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Westfund Limited

Gold Classic 500

$370.37 / month

(Before Rebate, Discount & Loading)

Available in SA

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: Only one person.

Policy ID: WFD/J25/SAXR10

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 $500 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-classic.pdf

Extras Cover

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/.

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

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$500 per policy

combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services

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

$100 per policy

  • Per monitor: $100
Chinese medicine 2

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$600 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

  • Initial visit: $30
  • Subsequent visit: $30
Endodontic 12

$1,600 per policy

combined limit for endodontic, general dental & major dental

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

$600 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$1,600 per policy

combined limit for endodontic, general dental & major dental

  • Fluoride treatment: $22
  • Scale & clean: $75
  • Surgical tooth extraction: $145
  • Periodic oral examination: $35
Health management / Healthy lifestyle 2

$500 per policy

combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services

  • Health management: $100
Hearing aids 36

$1,400 per policy

  • Hearing aid: $1400
Home nursing 2

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$1,600 per policy

combined limit for endodontic, general dental & major dental

  • Full crown veneered: $850
Non PBS pharmaceuticals 2

$500 per policy

combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services

sub-limits apply

  • Per eligible prescription: $50
Occupational therapy 2

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

  • Initial visit: $40
  • Subsequent visit: $40
Optical 2

$250 per policy

  • Multi-focal lenses & frames: $250
  • Single vision lenses & frames: $250
Orthotics (podiatric orthoses) 12

$200 per policy

  • Orthotics supply & fit: $200
Osteopathy 2

$600 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

$600 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

  • Initial visit: $50
  • Subsequent visit: $50
Remedial massage 2

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

  • Initial visit: $25
  • Subsequent visit: $25
Speech therapy 2

$400 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services

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

$500 per policy

combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services

  • Per service: $50
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services}

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 policy}

Examples of maximum benefits

{Per monitor: $100}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

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, exercise physiology, osteopathy & physiotherapy}

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

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

{combined limit for endodontic, general dental & 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

{$600 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & 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

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

{combined limit for endodontic, general dental & major dental}

Examples of maximum benefits

{Fluoride treatment: $22}

{Scale & clean: $75}

{Surgical tooth extraction: $145}

{Periodic oral examination: $35}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Health management: $100}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

{$1,400 per policy}

Examples of maximum benefits

{Hearing aid: $1400}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $48}

{Subsequent visit: $48}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

{combined limit for endodontic, general dental & major dental}

Examples of maximum benefits

{Full crown veneered: $850}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: $50}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$250 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $250}

{Single vision lenses & frames: $250}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

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, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $42}

{Subsequent visit: $42}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $48}

{Subsequent visit: $48}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for audiology, health management / healthy lifestyle, non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Per service: $50}

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Orthodontic

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-classic.pdf

Ambulance cover

In SA 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.

Other features of this ambulance cover: 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.

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

Insurer Details

Westfund Limited

Gold Classic 500

$370.37 / month

(Before Rebate, Discount & Loading)

Available in SA

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/J25/SAXR10

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