Compare Westfund health insurance


A nonprofit health fund that began in 1953 for miners, it continues to focus on regional communities today.

Fund information


Westfund summary

Is Westfund nonprofit? 

Does Westfund get many complaints from members? 

How good is Westfund's gap cover? 

How many hospital agreements does Westfund have in my state? 

Does Westfund offer any discounts?

Does Westfund offer ambulance cover?

Does Wesftund offer family policies that cover adult children?

Does Westfund let you claim online or in-app?

What CHOICE Community says about Westfund


Westfund summary

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 99,000 members.

Westfund contact details

Phone: 1300 748 984

Email: enquiries@westfund.com.au

Website: westfund.com.au


Is Westfund nonprofit?

Yes.


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Does Westfund get many complaints from members?

Westfund complaints rating: Low

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.
  • The infographic below shows the complaints about the fund to the Ombudsman as a percentage of all complaints. Complaints can be about benefits or customer service. The most serious complaints are escalated for investigation.
  • The higher the share of complaints a fund receives above its market share, the worse its performance compared to other funds. If its share of complaints is below its market share, that's a better result.

Westfund accounts for...

0.7% of the health insurance market

0.1% of all complaints about benefit payments

0.0% of all complaints about service

0.6% of all complaints that are escalated to investigations.

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

  • Above average
  • Average
  • Below average
  • Well below average

We also display the percentage of medical services that Westfund covers with no gap, and compare it to the industry average. The higher the percentage, the more effective the fund's gap scheme is in a state or territory.

Westfund gap cover performance by state

New South Wales (NSW)

Average

Australian Capital Territory (ACT)

Below average

Victoria (Vic)

Above average

Queensland (Qld)

Average

South Australia (SA)

Above average

Western Australia (WA)

Average

Tasmania (Tas)

Well below average

Northern Territory (NT)

Well below average

Percentage of medical services covered with no gap

New South Wales (NSW)

Westfund – 86.0%

Industry average – 86.3%

Australian Capital Territory (ACT) 

Westfund – 66.9%

Industry average – 76.7%

Victoria (Vic) 

Westfund – 84.6%

Industry average – 85.0%

Queensland (Qld) 

Westfund – 85.4%

Industry average – 85.1%

South Australia (SA) 

Westfund – 91.3%

Industry average – 86.8%

Western Australia (WA) 

Westfund – 86.2%

Industry average – 90.1%

Tasmania (Tas) 

Westfund – 76.9%

Industry average – 83.0%

Northern Territory (NT) 

Westfund – 62.9%

Industry average – 80.1%

How many hospital agreements does Westfund have in my 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.

Westfund has

ACT

6 private hospital agreements out of an industry maximum of 7

7 day hospital agreements out of an industry maximum of 8

NSW

99 private hospital agreements out of an industry maximum of 100

90 day hospital agreements out of an industry maximum of 100

NT

2 private hospital agreements out of an industry maximum of 2

1 day hospital agreements out of an industry maximum of 2

Qld

54 private hospital agreements out of an industry maximum of 58

47 day hospital agreements out of an industry maximum of 53

SA

26 private hospital agreements out of an industry maximum of 27

25 day hospital agreements out of an industry maximum of 28

Tas

8 private hospital agreements out of an industry maximum of 8

3 day hospital agreements out of an industry maximum of 6

Vic

78 private hospital agreements out of an industry maximum of 79

76 day hospital agreements out of an industry maximum of 79

WA

20 private hospital agreements out of an industry maximum of 23

24 day hospital agreements out of an industry maximum of 29

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Does Westfund offer any discounts?

Discount for direct debit: None

Discount for annual prepay: None

Total discount for annual prepay via direct debit: None


Does Westfund offer ambulance cover?

All Westfund extras, hospital and combined policies have emergency ambulance cover.

Cover is capped for non-emergency patient transport at $5000 per member.

Do you need ambulance cover?

Depending on where you live, you may not need a policy with ambulance cover. 

  • In Queensland or Tasmania, emergency ambulance services are covered by your state government. 
  • In NSW and the ACT, all hospital policies come with emergency ambulance cover – so you'll be covered with any hospital or combined policy you select. 
  • In South Australia, Victoria and the Northern Territory you can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover. 
  • Rural WA: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover. 
  • Metropolitan WA: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.


Does Westfund offer family policies that cover adult children?

Yes, adult children are covered up to age 25.


Does Westfund let you claim online or in-app?

Most extras can be claimed online.


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What CHOICE Community says about Westfund

CHOICE Community is the online forum for Australian consumers, open to CHOICE members and supporters. Join the conversation about Westfund to share your experiences or gain more insights into this health fund.