Gold Classic

Hospital and Extras

Tailored to mature singles and couples. Offers quality hospital cover and great extras, giving you what you will need and use. You won't pay for what you don't need (like obstetrics and orthodontia).

Download the Gold Classic Policy Summary

  • from $43.92* for singles
  • from $87.85* for couples
  • not available for families
* per week. Based on NSW prices, including $500 excess, claiming base tier Aust. Gov. rebate for under 65 and no Lifetime Health Cover loading.
Prices effective 1 June 2017.

Excess^:

  • Nil
  • $500 per adult per calendar year
^ Excess does not apply to hospitalisations due to an accident or same day procedures. Get a quote Join Online
Special Offer Join on Gold Classic by 31 December 2017 and receive either a $200 gift card (single policies) or a $400 gift card (couple and family policies).
Terms and Conditions apply. New members only. Not available in conjunction with any other offer.

What's included

Quality Hospital Cover

Top hospital cover with minimal exclusions and restrictions - for things you don't need such as obstetrics and IVF. An excess option is available.

High Extras

Mid-level extras cover with great annual limits.

Ambulance Cover

Ambulance cover included as part of this plan.

Member Advantages

Access to the full range of our Westfund Member Advantages, including our Accident Benefit, Advanced Surgery Benefit, and much more.

Hospital Cover

You're covered for

Westfund will pay towards your theatre fees, hospital accommodation and prosthetics costs when you are admitted to a contracted hospital for procedures that are included under your policy.

While this isn’t a complete list of the procedures covered under your policy, we recommend you contact us prior to any admissions to hospital or refer to the Policy Summary.

  • Appendicitis (Appendectomy)
  • Tonsillitis (Tonsillectomy)
  • Hospitalisation for Cancer Treatment
  • Joint reconstructions
  • Surgical treatment of a hernia
  • Minor Gynaecological procedures (excluding IVF)
  • Colonoscopies
  • Gastroscopies
  • Removal of kidney and gall stones
  • Joint Replacements
  • Cataract surgery and intraocular lens insertion
  • Dialysis for chronic renal failure
  • Spinal fusion

You're partially covered for

The listed procedures have ‘restricted’ cover if you are admitted to a Private Hospital – meaning we will only pay up to the public hospital shared room accommodation rate.

Significant out of pocket expenses may apply for admissions into a Private Hospital.

  • Psychiatric Care
  • Obesity surgery including lipectomy
  • Sterilisation

You're not covered for

No cover is provided for procedures for which Medicare pays no benefit (non-therapeutic cosmetic surgery), if disallowed by the Private Health Insurance Act 2007 or if listed as an exclusion on the policy.

You can still be treated as a Medicare patient in a Public Hospital for these exclusions.

Exclusions

  • Obstetrics
  • Assisted reproductive services

There are no co-payments and no benefit limitation periods on Gold Classic

Hospital Waiting Periods

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.

Accident Related One day
Psychiatric, Rehabilitation and Palliative Care Two months
Obstetrics-related services One year
Treatment of a Pre-existing Condition*
One year

* 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.

More about Hospital Cover

Westfund has contracts with numerous private hospitals throughout Australia covering theatre fees and hospital accommodation costs for most procedures. Hospital policies do not provide cover for treatment for which Medicare pays no benefit eg. Non-Therapeutic Cosmetic Surgery, or if disallowed by the Private Health Insurance Act 2007.

Where no contract exists with a private hospital, benefits are payable at a default rate determined by the Government. In these cases, out of pocket expenses may be incurred.

We recommend that members check with us prior to admission to hospital to ensure they are covered.

As a private patient in a public hospital, you will receive cover for accommodation and your choice of doctor from doctors with a right to practice at that hospital.

Westfund will pay benefits for surgically implanted prostheses up to the approved benefits in the Government's Prostheses List and in accordance with the requirements of the Act.

More about Medical Cover

Westfund pays benefits for the fees charged by a doctor, surgeon, other specialist services, including pathology and radiology, while you are in hospital. Medicare pays 75% of the Commonwealth Medical Benefits Schedule (CMBS) fee and Westfund pays the additional 25% up to the CMBS fee. Where the fees charged exceed the CMBS fee, Westfund will pay an additional benefit to reduce or eliminate out of pocket expenses where the doctor or specialist participates in our Access Gap Scheme.

Our Access Gap Scheme allows patients with hospital cover to eliminate or reduce out of pocket expenses for medical gap payments for in-patient hospital treatments. Westfund does not pay an amount charged by your doctor above the CMBS fees unless your doctor agrees to participate in the Access Gap Scheme. If a doctor does not use the Access Gap Scheme, patients will be responsible for any additional charges. Doctors are independent of Westfund and each doctor can choose on a case by case basis whether to participate in the Access Gap Scheme.

No benefits are paid for non-therapeutic cosmetic surgery.

Extras Cover

What's included

General, Major and Specialist Dental

$1,600 overall limit per member per year for all dental services (excludes orthodontics).

General Dental Rebates
Dental Services Maximum rebate per service
Examination up to $37.50
Simple extraction up to $80
Plaque removal up to $31.50
Calculus removal up to $69
Small filling up to $71.50
Medium filling up to $107.50
Large filling up to $150
Root canal up to $122
Mouth guard up to $94 per member
per calendar year
Full Dentures up to $977
Full Crown up to $850
Optical

$250 per member per calendar year with sub-limits listed below.

Optical Rebates and Sublimits
Type Sublimit per calendar year
Frame $80
Single vision lenses $100
Bifocal lenses $250
Multifocal lenses $250
Contact Lenses $250
Physiotherapy, Exercise Physiology, Chiropractic and Osteopathic

$600 per member per calendar year

Physiotherapy, Exercise Physiology, Chiropratic and Osteopathic Rebates
Type Rebate per service
Physiotherapy $42
Exercise Physiology $30
Group Exercise Physiology $10
Group/Class Physiotherapy $10
Chiropractic $30
Chiropractic x-ray $35
Osteopathic $30
Complementary Therapies

Includes services such as Massage, Acupuncture, Chinese Herbalism, Dietetics, Naturopathy, Podiatry, Psychology, Speech Therapy

$400 per member per calendar year

Complimentary Therapies Rebates
Type Rebate per service
Massage Therapies
(Remedial, Bowen Therapy, Aromatherapy, Myotherapy, Alexander Technique and Kinesiology)
$25
Acupuncture and Chinese Herbalism $25
Dietetics/Nutrition $25
Home Nursing - up to 6 hours / over 6 hours $12 / $48
Naturopathy and Homeopathy $25
Occupational Therapy $25
Orthoptics $25
Podiatry $34
Clinical Psychology $50
Speech Therapy - Initial / Subsequent $48 / $36
Prevention and Health Management

$500 per member per calendar year with sub-limits listed below

Health Management Benefits are for members with a chronic disease, such as diabetes, to have access to programmes that are intended to improve a specific health condition. Preventative health tests provide members assistance in the prevention of chronic disease.

Items such as Gym Classes, Weight Loss Programs, Pilates, Yoga, Vitamins etc.

Prevention and Health Management sub-limits
Service Annual Group Limit
Fitness Centre
Yoga
Vitamins
Omega 3
Weight Loss Programs
Virtual Gastric Banding
Pilates Centre
$100
Preventative Health Test
Mole Scanning, Bowel Testing Kits, Bone Density Tests, Mammograms, Thin Prep Pap Test, Calcium Score
$30 per service per calendar year
Hypnotherapy for Quit Smoking $250 Lifetime Limit
Ear and Eye Preventative Health Checks
Audiology test, Optical Coherence Tomography, Retinal Photography
$40 per calendar year
Chronic Disease Association Fees $30 per calendar year
$60 per policy limit
Prescriptions, Vaccinations and Injections (Non-PBS, Non-NHS or Private) $50 per prescription that exceeds the standard PBS co-payment
Non-surgically Implanted Prostheses

No overall limit see sub-limits listed below. A letter of recommendation is required from a practitioner in some instances.

Non Surgically Implanted Prostheses Limits
Health Aid or Appliance Sublimit per member Letter of recommendation required Letter valid for
Blood Glucose Monitor $100 per calendar year No  
Blood Pressure Monitor $150 per calendar year No  
Burn Suits $800 per calendar year Yes 12 months
Oral Appliance for diagnosed snoring $500 every three years
(every year for Oxygen and Accessories)
Yes Lifetime
CPAP (sleep apnoea) Machine Yes Lifetime
EPAP Treatment Yes Lifetime
Oxygen and Accessories Yes  
CPAP Masks and Accessories No  
Mammary Prostheses and Brassieres $225 per calendar year Yes (unless relevant hospitalisation recorded) Lifetime
Nebuliser $110 calendar year No  
Custom made orthopaedic boots $200 per calendar year Yes (unless provided by a physiotherapist or podiatrist) 12 months
Custom made / preformed orthotics $200 per calendar year Yes (unless provided by a physiotherapist or podiatrist) 12 months
Peak Flow Meter $35 per calendar year No  
Compression Garments $120 per calendar year No  
ISC Compression Calf Garments No  
Braces Yes 12 months
TENS Machine $150 every three years Yes Lifetime
INR Monitor $200 every two years Yes Lifetime
Wigs $150 every calendar year Yes (unless relevant hospitalisation recorded) Lifetime
Artificial Limbs $200 every calendar year Yes Lifetime
Mobility Aids $100 per calendar year Yes 12 months
Low Vision Aids for Age-Related Macular Degeneration Yes Lifetime
Repairs to Devices $100 per calendar year Yes (unless initial purchase of the device is recorded) 12 months
Hearing Aids and Frequency Modulated Systems $1,400 every three years No  

Ambulance Cover

Unlimited medically necessary emergency ambulance transport
1 day waiting period

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

We're easy to deal with

Our Care Centres are in regional locations so you can talk to someone in person, give our friendly staff a call or use our online services. 

No excess in an accident or for day procedures

For peace of mind if something unexpected should happen.

Not for profit

We’re here for our members. We’re returning approx. $3.5 million to eligible Gold and Platinum members in 2017. 

We're for regional Australians

Just like you, we work and live in regional Australia, so we understand what’s important to you.

 

Westfund Member Advantages

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

  • No Excess for day surgery, kids or in an accident

    Unlike many other funds, we don’t apply an excess* on any claim for day surgery, kids or hospitalisation resulting from an accident.
    * may apply within 12 months of transferring from another fund. Standard hospital waiting periods apply.

  • Accident Benefit

    We'll pay you an additional payment of $100 per night if you're hospitalised as the result of an accident.
    Available after 1 day

  • Sunglasses Benefit

    Receive $50 per member per calendar year for sunglasses bought from any Westfund Care Centre.
    Available after 1 year

  • Accommodation Benefit

    Up to $100 per night for accommodation expenses, up to $400 a year per policy.
    Available after 2 years

  • Advanced Surgery Benefit

    $200 per night additional benefit for advanced surgical procedures due to heart disease, stroke or cancer – up to $2,400 per hospitalisation.
    Available after 2 years

  • Forced Retrenchment Benefit

    We’ll waive your premiums for up to 6 months if you’re made redundant.
    Available after 3 years

  • Protected Industrial Action

    We’ll waive your premiums for up to 6 months due to union strike.
    Available after 3 years

  • Westfund Dental and Eyecare

    Higher per item benefits at Westfund Dental Care Practices than at other providers.
    Additional benefit of $60 per member to use on out of pocket costs associated with purchasing prescription glasses or contacts at Westfund Eye Care Practices. This amount will accrue up to $120 if no optical claims are made.
    Available after 2 months

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