Machine $200 every 3 years Lifetime letter
Wigs $300 per calendar year Lifetime letter unless relevant hospitalisation is recorded with Westfund
Hearing Aids and Frequency Modulated Systems $2000 every 3 years No
Ambulance

Unlimited medically necessary emergency ambulance transport

1 day waiting period

Up to $5,000 per member per calendar year for non-emergency patient transport (eg. Hospital to Hospital transfer)

2 month waiting period
Member Advantages
Westfund member advantages

There's amazing benefits you'll receive because you choose Westfund.

Sunglasses

$100 per member per calendar year
Available only at Westfund Care Centres

Available after 2 months

Laser Eye Surgery

$2000 per member, lifetime limit, services covered are LASIK, SMILE and ASLA

Available after 36 months

Forced Retrenchment / Protected Industrial Action

Waiver of premiums up to six months due to forced retrenchment or protected industrial action.

Available after 36 months

Westfund Services
Optical Bonus

$80 per member to use towards out of pocket costs, accrues to $160 if no optical claims made at any provider in consecutive years
Available only at Westfund Eye Care Centres. Bonus can be used towards prescription glasses and contacts only.

Available after 2 months