100% of gap (up to annual limit) to use towards eliminating the gap on General Dental and Dentures.
For dental completed by a General Dentist.
To use on major dental treatment like crowns, bridges, implants and veneers.
Dentures are available with no annual limit.
Limit accrues at $650 per member per policy year to use on orthodontics completed by a registered orthodontist with a maximum accrued lifetime benefit of $3250.
General Dentist sub-limit
Sublimit of $520 per member per policy year to use on orthodontics completed by a general dentist with a maximum accrued lifetime benefit of $2600.
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.
Annual limit shared by all members on the policy.
| Group / Class Item Limit | Individual Item Limit | |
|---|---|---|
| Physiotherapy | $10 | $52 |
| Exercise Physiology | $10 | $40 |
Annual limit shared by all members on the policy.
| Item Limit | |
|---|---|
| Chiropractic | $40 |
| Chiropractic X-ray | $70 |
| Osteopathic | $40 |
For diagnostic and preventative dental, periodontics, endodontics, fillings and extractions or oral surgery.
Set item benefits depending on service or item number
| Type | Maximum rebate per service | Single sub-limits per calendar year |
Family or couple sub-limits per calendar year |
|---|---|---|---|
| Remedial Massage and Myotherapy | $35 | $350 | $700 |
| Acupuncture | $35 | $350 | $700 |
| Dietetics and Nutrition | $55 | $350 | $700 |
| Home Nursing | $18 (up to 6 hours) $72 (over 6 hours) | $225 | $450 |
| Vision (Eye) Therapy | $35 | $350 | $700 |
| Occupational Therapy | $70 | $350 | $700 |
| Podiatry Podiatry Surgical Treatment |
$42 100% |
$336 | $672 |
| Clinical Psychology | $100 | $420 | $840 |
| Speech Therapy | $60 (initial) $42 (subsequent) |
$384 | $768 |
$75 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)
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.
| Type | Rebate per service | Annual Group Limit |
|---|---|---|
| Preventative Health Tests (Bone Density Test, Bowel Testing Kit, Calcium Score, Mammogram, Mole Scan, Thin Prep Pap Test) |
100% | $45 per member |
| Ear and Eye Preventative Health Checks (Audiology Test, Corneal Topography, Optical Coherence Tomography, Retinal Photography) |
$80 | $160 per member |
| Antenatal Calasses 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 |
| Health Aid or Appliance | Sub-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 |
Unlimited medically necessary emergency ambulance transport
1 day waiting periodUp to $5,000 per member per calendar year for non-emergency patient transport (eg. Hospital to Hospital transfer)
2 month waiting periodThere's amazing benefits you'll receive because you choose Westfund.
$75 per member per calendar year
Available only at Westfund Eye Care Centres
Available after 2 months
Waiver of premiums up to six months due to forced retrenchment or protected industrial action.
Available after 36 months
Member Fees at Westfund Dental Centre, Lithgow and Westfund Eye Care Centres.
Available after 2 months
$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
