Westfund Health Insurance Review
Established in 1953, Westfund Health Insurance is a regional health fund that prides itself on being wholly Australian owned. It serves members in 12 towns and cities across New South Wales and Queensland.
In addition to being an Australian owned company, Westfund Health is also not-for-profit. Their not-for-profit model drives their core values and company philosophies. Westfund Health touts the following patient-centered values:
- We genuinely care
- We are open and honest
- We act with integrity and respect
- We cooperate and work together
- We always have empathy
These values guide their business practices, leading them to refer to their customers as members who are a part of the family. They aim to make all decisions in the best interest of their members, as they do not have to answer to shareholders.
As Westfund Health is a regional insurance provider, not a national company, it is important to be aware of the extent of their service area and the extent of their support assets.
Westfund Health has over 180 employees available to help its members across 12 Care Centre locations and their home office in Lithgow, New South Wales. Members can find Care Centres in the following locations:
- Westfund Health is a regional, Australian-owned, non-profit health insurance company that has branches in Queensland and New South Wales
- Westfund Health Insurance is community focused and participates in several fundraisers and other initiatives throughout the year. They also provide a range of ‘no gap’ dental and optical services through several of their NSW and QLD Care Centres.
- Westfund Health offers several types of cover for people at various stages in life. Their coverage options can also include access to the Member Advantages Program, which offers additional benefits and perks.
Because Westfund Health Insurance is a smaller company that focuses its efforts regionally instead of nationally or globally, it is able to provide a level of personalised customer service that larger, publicly traded companies may not be able to match.
This personal service includes:
Cooling off period
Westfund Health Insurance affords all of its members a cooling off period. This period applies to those who have recently joined the company as well as existing customers who change cover types.
During this period, members have 30 days to give further review and consideration to their coverage plan. If they decide to cancel or change their cover type during the 30 days, Westfund Health will either refund their premium or transfer them to the new plan of their choice.
Their staff aims to treat members as individuals and strives to take the time to get to know each one more personally. With that, being friendly and taking the time to listen to and understand their members’ concerns and needs are amongst the top priorities for Westfund Health.
Although Westfield Health Insurance is a smaller company that can provide friendly, personal service and health insurance policies that are easy to understand, they lack the major risk sometimes associated with working with a small company – instability.
Many smaller companies often lack stability and financial soundness. However, Westfield Health has been serving Australians in New South Wales and Queensland for over 80 years. They are a stable company that continues to improve and diversify their services for members.
For those who value Social Responsibility, Westfund Health Insurance deserves a second look. This insurance company values giving back to the community and participates in many local fundraising events and other initiatives throughout the year. Some of their major initiatives include:
Westfund Christmas Appeal
Westfund Health Insurance has been running their Christmas Appeal for over 30 years. In that time, they have donated more than $500,000 to local families in need. In addition to financial help, the Christmas initiative also provides toys and non-perishable foods to the less fortunate in Westfund Health’s service areas.
Westfund Dental Care Visits
Every year, the Westfund Dental Care team visits local schools and other community organisations. During the visits, they use the Tooth Fairy to teach children about tooth decay, healthy gums, and other dental health related issues.
Westfund also supplies attending children with a dental pack that includes a new toothbrush and toothpaste!
The visits, presentation, and dental pack are all free to the communities Westfund Health serves.
Vision Screening Program
The Vision Screening Program is another free community service provided by Westfund Health Insurance.
Through this program, Westfund Health provides free eye checks for school children. They also provide the children’s parents with a report that details any eye health concerns, a basic assessment, and any recommendations for future care.
Westfund Health offers a Member Advantages Program in which members receive special benefits. Benefits depend on the members cover level and tenure with Westfund Health. The longer the member is with Westfund Health, the more benefits he or she has access to. Depending on the cover joined, some of the special benefits of the Member Advantages Program include:
No Excess for Day Surgery
Under the Member Advantages Program, Westfund Health does not apply an excess on claims for the following
Hospitalisation Resulting From an Accident
Westfund Health will pay eligible members $200 per night if they are hospitalised due to an accident.
Members can receive up to $100 each year for sunglasses purchased at a Westfund Care Centre.
Accommodation and Travel Benefit
After one year with Westfund Health, members can receive money to help pay for medical travel related expenses. This includes
Up to $150 per night for accommodation expenses
Up to $70 per round trip for travel expenses
Advanced Surgery Benefit
Members who require advanced surgical procedures due to heart disease, stroke, or cancer and have been with Westfund Health for at least two years, can receive $400 a night during their hospital stay. This benefits pays out up to $4,800.
Westfund Health will waive up to 6 months of premium payments for members who are subject to Forced Retrenchment or Protected Industrial Action
Waived premiums are available to those who have been with Westfund Health for at least 3 years.
Westfund Dental and Eye care
Westfund Health members can receive up to $80 to put toward out of pocket expenses related to prescription glasses or contacts. This benefits applies to those who utilise Westfund Eye Care Centres to buy their glasses and contacts.
Benefits Savings Accident Benefits $200/night Sunglasses Benefit $100/year Accommodation and Travel Benefit $150/night &
Advanced Surgery Benefit up to $4800 Westfund Dental and Eye Care $80 Total at least $5400 potential Member Rewards Savings
Westfund offers a variety of coverage options. They work to make the coverage options easy to understand for all of their current and potential members.
Their coverage options include:
Hospital and Extras Cover
Westfund Health’s Hospitals and Extras cover is their most comprehensive coverage option. It can include services related to:
- Complementary Therapies
- Preventative Health Treatments
The Hospital and Extras plan is available at several levels ranging from Gold Public to Platinum Plus.
Members who are enrolled in any Hospitals and Extras plan are also eligible for the highest level of Member Advantages Program benefits.
These plans are best suited for those who want the reassurance of a full hospital cover with added benefits.
Hospital Only Cover
The Hospital Only plan covers charges for treatment at all public and most private hospitals in Australia. This coverage includes:
- Ambulance costs incurred from a medical emergency
- Hospital costs for procedures included in your coverage level
- Hospital costs for procedures that qualify for a Medicare benefit
This coverage plan also includes access to the Member Advantages Program and is available at the Gold Hospital and Gold Hospital 500 levels.
- Gold Hospital level – Suitable for those who want to ensure they receive top care and cover for hospitals, but don’t need extras and complimentary services.
- Gold Hospital 500 level – Includes the same coverage as the Gold Hospital level, but with a $500 excess and lower the premium.
Extras Only Cover
Westfund Health’s Extras Only options are for those who want benefits that cover healthier living, but don’t want hospital or medical cover.
This coverage plan comes in three levels:
- Value Extras
- Gold Extras
- Platinum Extras
Value Extras includes:
- Ambulance cover
- Access to some Westfund Member Advantages
- Health Management
Gold and Platinum covers include additional services and higher benefits
The Ambulance cover plan provides unlimited comprehensive emergency ambulance services throughout Australia. It also provides members a non-emergency ambulance transport benefit of up to $5,000 per calendar year.
In the most recent State of the Health Funds Report, Westfund Health demonstrates performance that is in line with its size and market share.
In many areas, such as management expenses and member retention, it even performs better than the Health Funds industry as a whole.
The amount of complaints that Bupa receives is also less than to be expected from a fund its size. It maintains about 0.7% market share, but only received 0.3% of all PHIO complaints.
Medibank Private compared to Industry
Share of Private Health Insurance Ombudsman complaints
Westfund Health provides several options for its members to lodge claims.
Westfund Health Insurance participates in the Health Industry Claims and Payment Service (HICAPS). Members can swipe their Westfund membership cards to initiate claims when seeing any health provider associated with HICAPS. Those claims are processed automatically and do not require any additional forms.
Patients who choose to file a Westfund Health claim online can do so by logging onto the Members Area here.
Fax, Email, Post
Westfund Health members can also submit a physical claim form via fax, email, or post. Simply fill out the appropriate claim form and send it to Westfund based on the preferred method.
02 6352 3408
PO Box 235, Lithgow NSW 2790
Westfund Health Insurance is a community-focused company that aims to treat its members personally and respectfully. It provides a wide-range of services for members at all stages of life.
For more information on pricing and cover specifics, contact Westfund Health at:
59 Read Avenue
Lithgow NSW 2790
Locate specific care centers at: