Premium Increase October 2020

In 2020, as part of our commitment to supporting our members when they needed it the most, we put our scheduled 1 April premium increase on pause due to the widespread financial hardship caused by the COVID-19 pandemic. Read more about the assistance. There are several cost drivers associated with increases to premiums for our members.

They include:

Rising healthcare costs. Increases in costs associated with hospital, medical and other health-related services

Increased use of medical technologies. Advances in technology mean improved, more accessible health outcomes for all

We are getting older. Our ageing population means that there’s a greater demand for services and treatments

Chronic illnesses. Diagnosis, treatment and prevention of chronic illnesses is on the rise and providing access to improved interventions required by our members is important to us

Further information about the reasoning for premium increases and the approval process involved is available from the Private Health Insurance Ombudsman.

Other than going directly towards the cost of claims, we also invest your premiums in programs and initiatives to help our members live their healthiest lives, like our Health and Wellbeing Programs.

View our Health and Wellbeing Programs

Our response to COVID-19 – extension of programs to support our members

As COVID-19 continues to evolve and impact our lives in unexpected ways, Westfund is focused on helping you manage your health and financial wellbeing throughout this challenging time.

These include:

  • Extension of COVID-19 cover – hospital cover for admission related to COVID-19 for all eligible members; extended until at least 31 December
  • Extension of COVID-19 Financial Relief – extra support for members experiencing financial distress; extension of offering temporary suspensions until 31 December
  • Continued access to our Health and Wellbeing program suite – Care Connected will become an ongoing program and the extension of MindStep Online CBT until at least 31 December
  • We’ve extended the ability for members to claim for virtual consultations for psychology, physio, occupational therapy and a range of other allied health services (with registered providers) until at least the end of the year.

We’ve extended access to a number of programs and support measures until at least the end of 2020.

And, we’re continuing to monitor developments across Australia to ensure
we’re doing all we can to meet our members' needs today, while preparing for what the future may hold.


Committed to our members

We understand that affordability has never been more important for our members and we remain committed to providing you with value when it comes to your health cover. While nobody likes to pay more, premium increases reflect rising industry costs. Below is some information to explain what is driving these increases.

Here's a snapshot of some of the claims we paid to our members in 2019


Age: 56


Age: 73


Age: 72


Age: 69

Benefits paid on our most common procedures

1. Psychiatry 
Average age 49↑24% average benefit••
2. Lens procedures
Average age 72↑9% average benefit••
3. Dental procedures 
Average/patient $1,777•
Average age 28↑15% average benefit••
4. Tonsillectomy/Adenoidectomy 
Average age 11↑14% average benefit•
5. Coronary bypass 
Average/patient $48,163•
Average age 68↑6% average benefit••
6. Hip replacement 
Average age 69↓3% average benefit••
7. Obesity procedures 
Average age 46↑9% average benefit••
8. Colonoscopy 
Average age 63↑8% average benefit••

• per patient 2019 calendar year
•• per patient since 2015 through to 2019 calendar years


What other factors can affect the cost of my private health insurance policy?

The federal government offers a range of financial incentives and penalties to encourage Australians to take out private health insurance. These initiatives may affect the cost of your policy, whether that be through a discount or a surcharge.

Medicare Levy Surcharge

Australians may choose to take out a hospital policy in order to avoid paying the Medicare Levy Surcharge (MLS). MLS applies to Australian tax payers who do not have private hospital cover and who earn over a certain amount. The aim of the surcharge is to reduce demand on the public health system by encouraging those on higher incomes to purchase and use private health cover.

Learn more

Australian Government Rebate on PHI

The Australian Government Rebate on private health insurance is a way to help offset the cost of private health insurance premiums for policyholders. The rebate is income tested and applies to hospital, extras and ambulance policies. The rebate can be claimed in the form of a regular premium reduction through your private health insurer or can be claimed with your annual Income Tax Return.

Learn more

Lifetime Health Cover loading

Lifetime Health Cover (LHC) loading was implemented to encourage younger people to take out hospital cover earlier in life and to maintain that cover. LHC works by applying a financial penalty to those who choose to take out hospital cover after they turn 31 in the form of a two per cent loading for each year your age exceeds 30 when you do choose to join.

Learn more

Age-Based Discounts

The federal government has introduced a range of reform measures aimed at making private health insurance more transparent and affordable for consumers. As part of these reforms, private health insurers are now able to implement premium discounts of up to 10 per cent on eligible hospital cover for people aged between 18 and 29 years of age.

Learn more

Frequently asked questions

We know that there is a lot of information from a lot of different sources around the annual premium adjustment and that sorting through it all can be confusing. We've answered some of our members' most frequently asked questions.

Why are premiums increasing?

Why do premiums need to increase during COVID?

When does the increase take effect?

I rarely claim but my premium is increasing. Why?

What is rate protection? How far ahead can I pre-pay?

I can’t afford this increase. What are my options?

Is my direct debit/payroll payment automatically adjusted?

Why don’t extras benefits go up when the premiums go up?