Westfund Limited (WFD)
Westfund Health Insurance has been built on solid community values and a foundation of trust, located in the heart of regional Australia. We are proudly not-for-profit and are honoured to be trusted with looking after our members’ health.
Our history can be traced back more than six decades to the official registration of the Western District Mine Workers Medical Benefits Fund in Lithgow in 1953. The seeds of today’s Westfund were, however, sown long before this date and illustrate a potent connection to mutualism and of a community drawing strength by uniting together for collective purpose and benefit.
Today at Westfund, we still believe the member is the priority. We treat our members as people, not numbers.
While our care centres are located throughout regional communities, we have health providers located across Australia, providing support to our members nation-wide.
We empower our members to select the cover that best suits their needs with our Your Cover, Your Choice suite of products – linking individual Hospital and Extras covers together to provide greater flexibility.
Westfund Limited provide further information regarding:
- Gap cover doctors
- Agreement hospitals
- Branches
- Ambulance cover information
- Preferred providers
- Overseas visitors
Agreement Hospitals
This fund has agreements with some private hospitals or day surgeries to provide services at low or no out-of-pocket costs. You can see Agreement Hospitals for this insurer and further details are available from the insurer.
Business Structure
This insurer is a mutual organisation that operates on a not-for-profit basis.
Westfund Limited operates in all states and territories.
Performance
The Private Health Insurance Ombudsman prepares an annual report on the service delivery and performance of Australian health insurers. The following is a selection of statistics about this health insurer - the full report and an explanation of these figures is available from the Ombudsman's website. Please note information is not provided for some insurers in some states, as there are insufficient numbers reported to APRA for states in which the insurer does not have a large membership.
| Performance | Insurer | Industry |
|---|---|---|
| Benefits as a % of contributions | 84% | 86% |
| Management expenses (% cont) | 12.8% | 9.1% |
| Management expenses (average policy) | $528 | $350 |
| Surplus | 3.2% | 4.9% |
| Member retention (%) | 88% | 82% |
| Coverage | ACT | NSW | VIC | QLD | SA | WA | TAS | NT |
|---|---|---|---|---|---|---|---|---|
| Hospital Related Charges Covered | 94.2% | 94.1% | 95.4% | 92.4% | 96.1% | 93.1% | 95.3% | 93.8% |
| Industry Result | 83.8% | 90.4% | 92.2% | 90.8% | 94.6% | 93.0% | 93.9% | 90.2% |
| Medical Services with No Gaps | 73.5% | 92.4% | 90% | 90.1% | 89.2% | 79.4% | 85.4% | 75% |
| Industry Result | 78.5% | 88.9% | 85.6% | 88.4% | 87.3% | 85.0% | 88.6% | 84.2% |
| Medical Services with No or Known Gaps | 82.7% | 97.8% | 98.6% | 97.4% | 98.4% | 96.5% | 92.8% | 96.3% |
| Industry Result | 91.0% | 95.5% | 94.7% | 94.5% | 95.1% | 96.4% | 96.0% | 94.0% |
| General Treatment (extras) Covered | 43.2% | 50.1% | 46.2% | 52.6% | 49.3% | 46.6% | 44.4% | 35.8% |
| Industry Result | 48.1% | 50.7% | 52.4% | 54.3% | 57.4% | 57.5% | 54.3% | 59.1% |
| Private Hospital Agreements | 5 | 96 | 76 | 50 | 25 | 21 | 8 | 2 |
| Industry Maximum | 9 | 110 | 83 | 61 | 33 | 31 | 8 | 2 |
| Day Hospital Agreements | 8 | 92 | 73 | 49 | 29 | 23 | 4 | 1 |
| Industry Maximum | 6 | 98 | 78 | 57 | 29 | 23 | 5 | 2 |
| Share of PHIO complaints | Compared to insurer's market share | |
|---|---|---|
| Benefit Complaints | 0.6% |
0.8%
|
| Service Complaints | 0.7% | |
| All Complaints | 0.6% | |
| Investigations | 0% |
Lithgow
NSW 2790