This product meets the Department of Immigration and Border Protection (DIBP) VISA requirements for a 457 Working Visa and relevant subclasses.
Westfund will pay towards your theatre fees, hospital accommodation and prosthetic costs when you are admitted to a contracted hospital.
Services which Westfund covers to a limited extent and pays reduced benefits on hospital admissions. The benefit is not sufficient to cover the cost of a private room in a public hospital or any room in a private hospital. If you are admitted to a private hospital for services that are restricted, large out-of-pocket expenses will apply. If the services are eligible under Medicare, you can still receive treatment as a public patient - however public hospital waiting lists will apply.
Westfund will not pay benefits towards hospital or medical costs for these services. If you choose to proceed as a private patient for an excluded service, you will have very large out-of-pocket expenses. If the services are eligible under Medicare, you can still receive treatment as a public patient - however public hospital waiting lists will apply.
A Member who has held a Policy with Hospital cover for at least 2 months and upgrades to a Policy which includes psychiatric treatment may elect to waive the 2 month Waiting Period that applies to psychiatric treatment upon upgrade. This waiver can only be accessed once in a Member's lifetime.
When you switch health funds, we will guarantee continuity of cover for the benefits included in your previous cover. This applies only to the benefits you were entitled to under your previous cover, as long as these benefits are included under your new Westfund cover.
Benefits are not payable in respect of services provided during a waiting period. The following waiting periods apply to benefits payable for Hospital Treatment.| Hospital Waiting Periods | |
|---|---|
| Accident-related | 1 Day |
| Psychiatric, Rehabilitation and Palliative Care A Member who has held a Policy with Hospital cover for at least 2 months and upgrades to a Policy which includes psychiatric treatment may elect to waive the 2 month Waiting Period that applies to psychiatric treatment upon upgrade. This waiver can only be accessed once in a Member's lifetime. | 2 Months |
| Pregnancy and Birth | 12 Months |
| Treatment of a pre-existing condition | 12 Months |
| All other services | 2 Months |
The Commonwealth Ombudsman also provides general information about waiting periods.
* A pre-existing condition is an illness or condition for which, in the opinion of a medical practitioner appointed by Westfund, signs or symptoms existed during the 6 months before the date you joined Westfund or upgraded to a higher level of cover. A 12 month waiting period applies to all new Members for hospital costs relating to the treatment of pre-existing conditions.
For diagnostic and preventative dental, periodontics, endodontics, fillings and extractions or oral surgery.
Set item benefits depending on service or item number
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.
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.
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 |
| 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 and Chinese Herbalism | $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 (unless otherwise stated) |
|---|---|---|
| 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 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 |
| 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.
$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
$75 per member per calendar year
Available only at Westfund Care Centres
Available after 2 months
$200 per night per hospitalisation as the result of an accident
Available after 1 day
A limit of $600 per policy per calendar year applies to the Accommodation and Travel Benefit.
A benefit of $150 per night is available for Accommodation expenses.
Up to $70 per round trip (minimum 150 km) towards travel expenses for inpatient or outpatient specialist medical services.
Available after 12 months
$400 per night following the procedure, up to $4,800 per hospitalisation for advanced surgery admissions due to heart disease, stroke or cancer.
Available after 24 months
