On this page:
- Who is Westfund?
- Does Westfund get many complaints from members?
- How good is Westfund's gap cover?
- How many hospital agreements does Westfund have in each state?
- Does Westfund offer any discounts?
- Does Westfund offer ambulance cover?
- Does Westfund offer family policies that cover adult children?
- Does Westfund let you claim online or in-app?
Who is Westfund?
Westfund began its life as a nonprofit health fund for miners in 1953 and continues to focus on local communities today, particularly in regional NSW and Queensland. It has more than 120,000 members and is part of Members Health, an alliance of nonprofit and mutual health funds.
Phone: 1300 937 838
Website: westfund.com.au
Does Westfund get many complaints from members?
Westfund has a Low complaints rating.
When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don't get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.
How good is Westfund's gap cover?
A medical gap is the difference between Medicare's recommended fee and what your doctor actually charges for a treatment or service.
Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called 'no gap agreements', or part of that gap, which are called 'known gap agreements' (these will have lower out-of-pocket costs, usually less than $500).
Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.
Rating scale
- Well above average
- Above average
- Average
- Below average
- Well below average
How many hospital agreements does Westfund have in each state?
The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you're treated.
The table below shows how many hospital agreements Westfund has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don't have agreements with specific funds and are generally treated as though they're agreement hospitals.
Does Westfund offer any discounts?
Westfund doesn't offer any discounts for prepaying your premium or paying your premium by direct debit, but there are youth discounts offered on some hospital policies. These are transferable, meaning you can transfer a discount from another fund to one of these policies.
Does Westfund offer ambulance cover?
All Westfund hospital and extras policies have emergency ambulance cover.
Cover is capped for non-emergency patient transport at $5000 per member.
Does Westfund offer family policies that cover adult children?
- Adult children are covered on family policies for free until they turn 25.
- Full-time students are covered on family policies until they turn 31 for an extra cost.
- Adult children younger than 31 can be covered on extended family policies for an extra cost.
Does Westfund let you claim online or in-app?
Most extras can be claimed online.
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