Westfund Health Insurance Questions & Answers

Hi Linda m, thank you for taking the time to ask this question. Unfortunately, cosmetic surgery would only be covered if it sits under the clinical category of plastic and reconstruction surgery and is deemed medically necessary.

Weight loss surgery is an inclusion on our Gold Hospital policy. This policy covers the below weight loss procedures:

o Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
o For example: gastric banding, gastric bypass and sleeve gastrectomy.

To ensure you are covered for your elected procedure, we advise you to get a quote from your doctor which includes the Medicare Benefits Schedule (MBS) item numbers and email the quote with your enquiry to [email protected]

If you wish to discuss your enquiry in further detail, please send us a private message with your best contact number and we will arrange for a member of our team to give you a call.

Hi Michael, thank you for taking the time to ask this question. Our Gold Hospital and Silver Plus Assure Hospital policies have coverage for cataract surgery as an in-patient in hospital for members who have served their waiting periods.

Hi Wayne, thanks for your question. We do not currently have an optical provider in Redcliffe, however our Provider of Choice Network is constantly growing. For the most updated look of our providers head to https://www.westfund.com.au/health-services/provider-of-choice/

Hi Qqq, you can claim from a dentist who is not from our Provider of Choice Network. By choosing a dentist from the Provider of Choice Network, you will not pay any out-of-pocket expenses on selected services. I hope this helps to answer your question.

Hi Vickie, We thank you for your question. Please be assured we are operating as usual. We did experience a phone system issue this yesterday, but our system is now operating as normal.

Hi Fred,
Westfund members on a Gold policy can claim $50 per prescription for the amount that exceeds the Pharmaceutical Benefits Scheme (PBS) co-payment, up to a limit of $400 per member per calendar year.
We hope this answers your query.

Hi Graeme,
Westfund is pleased to offer our Provider of Choice Network to members. Our Provider of Choice Network is a group of dental, physiotherapy and optical providers who are committed to providing exceptional treatment to our members while lowering or eliminating out-of-pocket costs for Extras services on preventative dental, physiotherapy and optical treatments.
For more information or to find a Provider of Choice in your area, visit https://www.westfund.com.au/health-services/provider-of-choice

Hi Helen,
Currently our Provider of Choice Network in Western Australia only includes dental practices, however the Network itself does now also include physiotherapists. If you would like to recommend a dental or physiotherapy practice for the Provider of Choice Network, simply email their details to [email protected]

Hi Kerry, Thank you for reaching out. Generally, if your husband goes through the public emergency system he will be covered. If you have any detailed questions about your particular cover we recommend calling one of our friendly staff on 1300 937 838. Thank you for your question Kerry.

Hi Beagles05, we do cover up to $150 per member per year for blood pressure monitors on our Bronze, Bronze Plus, Silver, Silver Plus, Gold, Gold Classic, Platinum and Platinum Plus covers. This benefit is subject to waiting periods. If you would like to talk to our team members about which policy is right for you or any waiting periods you may have please call us on 1300 937 838.

Hi Pru, we service members from around Australia. Although we do not have Care Centre locations in Sydney, we are always here to help over the phone, or if you'd prefer online you can use our Members Online area or claim on our app. Please do not hesitate to give one of our friendly staff a call 1300 937 838 if you have any questions. Thank you.

Hi Shirley,
Thank you for your question. If you are referring to our Providers of Choice network, we are always able to look into Physiotherapists for our members in their area. If you would like to pass on a suggestion call us on 1300 937 838 and let us know.

Hi Cass, unfortunately, we do not have a Care Centre in Penrith. One of our Contact Centres are located in Penrith and are always here to help on 1300 937 838.

Hello, In order for us to give you the most accurate quote please give us a call on 1300 937 838 so we can discuss your personal circumstances and the best option for you. We will able to compare your current policy with a Westfund Policy for you. Thank you.

Hi Jacc, we are Australian owned with our Contact Centres in Maroochydore, Lithgow and Penrith. You can call us anytime on 1300 937 838. Thank you for your question.

Hi Sharon, Thank you for comparing with us. You will not serve any waiting periods on equal benefits on your new Westfund Policy.

Where you may serve waiting periods:

- any benefits under your new policy that were not included in your previous cover
- any difference between a Westfund benefit and the one provided by your previous fund, where the Westfund benefit is higher
- the unexpired portions of any waiting periods that haven’t been fully served under the terms of your previous cover
- the difference between any excess or co-payment payable under the previous cover and the new cover (where the previous cover carried a higher excess or co-payment)

We understand switching may seem difficult, Sharon. However, if you’d like to call our Contact Centre on 1300 937 838 we will be more than happy to personally compare your current policy and waiting periods for you.