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Westfund Limited

Gold 500

$729.17 / month

(Before Rebate, Discount & Loading)

Available in TAS

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: Two adults (and no-one else).

Policy ID: WFD/J1/TAPC20

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
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.

The following payments may also apply for hospital admissions

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.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members Waiting periods:
  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments
Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

An EXCESS WAIVER applies for admissions into PRIVATE hospitals as a result of an accident. 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).

For further information about this policy see: https://www.westfund.com.au/dl/summaries/gold.pdf

Extras Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$500 per policy

combined limit for acupuncture & chinese medicine

  • Initial visit: $25
  • Subsequent visit: $25
Ante-natal/Post-natal classes 12

$200 per policy

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Audiology 2

$160 per person

  • Initial visit: $80
  • Subsequent visit: $80
Blood glucose monitors 12

$100 per person

  • Per monitor: $100
Chinese medicine 2

$500 per policy

combined limit for acupuncture & chinese medicine

  • Initial visit: $25
  • Subsequent visit: $25
Chiropractic 2

$600 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: $30
  • Subsequent visit: $30
Dietetics/dietary advice 2

$500 per policy

  • Initial visit: $45
  • Subsequent visit: $45
Endodontic 12

$1,400 per person

combined limit for endodontic & major dental

  • Filling of one root canal: $140
Exercise physiology 2

$840 per policy

combined limit for exercise physiology & physiotherapy

  • Initial visit: $30
  • Subsequent visit: $30
Eye therapy (orthoptics) 2

$500 per policy

  • Initial visit: $25
  • Subsequent visit: $25
General dental* 2

No annual limit

  • Fluoride treatment: $24
  • Scale & clean: $85
  • Surgical tooth extraction: $150
  • Periodic oral examination: $40
Health management / Healthy lifestyle 2

$150 per policy

  • Health management: 100% of charge
Hearing aids 36

$1,400 per person

  • Hearing aid: $1400
Home nursing 2

$300 per policy

  • Initial visit: $48
  • Subsequent visit: $48
Major dental 12

$1,400 per person

combined limit for endodontic & major dental

  • Full crown veneered: $1000
Non PBS pharmaceuticals 2

$400 per person

combined limit for non pbs pharmaceuticals, vaccinations & other services

  • Per eligible prescription: $50
Occupational therapy 2

$800 per policy

  • Initial visit: $50
  • Subsequent visit: $50
Optical 2

$250 per person

  • Multi-focal lenses & frames: $250
  • Single vision lenses & frames: $250
Orthodontic* 12

$500 per person

$2,500 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $2500
Orthotics (podiatric orthoses) 12

$200 per person

  • Orthotics supply & fit: $200
Osteopathy 2

$600 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: $30
  • Subsequent visit: $30
Physiotherapy 2

$840 per policy

combined limit for exercise physiology & physiotherapy

  • Initial visit: $42
  • Subsequent visit: $42
Podiatry 2

$544 per policy

  • Initial visit: $45
  • Subsequent visit: $45
Psychology 2

$600 per policy

  • Initial visit: $75
  • Subsequent visit: $75
Remedial massage 2

$500 per policy

  • Initial visit: $30
  • Subsequent visit: $30
Speech therapy 2

$800 per policy

  • Initial visit: $48
  • Subsequent visit: $48
Vaccinations 2

$400 per person

combined limit for non pbs pharmaceuticals, vaccinations & other services

  • Per service: $50
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture & chinese medicine}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Ante-natal/Post-natal classes

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$160 per person}

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $80}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$100 per person}

Examples of maximum benefits

{Per monitor: $100}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture & chinese medicine}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,400 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $140}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$840 per policy}

{combined limit for exercise physiology & physiotherapy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $24}

{Scale & clean: $85}

{Surgical tooth extraction: $150}

{Periodic oral examination: $40}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per policy}

Examples of maximum benefits

{Health management: 100% of charge}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

{$1,400 per person}

Examples of maximum benefits

{Hearing aid: $1400}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Initial visit: $48}

{Subsequent visit: $48}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,400 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $1000}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Per eligible prescription: $50}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $250}

{Single vision lenses & frames: $250}

Orthodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{$2,500 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $2500}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Orthotics supply & fit: $200}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$840 per policy}

{combined limit for exercise physiology & physiotherapy}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $42}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$544 per policy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

Examples of maximum benefits

{Initial visit: $48}

{Subsequent visit: $48}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Per service: $50}

Other features of this general treatment cover: Additional benefits included in this policy are Counselling, Health Aids & Appliances (e.g. Devices for Sleep Apnoea and Diagnosed Snoring, Respiratory Aids, Blood Pressure Monitors), Outpatient Travel, and 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.

For further information about this policy see: https://www.westfund.com.au/dl/summaries/gold.pdf

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover: Permanent Tasmania residents are covered for emergency pre-hospital ambulance treatment and transport in Tasmania, residents must purchase cover for non-emergency ambulance transport or emergency transport in another state. This product provides coverage for emergency and non-emergency 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.

For further information about this policy see: https://www.westfund.com.au/dl/summaries/gold.pdf

Insurer Details

Westfund Limited

Gold 500

$729.17 / month

(Before Rebate, Discount & Loading)

Available in TAS

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/WFD/J1/TAPC20

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