(before any rebate, loading or discount)
Covers two adults & dependants (3 or more people, only 2 of whom are adults)
Available in South Australia
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
This policy covers children and other dependants up to and including the age of 24, as well as persons with a disability who qualify as a child or other dependant in this age range.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Assisted reproductive services | Eye (not cataracts) | Pain management |
| Back, neck and spine | Gastrointestinal endoscopy | Palliative care |
| Blood | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Bone, joint and muscle | Heart and vascular system | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Brain and nervous system | Hernia and appendix | Pregnancy and birth |
| Breast surgery (medically necessary) | Implantation of hearing devices | Rehabilitation |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Skin |
| Dental surgery | Kidney and bladder | Sleep studies |
| Diabetes management (excluding insulin pumps) | Lung and chest | Tonsils, adenoids and grommets |
| Digestive system | Male reproductive system | Hospital psychiatric services |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Cataracts | Insulin pumps | Pain management with device |
| Dialysis for chronic kidney failure | Joint replacements | Weight loss surgery |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.
Excess payments do not apply to hospital admissions for accidents or dependants.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
Travel & Accommodation benefits for inpatient hospitalisations. Access to health and wellbeing programs to provide rehabilitation and hospital care from home as well as management of chronic conditions (mental health, cancer support, weight management).
By using this health insurer's "preferred providers" you will have lower out-of-pocket costs on Dental and have access to more "no gap" services. A list of "preferred providers" is available from the health insurer. See https://www.westfund.com.au/find-a-provider/.
| Note, for items marked with an asterisk *: Access our Provider of Choice network — dental providers nationwide who work with us to help lower or eliminate out-of-pocket costs on selected preventative treatments | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $800 per person up to $1,600 per policy (combined limit for general dental, major dental & endodontic) | Periodic oral examination - 60% of charge Scale & clean - 60% of charge Fluoride treatment - 60% of charge Surgical tooth extraction - 60% of charge |
| Major dental | 12 | Full crown veneered - 60% of charge | |
| Endodontic | 1 | Filling of one root canal - 60% of charge | |
| Optical | 2 | $200 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $500 per person up to $1,000 per policy (combined limit for non pbs pharmaceuticals, physiotherapy, chiropractic, podiatry, psychology, acupuncture, remedial massage, audiology, ante-natal/post-natal classes, chinese medicine, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), health management / healthy lifestyle, home nursing, occupational therapy, osteopathy, speech therapy, vaccinations & other services) | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Chiropractic | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Podiatry | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Psychology | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Acupuncture | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Remedial massage | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Audiology | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Ante-natal/Post-natal classes | 12 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Chinese medicine | 0 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Dietetics/dietary advice | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Exercise physiology | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Eye therapy (orthoptics) | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Health management / Healthy lifestyle | 2 | Health management - 60% of charge | |
| Home nursing | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Occupational therapy | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Osteopathy | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Speech therapy | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Vaccinations | 2 | Per service - 60% of charge | |
| Blood glucose monitors | Orthodontic |
| Hearing aids | Other treatments - check with your insurer |
Additional benefits included in this policy are Counselling, Sunglasses purchased through a Westfund Care Centre or through Westfund’s online sunglasses store, The Collection. Please contact Westfund for details or visit www.westfund.com.au/help/ for additional claiming information.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: transport with a waiting period of 2 months, limited to $5,000 per person per year.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Cover for the unexpected. Feel assured with Australia-wide ambulance cover for emergency and non-emergency transportation (up to available limits). This product provides coverage for transport by a Westfund recognised Ambulance service provider in Australia either by covering the cost of state government levies or by covering the ambulance account. Recognised Ambulance service providers include: NSW Ambulance, Ambulance Victoria, Queensland Ambulance Service, ACT Ambulance Service, SA Ambulance Service, Ambulance Tasmania, St John Ambulance NT, St John Ambulance WA, St John Ambulance Norfolk Island and NSW Government local service providers.
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.