Continuity of Cover

If you transfer to Westfund from another registered health fund 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 they are included in your new Westfund cover.

Waiting Periods

Benefits are not payable in respect of services provided during a waiting period.

Hospital Waiting Periods
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

Extras Waiting Periods
The following waiting periods apply to benefits payable for General Treatment:

Extras Waiting Periods
Emergency Ambulance Transport 1 Day
Non-emergency Ambulance Transport, General Dental, Optical, Chiropractic, Osteopathy, Physiotherapy, Exercise Physiology, Complementary Therapies, Prescriptions/Vaccinations/Injections, Prevention and Health Management (excluding antenatal classes) 2 Months
Specialist Dental, Major Dental, Orthodontia, Dental Top-Up, Antenatal Classes, Health Aids & Appliances, Surgical Treatment by a Podiatrist 12 Months
Hearing Aids, Laser Eye Surgery 36 Months

Member Advantages Waiting Periods
The following waiting periods apply to benefits payable for Member Advantages:

Member Advantages Waiting Periods
Accident Benefit 1 Day
Sunglasses 2 Months
Accommodation and Travel Benefit 12 months
Chronic Disease Management Programs 12 months
Advanced Surgery Benefit 24 Months

The Commonwealth Ombudsman also provides general information about waiting periods.

Policy Conditions

Before you select your health plan please review the policy summary which can be found at the top of each product page. This has full details on the important Terms and Conditions, waiting periods and benefits available.

What is a pre-existing condition?

A pre-existing condition is an illness or condition for which, in the opinion of a medical practitioner appointed by Westfund, signs and symptoms existed during 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.

Should you wish to claim a benefit for hospital treatment before this period ends, you will need to ask your certified medical practitioner to complete the Medical Practitioner Certificate regarding ‘Pre-Existing Ailments’ form. This certificate helps Westfund determine the level of health insurance benefits that will apply when hospitalisation is required for members who have been with Westfund for less than 12 months. Once this period is over you are entitled to the full benefits available under your policy.