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Insurer

Westfund

Reviewed and updated 16 March 2024

About Westfund

What is Westfund?

Westfund Health Insurance (Westfund) is a private health insurer that operates as an open health fund

Background

Established in 1953, Westfund began as the Western District Mineworkers Medical Benefits Fund. It was set up to help miners based in central western New South Wales with hospital and medical expenses. In the 1990s, the fund expanded into regional Queensland. 

In 2021, it re-branded as Westfund Health Insurance.

Today, Westfund has over 110,000 members mainly located in regional New South Wales and Queensland.

Who can join Westfund?

Anyone can join Westfund as it is an open health fund.

What products does Westfund offer?

Westfund offers:

Do Westfund policies include Ambulance Cover?

Westfund includes emergency Ambulance Cover with:

  • Hospital Cover
  • Extras Cover.

This also includes non-emergency transport but your policy may place a cap on this service. Check your policy for details.


Is Westfund Health a not-for-profit health insurer?

Yes. Westfund is a not-for-profit health insurer.


Does Westfund Health operate in all Australian states and territories?

Yes. Westfund operates in all Australian states and territories.


How does Westfund Health Hospital Cover compare with other insurers?

BenchmarksWestfundIndustry average
Member retention for Hospital Cover88.3%88.6%
% hospital-related charges covered91.3%90.6%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022


Does Westfund Health have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. Westfund has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

LocationNumber of private Agreement HospitalsIndustry maximum
ACT56
NSW9698
NT22
QLD5260
SA2023
TAS89
VIC7376
WA2124

Westfund also has agreements with a number of day hospitals to allow it to provide services at low cost or no out-of-pocket costs:

LocationNumber of day Agreement HospitalsIndustry maximum
ACT89
NSW86103
NT12
QLD4957
SA2430
TAS48
VIC6979
WA2024

Source: Westfund Health: performance


How does Westfund Extras Cover compare with other insurers?

BenchmarkWestfundIndustry average
% Extras Cover charges covered46.1%52.0%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022


How does Westfund Health compare with other private health insurers?

BenchmarksWestfundIndustry average
Market share0.9%
% services with no gap90.9%88.8%
% services with no gap or where known gap payment made98.0%97.4%
Market share of complaints to the PHIO1.0%
% complaints investigated by the PHIO2.5%
Benefits as a % of contributions79.7%83.1%
Management expenses as a % of contribution income12.9%9.9%
Management expenses per average policy$542$375

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2022


Is Westfund a member of any industry organisations?

Yes. Westfund is a member of Private Healthcare Australia (PHA), a body that represents 20 registered health insurers and 97% of people covered by private health insurance.

It is also a member of the Members Health Fund Alliance, an alliance of not-for-profit, member-owned, regional or community-based health insurers.


Does Westfund let me claim online or via an app?

Yes. Westfund Health allows you to make a claim online via the Members Online portal or using the Westfund app.


How to contact Westfund

Phone:

1300 937 838

Website:

https://www.westfund.com.au/

Email:

enquiries@westfund.com.au

Address:

59 Read Avenue
LITHGOW NSW 2790

Postal address:

PO Box 235
LITHGOW NSW 2790


Compare Westfund with other private health insurers


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