Westfund Health Insurance Review

Westfund Health Insurance offers 5 main hospital-only plans (Basic Public Hospital, Bronze Plus Hospital, Silver Hospital) starting from 22.10 AUD per week. There are also 6 extras-only, 2x Ambulance, and 3x Overseas Visitors Plans.

Westfund Health Insurance has a large network of contracted private hospitals and offers comprehensive Health and Wellbeing Programs to support members’ physical and mental health.

 

🔎 Date Established	1953
📌 Headquartered	Lithgow, New South Wales, Australia
📍 Registration Number	ABN 55 002 080 864
👤 Average Number of Members	Over 135,000 members
👥 Number of Employees	Approximately 200+
🛡️ APRA-Regulated	✅Yes
📉 Most Recent Market Cap Reported	Premium revenue of 274 million AUD in June 2023
💛 Average Customer Rating	4.6/5
⭐ Average Number of Reviews	1,000+
📈 Market Share	Approximately 0.9% of the Australian private health insurance market
📊 Number of Plans Offered	5 Hospital Only, 6 Extras Only, 2 Ambulance Plans, and 3 Overseas Plans
💹 Sponsorships	Community support through grants, local events, and initiatives like the Lithgow Show
📲 Mobile App	✅Yes
💻 Medical Claims Portal	Available through the Members Online Portal and Westfund app
⏰ Customer Support Operating Hours	Monday to Friday, 8 am to 5 pm AEDT
📚 Information Hub and Blog	Includes various updates and health-related articles
💊 Chronic Illness Benefits	Through chronic disease management programs
🩺 Screening and Prevention Offered	Preventive services, including health checks and various screenings
🍼 Maternity Benefit	Covered under specific hospital plans
💷 Health Insurance Premium Range (AUD)	Ranges from around $22.10 per week for basic cover
⌛ Average Waiting Period	Ranges from 1 day to 12 months, depending on the service
🌎 Is International Medical Cover Offered	No specific cover, but some policies include limited travel-related benefits
✈️ International Travel Benefit	Travel insurance is offered through a partnership with Allianz Travel Insurance

 

 

Westfund Health Insurance Plan Overview

 

🔎 Plan	💶 Premium Range AUD	❌ Exclusions	❤️ Ideal For	🔃 Gap Cover	📌 Rebate Percentage	⏰ Average Waiting Period	🔑 Key Features
🥇 Basic Public Hospital	Singles from $22.10 per week	Private hospital treatment, Dialysis for chronic kidney failure, Weight loss surgery	Minimal coverage with public hospital access	✅Yes	Based on age and income	1 day to 12 months	Unlimited emergency ambulance, choice of doctor, shared room accommodation, age-based discounts, extended dependant cover options
🥈 Bronze Hospital	Singles from $21.05 per week	Assisted reproductive services, Back and spine treatments, Pregnancy, and birth	Cost-conscious singles, couples, and families	✅Yes	Based on age and income	1 day to 12 months	Coverage for ear, nose, and throat services, joint reconstructions, cancer support programs, access to private hospitals, age-based discounts
🥉 Bronze Plus Hospital	Singles from $23.00 per week	Assisted reproductive services, Back and spine treatments, Cataracts, and eye surgery	Basic coverage with extras for young individuals and families	✅Yes	Based on age and income	1 day to 12 months	Coverage includes dental surgery, unlimited emergency ambulance, private hospital access, extended dependant cover options
🏅 Silver Hospital	Singles from $26.44 per week	Assisted reproductive services, Pregnancy and birth, Weight loss surgery	Individuals who require comprehensive coverage without maternity or joint replacements	✅Yes	Based on age and income	1 day to 12 months	No excess for accidents or dependents, extensive private hospital access, travel and accommodation benefits, mental health programs
🎖️ Gold Ultimate Hospital	Singles from $60.72 per week	Weight loss surgery, Non-medically necessary dental surgery, Cosmetic procedures	Individuals and families who need the most comprehensive cover	✅Yes	Based on age and income	1 day to 12 months	Top-level cover with no exclusions or restrictions, full health and wellbeing program range, maternity and birth coverage, unlimited emergency ambulance

 

 

Westfund Health Insurance Plans – Features and Benefits

 

Basic Public Hospital Cover

Westfund’s Basic Public Hospital Cover is ideal for individuals who require cost-effective hospital insurance with some essential benefits. This plan focuses on providing private patient treatment in public hospitals, including shared room accommodations.

 

Key Differentiating Features

 

• Allows members to be treated as private patients within public hospitals.
• Unlimited emergency ambulance coverage through Westfund-recognized providers.
• Non-emergency transport benefits of up to $5,000 per member annually are included.
• Includes coverage for dependents up to 31 years old, accommodating extended and disability dependents.

 

Plan Benefits and Coverage Breakdown

 

🔎 Category	📌 Details
💶 Pricing	Singles from $22.10 per week (NSW prices, $750 excess)
📉 Type of Cover	Private patient coverage in public hospitals
📈 Covered Treatments	Cancer treatments, diabetes management, back, neck, and spine care, pregnancy and birth, rehabilitation, psychiatric services
📊 Exclusions	Private hospital treatment, dialysis for chronic kidney failure, weight loss surgery
💹 Waiting Periods	Varies by service: 1 day for emergency ambulance, 2 months for non-emergency patient transport, 12 months for pregnancy and birth
🅰️ Annual Limits	Emergency ambulance: Unlimited. Non-emergency transport: $5,000 per member annually
🅱️ Additional Information	Excess of $750 per member per year, capped at $1,500 per family
📍 Ideal For	Affordable hospital coverage within public hospitals for individuals
💚 Singles	Pros: Age-based discounts, essential services coverage Cons: No private hospital options
💙 Couples	Pros: Shared room coverage in public hospitals, flexibility in doctor choice Cons: No private hospital services
🩷 Families	Pros: Coverage for dependents up to age 31, unlimited emergency ambulance coverage Cons: Limited private room accommodation
💜 Single Parents	Pros: Budget-friendly excess cap, emergency transport services Cons: Restricted private room benefits

 

 

Westfund’s Bronze Hospital Cover

Westfund’s Bronze Hospital Cover is for individuals, couples, and families. It offers access to a network of contracted private hospitals across Australia. It focuses on treatments that address common medical needs such as ear, nose, and throat issues and joint reconstructions.

 

Key Differentiating Features

 

• Offers discounts for adults under 30, making it more affordable for younger members.
• Options to cover dependents up to age 31, including those with disabilities with active NDIS plans.
• Provides coverage for treatment in Westfund’s contracted private hospitals, ensuring flexibility and choice for members.

 

Plan Benefits and Coverage Breakdown

 

🔎 Category	📌 Details
💶 Pricing	Singles from $21.05 per week (NSW prices, $750 excess)
📉 Type of Cover	Private hospital access, shared room accommodation
📈 Covered Treatments	Bone, joint, and muscle treatments, chemotherapy, radiotherapy, and immunotherapy for cancer, ear, nose, and throat services
📊 Exclusions	Weight loss surgery, assisted reproductive services, dialysis for chronic kidney failure
💹 Waiting Periods	1 day for emergency ambulance transport, 2 months for non-emergency patient transport, 12 months for pre-existing conditions
🅰️ Annual Limits	Emergency ambulance: Unlimited. Non-emergency transport: $5,000 per member annually
🅱️ Additional Information	Excess of $500 to $750 per member, capped at $1,500 per family
📍 Ideal For	Cost-conscious members accessing essential treatments
❤️ Singles	Pros: Age-based discounts, access to private hospitals Cons: Limited private room accommodations
🧡 Couples	Pros: Flexibility in doctor choice, shared hospital rooms Cons: Exclusions on advanced treatments
💛 Families	Pros: Coverage for dependents up to age 31, comprehensive emergency transport Cons: Restrictions on weight loss surgery and other treatments
🩷 Single Parents	Pros: Flexible coverage for children, budget-friendly premium options Cons: Limited benefits in private hospital settings

 

 

Bronze Plus Hospital Cover

The Bronze Plus Hospital Cover by Westfund is an extended version of the Bronze plan with additional benefits and coverage options. This plan is for young, healthy individuals and families just starting out who need a bit more than the basic hospital coverage.

 

Key Differentiating Features

 

• Covers treatment in both public and private hospitals within Westfund’s extensive contracted network.
• No- No excess charged for dependents under eligible policies.
• Includes dental and podiatric surgeries by registered surgeons, offering broader medical support.

 

Plan Benefits and Coverage Breakdown

 

🔎 Category	📌 Details
💶 Pricing	Singles from $23.00 per week (NSW prices, $750 excess)
📉 Type of Cover	Private and public hospital access, shared room accommodation
📈 Covered Treatments	Dental surgery, podiatric surgery, diabetes management, joint reconstructions, male reproductive system
📊 Exclusions	Assisted reproductive services, weight loss surgery, sleep studies
💹 Waiting Periods	1 day for emergency ambulance, 2 months for non-emergency transport, 12 months for major surgeries
🅰️ Annual Limits	Emergency ambulance: Unlimited. Non-emergency transport: $5,000 per member annually
🅱️ Additional Information	Excess options include Nil, $250, $500, or $750 per member annually
📍 Ideal For	Additional coverage beyond basic hospital plans for young individuals and families
💚 Singles	Pros: Access to private hospitals, expanded services Cons: Exclusions for weight loss and reproductive services
💙 Couples	Pros: Broader coverage, including podiatric and dental surgeries Cons: Limited private room accommodation in private hospital
🩷 Families	Pros: Unlimited ambulance services, multiple excess options Cons: Exclusions on advanced treatments like reproductive services
💜 Single Parents	Pros: Flexibility in managing dependents’ health needs, expanded services Cons: Higher premiums with additional coverage

 

 

Silver Hospital Cover

Westfund’s Silver Hospital Cover offers mid-level hospital insurance and caters to members who want substantial cover without paying for pregnancy, birth, or advanced joint replacements.

The plan includes comprehensive support programs and travel benefits for members who require care outside their state.

 

Key Differentiating Features

 

• Private Hospital Network Access: Extensive coverage in Westfund’s private hospital network ensures flexibility in choosing medical services.
• No Excess for Dependents and Accidents: Dependents and accident-related admissions have no excess charges, offering financial ease.
• Accommodation and Travel Benefits: Provides support for members needing to travel for care, covering hospital stays and travel costs.

 

Plan Benefits and Coverage Breakdown

 

🔎 Category	📌 Details
📉 Pricing	Singles from $26.44 per week (NSW prices, $750 excess)
📈 Type of Cover	Comprehensive private hospital coverage
📊 Covered Treatments	Heart and vascular system, joint reconstructions and replacements, cataracts, mental health services
💹 Exclusions	Assisted reproductive services, weight loss surgery
💱 Waiting Periods	1 day for emergency ambulance transport, 12 months for major surgeries and pre-existing conditions
🅰️ Annual Limits	Accommodation benefits: $80/night, up to 4 nights per admission
🅱️ Additional Information	No excess for dependents and accident-related admissions
📍 Ideal For	Extensive medical support without advanced pregnancy or weight loss coverage
💚 Singles	Pros: Comprehensive benefits for heart and joint treatments Cons: Limited benefits for pregnancy and reproductive services
💙 Couples	Pros: Broad hospital network access, travel and accommodation support Cons: Exclusions for assisted reproductive services
💜 Families	Pros: No excess for dependents, extensive emergency services Cons: Higher premiums due to extended coverage
💛 Single Parents	Pros: Flexibility in dependents’ coverage, multiple support programs Cons: Limited benefits for pregnancy and birth

 

 

Gold Ultimate Hospital Cover

Westfund’s Gold Ultimate Hospital Cover is the top-tier hospital insurance plan for individuals and families who want extensive coverage and essential benefits like full support for complex procedures, no-excess policies for dependents, and complete access to health and well-being programs.

 

Key Differentiating Features

 

• Members can access an extensive network of private hospitals across Australia.
• Dependents are not required to pay an excess, offering financial ease for families.
• Includes unlimited emergency ambulance services and up to $5,000 per member for non-emergency transport.
• Members can access all health programs, including cancer support and rehabilitation services.
• Provides support for members needing to travel for care, covering accommodation and travel costs.

 

Plan Benefits and Coverage Breakdown

 

🔎 Category	📌 Details
📉 Pricing	Singles from $60.72 per week (NSW prices, $750 excess)
📈 Type of Cover	Top-tier hospital cover with no exclusions or restrictions
📊 Covered Treatments	Assisted reproductive services, heart and vascular system, joint replacements, cataracts, psychiatric services, and diabetes management
💹 Exclusions	Weight loss surgery, dental surgeries not medically necessary, certain cosmetic procedures
💱 Waiting Periods	1 day for emergency ambulance transport, 12 months for major surgeries and pre-existing conditions
🅰️ Annual Limits	Accommodation benefits: $100/night, up to 4 nights per admission
🅱️ Additional Information	Pay no excess for dependents and accident-related admissions
📍 Ideal For	Full-scale hospital coverage with comprehensive support programs and family-friendly policies
💚 Singles	Pros: Comprehensive support for complex treatments and surgeries Cons: Higher premiums compared to lower-tier plans
💙 Couples	Pros: Allows shared coverage for joint replacements and cardiac care Cons: Limited cosmetic surgery coverage
❤️ Families	Pros: No excess for dependents, extensive emergency services Cons: Excludes weight loss surgeries and dental treatments
🧡 Single Parents	Pros: Reduced costs with no excess for dependents, flexible policies Cons: Premiums are less favorable if minimal coverage is needed

 

 

Westfund Health Insurance Additional Plans

 

🔎 Plan Name	💶 Pricing	❤️ Ideal For	☑️ Covered Services	🗝️ Key Features
📉 Starter Extras	Singles: $5.47/week, Families: $11.47/week	Healthy singles/couples	Dental, optical, physio, chiro, vitamins, mental health	Choose where to spend limits, dental up to $180, annual flex limit
📈 Choice Extras	Singles: $8.92/week	Young adults/growing families	Dental, optical, physio, massage, vitamins, emergency transport	Grouped benefit limit, 50% back, no-excess ambulance transport
📊 Mid Extras	Singles: $10.27/week	Families needing balanced key services	Optical, dental (inc. orthodontics), physio, chiro	$1125 dental limit, $2,500 orthodontics lifetime limit
💹 High Extras Over 50s	Singles: $12.37/week	Mature singles/couples over 50	Dental, optical, physio, gym memberships, hearing aids	Higher annual limits, targeted older member services
📉 High Extras	Singles: $14.31/week	Health-focused families	Optical, dental, physio, mental health, speech pathology	No annual limit on dental, $600 mental health support
📈 Ultimate Extras	Singles: $21.97/week	High-level proactive care seekers	Dental, orthodontics, physio, massage, mental health	No annual limit on dental, dental top-up bonus

 

 

Recent User Reviews

 

🥇 Excellent Coverage and Efficient Claims Process

After conducting extensive research, I chose Westfund since its coverage for extras like dental and physio appeared to be far greater than that of other funds. The wait times were moderate, and the claim procedure was speedy using their app. It’s also fantastic that they’re a non-profit, so my premiums feel like they’re contributing to something worthwhile.

 

🥈 Great Gap Cover and Smooth Surgical Experience

One thing that drew me to Westfund was their great gap cover. I just underwent minor surgery and had almost no out-of-pocket expenses. It’s such a comfort to know that unforeseen bills are covered, and the entire process went smoothly from beginning to end.

 

 

Westfund Health Insurance vs TUH Health Insurance vs nib Health Insurance – A Comparison

 

🔎 Provider	🥇 Westfund Health Insurance	🥈 TUH Health Insurance	🥉 nib Health Insurance
📌 Years in Operation	71 years	52 years	Over 70 years
👤 Average Number of  Members	Over 135,000	85,000+	Over 1.7 million members
📍 APRA Regulation	✅Yes	✅Yes	✅Yes
👥 Number of Employees	Approximately 200+	50 – 200	Approximately 1,500 employees
📉 Market Share	Approximately 0.9%	1.5%	9.6% of the Australian private health insurance market
📈 Market Coverage	Australia-wide coverage	Australia-wide coverage	Australia-wide coverage
💛 Customer Rating	4.6/5	4.7 out of 5	Average of 4.8 out of 5
⭐ Number of reviews	1,000+	800+	1,000+ reviews
📲 Mobile App	✅Yes	✅Yes	✅Yes
🏆 Premium Range (AUD)	Ranges from around $22.10 per week for basic cover	From $36.30 per fortnight to $3,253.55 per year	From $3.34 per week to $3,067.69 per year, depending on the plan and coverage options
🌎 International Travel Benefit	Yes, through Allianz Travel Insurance	None	Yes, comprehensive international travel insurance is available
↪️ Market Capitalisation	Premium revenue of 274 million AUD in June 2023	Not applicable	AUD 2.90 billion
❤️ Unique Features	Co-payments, Excess-options, Health-programs, Gap-cover, Ambulance-cover	Not-for-profit, affordable premiums, range of cover options, focus on teacher members, award-winning health cover	GreenPass membership, partnership with Priceline for branded hospital and ancillary cover, sponsorship of notable sports teams, comprehensive mobile app support

 

 

Advantages of Using Westfund Health Insurance

Westfund Health Insurance is known for its regional presence, comprehensive healthcare services, and targeted programs for members.

From digital health initiatives to no-gap arrangements with partner providers, Westfund offers unique advantages that set it apart in the health insurance landscape.

 

• Westfund has a deep commitment to serving regional communities in Australia. This focus on regional areas means members can benefit from tailored healthcare solutions that address local challenges.
• Westfund offers no-gap arrangements with specific healthcare providers.
• All Westfund extras and hospital covers include emergency ambulance transport.
• Westfund offers direct billing arrangements to simplify the claims process through a network of partner providers.
• There are a few mental health support options, like counseling services and wellness programs, to help members manage stress, anxiety, and other challenges.

 

Westfund offers programs to promote member wellness, including chronic condition management programs and preventive health initiatives.

 

 

Overview of Westfund Health Insurance Gap Cover

Westfund’s gap cover policy reduces unexpected costs for members by offering clear no-gap and known-gap arrangements within a network of approved hospitals and healthcare providers.

 

🔎 Service	🅰️ Gap Arrangement	🅱️ Details
📉 General Surgery	No-Gap	Covered in full at partner hospitals
📈 Orthopaedics	No-Gap	No additional cost at approved hospitals
📊 Cardiology	Known-Gap	Clear gap fees listed for non-partner providers
💹 Maternity and Obstetrics	No-Gap	Covered at select partner hospitals

 

How to apply for Gap Cover with Westfund Health Insurance

Westfund offers Gap Cover as part of their hospital cover plans, providing additional financial protection for members. Follow these specific steps to apply for gap cover:

 

• Ensure you have a qualifying Westfund hospital cover plan with gap cover options.
• Review the policy details to confirm your eligibility for gap cover benefits.
• Prepare proof of your hospital cover enrollment and identification. You might also need to provide details about your healthcare provider and planned medical procedures.
• Access the application form through the Westfund member portal or request a form at a branch.
• Provide information about your hospital plan and confirm your selected healthcare provider.
• Submit the completed application through the member portal, in person at a Westfund branch, or by mail. Ensure all required documents are attached.

 

Once your application is reviewed, you will receive confirmation of your gap cover activation via email, like specific terms or conditions related to the arrangement.

 

 

Westfund Health Insurance App Features

The Westfund iOS and Android app has several essential tools that help members manage their healthcare from anywhere in the world. The app offers direct access to key services and essential information in addition to the following:

The Digital Membership Card offers access to member details and coverage information for instant verification at healthcare providers.

 

Member Communication Hub

Direct communication with Westfund representatives for personalized support.

 

Notifications and Alerts

Members can remain informed about policy updates, claim statuses, and scheduled appointments.

 

Claims Submission and Tracking

Members to lodge claims directly from the app and monitor their processing status in real time.

 

Find a Provider

Members can locate nearby Westfund-approved healthcare providers, including hospitals, specialists, and extra service providers.

 

Gap Cover Information

Detailed view of gap cover arrangements and partner hospitals, ensuring clarity on coverage.

 

Telehealth Integration

Direct access to telehealth services for consultations and support.

 

Health History Records

Secure, organized log of members’ health services and claim history for easy reference.

 

Appointment Bookings

Members can schedule appointments with healthcare providers and receive reminders.

 

Health Programs and Resources

Access to health management programs and educational resources to support ongoing wellness.

 

In summary, the Westfund Health Insurance app provides a comprehensive suite of features that make managing healthcare both convenient and efficient. With tools for communication, claims tracking, telehealth services, and more, members can easily stay connected and in control of their health needs at any time and from anywhere.

 

 

How to apply for Health Insurance with Westfund Health Insurance

Applying for coverage with Westfund Health Insurance is easy, and you can use any of the following options:

 

Online Application

 

• Visit the Westfund Health Insurance website and go to the “Join Westfund” section.
• Complete the application form with your personal information, preferred health cover, and dependents.
• Keep scanned copies of identification and eligibility documents ready for upload.

 

In-Person Visits

 

• You can visit any Westfund branch to receive personalized assistance.
• A customer service representative will guide you through the application process, help with document submissions, and plan selection based on your specific requirements.

 

Phone Assistance

 

• Call the Westfund customer support line for guided application assistance.
• A representative will walk you through the required steps, and you’ll receive follow-up instructions for submitting documents electronically.

 

Documentation Submission

 

• Regardless of the registration avenue, ensure that your identification and eligibility documents (proof of residence and Medicare status) are available for submission.
• You’ll receive detailed instructions during your application process.

 

Once your application is submitted and documents are verified, you will receive an email confirmation with your policy details and a digital membership card.

 

 

How to Submit a Claim with Westfund Health Insurance

Westfund offers multiple claim submission methods; members can choose the most convenient one. Here’s how you can submit a claim:

 

Log into the Members Online Portal

 

• Access Westfund’s online portal by signing in or registering.
• Go to the ‘Claims’ section and follow the instructions to submit your claim electronically.

 

Use the Westfund App for Quick Photo Claims

 

• Open the app and select the photo claim option.
• Capture a clear photo of your receipt and upload it through the app.

 

Complete a Claim Form

 

• Download the claim form from the Westfund website.
• Complete the form and attach relevant receipts or invoices.

 

Send your completed claim form along with scanned or photocopied receipts to [email protected]. Alternatively, post them to the designated Westfund office.

 

 

How to Downgrade My Plan with Westfund Health Insurance

To initiate a downgrade, first confirm your eligibility and any restrictions, such as checking if minimum waiting periods on your current plan are met or if downgrading will affect specific benefits.

Contact Westfund’s Member Support via their hotline or email to express your intent, ensuring you have your member ID and relevant details ready for verification.

Complete the official downgrade request form, available on Westfund’s website or through Member Support, and submit it at least 30 days before your desired effective date. After submission, request confirmation of the downgrade and verify the details of your new plan.

 

 

How do I add a Beneficiary to Westfund Health Insurance?

If you want to add a child or adult dependent, you can log into your Westfund Health Insurance profile and follow these steps:

 

• Contact Westfund’s Member Support via their hotline or email to start the process of adding a beneficiary.
• Specify whether the beneficiary is a partner, child, or eligible dependent.
• Confirm the beneficiary’s eligibility and keep the necessary documents like proof of relationship or guardianship papers for children nearby. Westfund might also require birth certificates or proof of partnership.
• Complete the official form provided by Westfund to add a partner or dependent to your policy. The form can be accessed through the Members Online portal or Member Support.

 

Submit the form and required documents to Westfund via email or through their online portal. Once processed, request a confirmation of the addition and review any changes to your policy.

 

 

How to Submit a Compliment or Complaint with Westfund Health Insurance

If you need to submit feedback to Westfund, you can do so through the following channels:

 

• Visit any of Westfund’s Care Centres in person to provide feedback directly to the staff
• Submit a written complaint via email at [email protected].
• Send feedback through mail to the Resolutions Officer at PO Box 235, Lithgow NSW 2790.
• Call Westfund’s dedicated line at 1300 937 838 to register your compliment or complaint.

 

Once you’ve submitted feedback, Westfund will acknowledge it and aim to resolve it within three business days. If the issue requires additional consideration, it will be escalated to the relevant team manager with a target resolution of 14 business days.

If the complaint is not resolved at the first point of contact, it will be referred to the Resolutions Officer. The officer will acknowledge the complaint and aim to resolve it within 21 business days.

 

 

How to Switch My Health Insurance to Westfund Health Insurance

Switching your cover from another health insurance fund to Westfund is easy, and here’s how to do it:

 

• Get a personalized quote from the Westfund Health Insurance website to ensure you get a plan that suits your needs.
• Choose a plan from the list of options available.
• Westfund will cancel your previous policy on your behalf and manage the associated paperwork.
• Your only responsibility is to cancel any direct debits linked to your previous insurer to avoid duplicate payments.

 

If you’re switching from another private health insurer and your previous policy had similar or lower benefits, Westfund will transfer your waiting periods, ensuring you don’t have to re-serve them. However, if your old coverage had lower benefits, those limits will apply until the waiting period with Westfund is completed.

Westfund offers a 30-day satisfaction guarantee. You can try your new policy for 30 days, and if you decide it’s not the right fit, you’ll receive a full refund of any premiums paid, provided you haven’t made any claims during that period.

 

 

Westfund Health Insurance Travel Insurance

Westfund Health Insurance offers travel insurance through a partnership with Allianz Global Assistance. Westfund offers multiple travel insurance plans through Allianz, including Comprehensive, Essentials, Domestic, and Multi-Trip options.

 

• The Comprehensive Plan covers international travel with benefits like medical, hospital, and dental expenses, personal liability, and trip cancellations.
• The Essentials Plan focuses on budget-friendly international coverage.
• The Domestic Plan covers travel within Australia.
• The Multi-Trip Plan allows multiple trips per year with durations of 15, 30, or 45 days each, depending on the option.

 

Westfund provides round-the-clock emergency assistance via Allianz’s Australian-based support team, including registered nurses and doctors for overseas policies. Depending on the nature of your trip, you can enhance your policy with optional add-ons like Adventure, Cruise, or Snow Packs.

Travel insurance policies are subject to terms, conditions, and exclusions. Members must review the Product Disclosure Statement (PDS) and check travel advisories on Smartraveller.gov.au for any restrictions related to their destinations.

 

 

Westfund Health Insurance Corporate Responsibility

Westfund’s Community Grants Program provides over $120,000 in annual grants to support community groups across New South Wales, Queensland, and the Australian Capital Territory.

In addressing regional healthcare challenges, Westfund has taken steps to improve accessibility and affordability of services.

Here’s a summary of Westfund’s initiatives:

 

• Community Grants Program
• Here for Hearts Defibrillator Initiative
• Regional Health Gap Report
• Charles Sturt University Scholarships
• Lithgow Show Sponsorship
• “Play Like a Panther” Clinic Sponsorship

 

They actively invest in closing the regional health gap through projects like the Regional Health Gap Report, which advocates for proactive and preventive health measures in regional Australia.

Westfund’s partnership with Charles Sturt University supports future medical professionals through the Healthy Futures Scholarship Program.

Westfund has a strong connection with local communities through sponsorships of events such as the Lithgow Show and the “Play Like a Panther” clinic in Bathurst. Their sponsorships aim to foster youth engagement and promote community health and well-being.

 

 

Westfund Health Insurance Regulation

The Australian Prudential Regulation Authority (APRA) and the Australian Competition and Consumer Commission (ACCC) regulate private health insurance in Australia.

Westfund Health Insurance is a member of APRA under the Registered Name Westfund Limited (ABN 55 002 080 864).

The primary regulatory framework comes under the Private Health Insurance Act 2007, alongside the oversight functions of APRA and ACCC. Specific Responsibilities and Regulatory Focus Areas of APRA and ACCC:

 

• Maintaining Financial Stability: APRA actively monitors private health insurers through regular risk assessments and financial stress testing to ensure their solvency.
• Ensuring Fair Pricing and Transparency: The ACCC oversees premium adjustments, reviewing increases to confirm they meet regulatory standards and safeguard consumer fairness.

 

Protecting Members’ Interests: APRA and ACCC are dedicated to enforcing market integrity and shielding members from misconduct and potential financial threats.

 

 

Westfund Health Insurance Awards and Recognition

 

🏆 Award	📌 Category	📍 Year
🥇 Western NSW Business Awards	Business of the Year	2024
🥈 Western NSW Business Awards	Excellence in Large Business	2024
🥉 Western NSW Business Awards	Excellence in Innovation (Westfund Dental Care)	2024
🏅 Finder Health Insurance Awards	Best Health Insurance - Core Extras	2024
🎖️ Finder Health Insurance Awards	Highly Commended - Comprehensive Extras	2024
🥇 WeMoney Awards	Best for Value	2024
🥈 WeMoney Awards	Best for Gold Hospital Cover	2024
🥉 WeMoney Awards	Best for Silver Hospital Cover	2024
🏅 WeMoney Awards	Health Insurer of the Year (Finalist)	2024
🎖️ WeMoney Awards	Best for Quality (Finalist)	2024
🥇 WeMoney Awards	Outstanding Claims Experience (Finalist)	2024
🥈 WeMoney Awards	Best for Comprehensive Cover (Finalist)	2024
🥉 Energy Australia Black Rose Excellence in Business Awards	Excellence in Large Business	2023
🏅 Energy Australia Black Rose Excellence in Business Awards	Excellence in Innovation (Westfund Dental Care)	2023

 

 

Customer Support and Contact Details

Westfund offers multiple avenues for customer support to ensure members can easily access assistance when needed. Whether online, over the phone, or in person, there are various ways to reach out for help with your healthcare needs.

 

Online Support

Members can access the online chat from 8 am to 5 pm AEDT, Monday to Friday, or email [email protected]. The website also provides frequently asked questions and detailed help sections.

 

Phone Support

You can reach Westfund by calling 1300 937 838 from 8 am to 5 pm AEDT, Monday to Friday.

 

In-Person Assistance

Westfund operates multiple Care Centres in New South Wales and Queensland. These centers are cashless for member convenience and security. Here are some key locations:

 

• Lithgow, NSW: 120 Main Street
• Bathurst, NSW: Suite 3, Reliance Building, 203-209 Russell Street
• Mackay, QLD: Caneland Central Shopping Centre, Mangrove Road & Victoria Street

 

Other Methods

Members can send inquiries or feedback via post to PO Box 235, Lithgow NSW 2790.

 

• Feedback and Complaints: Feedback is encouraged through the Complaints Resolution Policy, and members can call the support number for assistance with complaints.

 

With these convenient contact options, Westfund makes it simple for members to get the support they need. Whether you’re seeking information, or assistance, or want to provide feedback, their customer service team is readily available to assist you.

 

 

Westfund Health Insurance Rebates and Discounts

Westfund offers several rebates and discounts to its members. Members of an approved contribution group are eligible for a maximum annual discount of 12%. The Age-Based Discount provides progressive premium reductions for members aged 18 to 29, starting at 10% for those aged 18 to 25 and gradually decreasing to 2% by age 29.

This discount remains in effect until members turn 41, after which it phases out by 2 percentage points each year, eventually reaching zero by age 45. Additionally, members who take out hospital cover before turning 30 avoid extra premium loadings, while those who delay hospital cover beyond 30 face a 2% loading for each year, up to a maximum of 70%.

Westfund also offers exclusive optical benefits, including 20% off prescription lenses, 10% off contact lenses, and special deals like two frames for $99 (excluding prescription lenses).

 

 

Additional Health Services and Products

Westfund enhances the healthcare experience of its members by providing several additional services and products, including:

 

🔎 Benefit/Program	➡️ Description
1️⃣ Quality Lenses and Discounts	20% off prescription lenses and 10% off contact lenses at Westfund Eye Care Centers.
2️⃣ MotionPlus Program	A 12-week movement improvement program for members with osteoarthritis preparing for surgery.
3️⃣ Preventative Dental Treatments	Low or no-gap services for selected preventative dental treatments.
4️⃣ Bulk-Billed Clinical Services	Vision testing, comprehensive eye health tests, and managing eye conditions, bulk-billed for applicable cases.
5️⃣ Telehealth Services	Access to qualified practitioners anytime with exclusive member discounts.
6️⃣ Birth Beat Partnership	Online courses supporting pregnancy and early parenting, with member discounts available.
7️⃣ Hospital Care at Home	Recovery at home with the support of healthcare professionals after certain hospital procedures.
8️⃣ Rehab at Home	In-home rehabilitation services for a more comfortable recovery process.
9️⃣ Preventative Health Checks	Benefits for preventive health tests, such as mammograms and skin checks.
🔟 Claim on Vitamins	Eligible Extras cover members can claim benefits for specific vitamins and supplements.

 

 

Pros and Cons

 

✅ Pros	❌ Cons
Transparent rebate and discount schemes adhering strictly to the Private Health Insurance (PHI) Act	Limited benefits for private room accommodation
Offers a Health Co-Op initiative providing unique access to digital health programs	Coverage only applies to recognized service providers
Provides nightly accommodation benefits for members who travel for healthcare	Specific plans exclude major procedures
30-day money-back guarantee on policies if no claims are made	Cosmetic surgeries not deemed medically necessary are not covered
Community-focused initiatives like regional health support and sponsorships for local events	Premiums for comprehensive plans are high

 

In Conclusion

Based on our experience, Westfund Health Insurance distinguishes itself with its specialized hospital plans, comprehensive Extras cover, and dedicated ambulance and overseas options.

While the innovative health app provides members with convenient access to services, it could benefit from additional features and a more streamlined interface.

Westfund’s Health Co-Op Programs offer unique value by granting members access to exclusive digital health programs and preventive services. The 30-day money-back guarantee also provides new members with peace of mind when trying out their coverage.

However, the standard waiting periods for certain services and some limitations in app functionality may deter potential members.

In summary, Westfund delivers strong options with substantial member benefits and practical features, but there is potential for further innovation in their digital services and greater flexibility in waiting periods.

 

You might also like: 

 

• Qantas Health Insurance
• TUH Health Insurance
• Union Health

 

Frequently Asked Questions

 

How can I claim with Westfund?

Members can claim online using the Members Portal or the Westfund app for hospital admissions, dentistry, optical, and other eligible services.

 

How does a premium increase work?

Premiums are evaluated yearly according to increasing healthcare expenses, developments in medical technology, and regulatory factors. Westfund tries to keep premiums lower than the industry average for members and their dependents.

 

What are the waiting periods for Westfund policies?

Waiting periods start from one day for emergency ambulance services and can last a year for more specialized services like maternity coverage.