Gold Public

Hospital and Extras

Public Hospital Cover only. Receive treatment as a private patient in a public hospital as well as extras cover for singles, couples and younger families.

Download the Gold Public Policy Summary

  • from $28.65* for singles
  • from $57.37* for couples or families
* per week. Based on NSW prices, claiming base tier Aust. Gov. rebate for under 65 and no Lifetime Health Cover loading.
Prices effective 1 April 2017.

Excess^: $500 per adult per calendar year

^ Excess does not apply to hospitalisations due to an accident, same day procedures or for dependants. Get a quote Join Online

What's included

Public Hospital Cover

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

Top Extras Cover

Our most popular extras cover with great annual limits and benefits.

Ambulance Cover

Ambulance cover is included as part of this plan.

Member Advantages

Access to a range of our Westfund Member Advantages, including our Forced Retrenchment benefit, sunglasses benefit, and more.

Public Hospital Cover

You're covered for

In a public hospital as a private patient, you will receive cover for shared room accommodation and your choice of doctor from doctors with a right to practice at that hospital. . This policy doesn’t provide hospital or medical cover into private hospitals.

  • Appendicitis (Appendectomy)
  • Tonsillitis (Tonsillectomy)
  • Hospitalisation for Cancer Treatment
  • Surgical extraction of wisdom teeth
  • Joint reconstructions
  • Surgical treatment of a hernia
  • Minor Gynaecological procedures
  • Colonoscopies
  • Gastroscopies
  • Removal of kidney and gall stones
  • Joint Replacements
  • Cataract surgery and intraocular lens insertion
  • Obstetrics
  • Assisted reproductive services
  • Sterilisation
  • Spinal fusion

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

  • Obesity surgery and lipectomy
  • Dialysis for chronic renal failure

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

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 Public Hospital cover

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.

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.

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

This policy does not provide hospital or medical cover in a private hospital.

More about Medical Cover

Westfund pays benefits towards the fees charged by a doctor, surgeon, other specialist services, including pathology and radiology, while you are admitted to hospital. Medicare pays 75% of the Commonwealth Medical Benefits Schedule (CMBS) fee and Westfund pays the additional 25% up to the CMBS fee.

No benefits are payable for outpatient medical treatment.

Extras Cover

What's included

General and Major Dental

General Dental
No annual or lifetime limit on General Dental like checkups, cleans and fillings.

Major Dental
$1,275 per member per calendar year to use on major dental treatment like crowns, bridges, implants and veneers.

Specialist Dental
No annual or lifetime limit

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
Orthodontics

$500 per member per policy year to use on orthodontics completed by a registered orthodontist with a maximum accrued lifetime benefit of $2,500.

$240 per member per policy year to use on orthodontics completed by a general dentist with a maximum accrued lifetime benefit of $1200.

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
Chiropractic and Osteopathy

Annual limit shared between all members on the policy

  • $300 per calendar year for singles
  • $600 per calendar year for couples or families
Chiro and Osteo Rebates
Type Rebate per service
Chiropractic $30
Chiropractic x-ray $35
Osteopathic $30
Physiotherapy and Exercise Physiology

Annual limit shared between all members on the policy

  • $300 per calendar year for singles
  • $600 per calendar year for couples or families
Physiotherapy and Exercise Physiology Rebates
Type Rebate per service
Physiotherapy $42
Exercise Physiology $30
Group Exercise Physiology $10
Group/Class Physiotherapy $10
Complementary Therapies

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

Annual limit shared between all members on the policy

  • $500 per calendar year for singles
  • $1,000 per calendar year for couples or families
Complementary Therapies Sublimits and Rebates
Type Rebate per service Single sublimits
per calendar year
Family or couple sublimits
per calendar year
Massage Therapies
(Remedial, Bowen Therapy, Aromatherapy, Myotherapy, Alexander Technique and Kinesiology)
$25 $150 $300
Acupuncture and Chinese Herbalism $25 $150 $300
Dietetics/Nutrition $25 $150 $300
Home Nursing - up to 6 hours / over 6 hours $12 / $48 $150 $300
Naturopathy and Homeopathy $25 $150 $300
Occupational Therapy $25 $150 $300
Orthoptics $25 $150 $300
Podiatry $34 $150 $300
Clinical Psychology $50 $150 $300
Speech Therapy - Initial / Subsequent $48 / $36 $300 $588
Prescriptions/Vaccinations and Injections

$50 per prescription for the amount that exceeds the standard PBS co-payment.
Annual limit of $400 per member per calendar year.

Prevention and Health Management

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 Policy Limits
Service Single Policy Limit Couple or Family Policy Limit
Fitness Centre
Yoga
Vitamins
Omega 3
Weight Loss Programs
Virtual Gastric Banding
Pilates Centre
Swimming Lessons/Training for children under 18
$75 $150
Antenatal Classes and pre-postnatal consultations (12 month waiting) $120 lifetime limit

Prevention and Health Management Member Limits
Service Benefit per member
Preventative Health Tests
Mole Scanning, Bowel Testing Kits, Bone Density Tests, Mammograms, Thin Prep Pap Test, Calcium Score
$30 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
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 Yes Lifetime
CPAP (sleep apnoea) Machine Yes Lifetime
EPAP Treatment Yes Lifetime
CPAP Masks and Accessories $100 per calendar year 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
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 for kids or in an accident

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.

  • Sunglasses Benefit

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

  • 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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