Westfund Health Insurance Questions & Answers

Hi Odelle, thanks for reaching out! If you were overseas on your Lifetime Health Cover (LHC) base day, which marks the anniversary of becoming eligible for Medicare, you have a 12-month period from your first return to Australia for a period of 90 days or more. The anniversary of the first return to Australia of 90 days or more becomes your new LHC base day.

To further assist you, we would need a copy of your Medicare Registration letter along with an International Movement Record. This documentation will help prove that you were not in Australia on your original base day and that you haven’t returned for a period of 90 days or more without holding Private Hospital cover.

We can arrange for a member of our team to get in touch with you to help you with your enquiry. If you would like us to arrange this for you, please send us a private message with your best contact number and membership number.

Hi Miliakere, thanks for reaching out. We would be happy to help you, please send us a private message with your best contact number and a member of our team will get in touch with you to help you with your enquiry.

Yep I've never had a problem, just went a month ago and no out of pocket expense.

Hi Roland, thanks for reaching out! Our no-out-of-pocket preventative dental care can be claimed at dentists in our Provider of Choice Network. However, you can use your dental limit at any registered provider. If you have any further questions our team would be happy to assist you.

Give them a call I have found the staff very helpful and accomodating

I don't use the Westfund eye centres, go to any optometrist and get your glasses. My last pair of prescription sunglasses cost me $48.00 out of pocket and I think they cost $450 odd.

Hi Lisa, thank you for considering joining us! Unfortunately we do not have a Westfund Eyewear or optical Provider of Choice near you, however you are able to use your optical limit at any registered provider. If you would like, we can happily arrange for a member of our team to give you a call to discuss your options.

Not sure but if you call them I have found they are extremely helpful and able to answer any questions I've had

Hi Cindy, thanks for asking this question. If you have served your three-year waiting period, you’ll be able to claim a $1,400 benefit. However, the hearing aid must be purchased from an Audiologist or Audiometrist. If you have any further questions, please don’t hesitate to call us on 1300 937 838 or email enquiries@westfund.com.au.

Hi Kim, thanks for reaching out. To answer your question, we'll need to know some additional details. We'd like to arrange for a member of our team to get in touch with you to help you with your enquiry. If you would like us to arrange this for you, please send us a private message with your best contact number and membership number.

In the meantime, you can find out more about Access Gap cover on our website - external link 

Hi Janet. We have several providers in network in and around Perth. The best way to Find a Provider near you is to use our online search tool available here: external link . With Westfund, you can also use your extras benefits at any registered provider.

Thanks. At present only 2 dentists in my area. Will keep following the expanse of Westfund and hopwfu;;y can change to any provider here with a Hicaps machine

Not sure but their head office is in NSW and I live in Queensland so I think they might.

Hi Jitender A., Thanks for asking this question. Yes, you can join Westfund. Although, we don't have a Westfund Care Centre in Victoria. Our team are more than happy to talk you through your cover options to ensure you choose the right level of cover to suit your lifestyle needs. If you would like us to arrange for a member of our team to get in touch with you, please send us a private message with your name and best contact number or email address.

Hi Joshua H., thanks for asking this question. We are more than happy to help our members who may be experiencing financial difficulties. If you would like to discuss your options, we'd be happy to arrange for a member of our team to get in touch with you. If you would like us to arrange this for you, please send us a private message with your membership number and best contact number.

Hi Jamie, thanks for asking this question. Yes, we do provide Overseas cover to people who hold 417 visas. If you would like to further discuss your cover options, please send us a private message with your best contact number or email address and we’ll happily arrange for a member of our team to get in touch with you.

Hello yes thank you for getting back to us, it is our daughter who is looking for insurance but has ask us to help her select the right plan, she is currently in Australia and working and is not able to talk during the day, we live in Canada and can speak to you at any time that is mutually agreeable, our email is [Contact Details Removed] and our cell is [Contact Details Removed] or [Contact Details Removed] my name is jamie and my husband is nick please let us know if it is possible to speak with us for the plan types and the quotes, of course our daughter will connect once we can guide her to which plan would be suitable for her. Thank you for your time...

Hi Jamie, we'd be happy to discuss the best cover options for your daughter with you. We can confirm that we will be in touch via email shortly.

Hello and Good Morning from Canada, we have not yet heard from anyone in your office via email at [Contact Details Removed], we realize we are on different time zones, but if we could get the standard packages offered for a Canadian Female Age 29 on a working 417 visa, with descriptions of what is included and what is not and the costing we can then help our daughter pick the right package and she will contact you from Australia to set the policy up, we look forward to hearing back as we need to make a decision this week as her canadian insurance is set to expire the first week of May, thank you

Hi Jamie, we apologise for the delay in response. Our team have now reached out to you via email. If you have any further questions, please don't hesitate to reach out again.

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Amazing answer! Very polite and so comprehensive!!!

Maybe there are someone who know anything? I am in palm cove and want to use your $100 gift card but not sure where??!!!

Hi Simon, thanks for asking this question. Our egift cards can be used at a variety of major retailers that you can choose from and can either be redeemed online or in store, if that retailer is near you. To view the full range of retailers and to redeem your egift card, you’ll need to open the email you were initially sent and follow the prompts. If you have any further questions, or would prefer for a member of our team to walk you through this, please send us a private message with your membership number and best contact number.

The best answer I can give is for you to call them on 1300 937 838 as mine membership is fully tailored to my needs so what it may cost me may be different for someone else. The ladies at WestFund Lithgow are extremely helpful with any and all queries. Sorry I could not give you a set figure.

Hi Jac, thanks for asking this question. In order to give you an accurate quote, please send us a private message with your membership number and best contact number or email address and we’ll be in touch shortly.

Hi Sky, it's difficult to answer this question as everyone's plan is on a different level, depending on the cost of premium you choose. We haven't gone with Top cover but we have chosen to have a $500 excess for hospital. It really is useful to chat with the Compare The Market people, they will talk through what you need from the health fund.

Thank you. I will try that. There is also a dr came up in Campbelltown for this op also.

Hi Sky A., thanks for asking this question. We do cover weight loss surgery under our Gold Hospital cover, if it is considered a medically necessary procedure. It's important to note that the procedure needs to have an applicable Medicare Item Number to be payable by Westfund. If you have a pre-existing condition and do not currently have hospital cover, you would need to serve a 12 month waiting period. You are able to choose your own doctor, however to be covered for this procedure your doctor would need have rights to one of Westfund's contracted hospitals. We are more than happy to discuss your options with you. If you would like further information, please send us a private message and we'll ensure it is followed up.

Thank you. I called your team today go chat

Hi Mona, thanks for asking this question. We do cover sleeve gastrectomy surgery under our Gold Hospital cover, if it is considered a medically necessary procedure. It's important to note that the procedure needs to have an applicable Medicare Item Number to be payable by Westfund. If you have a pre-existing condition and do not currently have hospital cover, you would need to serve a 12 month waiting period. If you would like further information, please send us a private message and we'll ensure it is followed up.

What is considered “pre-existing”?

Hi Sandra, thanks for asking this question. 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 - external link 

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.

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

What is the amount payable under gold cover?

Hi Debi J., thanks for asking this question. There are many factors that contribute to the cost of a procedure. We encourage you to get in touch with us to discuss your enquiry in further detail, please send us a private message with your best contact number and we will be happy to arrange for a member of our team to give you a call.

Hi Peter, thank you for asking this question. We are a regional not-for-profit health fund with locations across NSW and Queensland and have been serving Westfund members since 1953. You can find more information about Westfund’s history on our website - external link . For information regarding our waiting periods, we recommend you visiting our dedicated waiting periods page - external link .

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

Hi Peter, thank you for asking this question. We are a regional not-for-profit health fund with locations across NSW and Queensland and have been serving Westfund members since 1953. You can find more information about Westfund’s history on our website - external link . For information regarding our waiting periods, we recommend you visiting our dedicated waiting periods page - external link .

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

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 enquiries@westfund.com.au

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.

Suggest you get a friend to ring and ask for details

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.

I am in NSW and go to a Specsaver shop and Westfund give me a refund of approx $250 ( sometimes I don’t spend that as with most places they cover the eye test through Medibank and Specsavers claim and I don’t have to do a thing) I know there is a Westfund at Maroochydore Qld. Just give them a call. Good luck with it all

Thanks.This has been helpful.