Benefit Changes 2025

Changes to Extras cover

We’re proud to support over 135,000 members on their health journey. We're privileged that you have chosen Westfund to look after your health - thank you. As your health fund, we’re focused on providing quality health cover and genuine care to our members every day.

To keep our commitment to you, we review benefits annually to ensure we continue to provide a range of support and services to help protect our members' health and wellbeing.

Changes to Extras cover

We’re here to help our members get the most from their membership while proactively supporting their health and wellbeing. That’s why we’ve made a number of improvements to your cover. These changes took effect on 1 January 2025. We’ve outlined these changes below in detail.

The best way to view your updated benefits is by checking your Policy Summary, available on the Westfund app or via Members Online.

You can now claim counselling services offered by registered providers

Your cover prior to 1 January

No benefit was payable for counselling services under your Clinical Psychology benefit.

Your cover from 1 January

You can now claim counselling services from registered providers under your Clinical Psychology benefit.

What this means for you

To improve access to personalised treatment for mental health conditions for our members, we’ve increased the existing benefit for Clinical Psychology to incorporate counselling services offered by Medicare registered social workers or mental health nurses and counsellors registered through the Australian Regional Health Group. There’s no change to your existing item benefits or annual group limits.

This change applies to Mid Extras.

We’re renaming and expanding our Preventative Health Tests benefit

Your cover prior to 1 January

Previously, the Preventative Health Tests benefit covered only a limited range of tests, including Bone Density Test, Bowel Testing Kit, Calcium Score, Chronic Disease Health Screen, Mammogram, Mole Scan, and Thin Prep Pap Test.

Your cover from 1 January

We’re renaming this benefit to Preventative Health Checks and expanding it to include a wider variety of health checks. This change allows you to claim any preventative health checks designed to help you stay proactive and identify potential health issues early.

What this means for you

Prevention and early detection are essential for achieving better health outcomes. With this change, you are no longer limited to a predefined list of preventative health checks. You can now claim any preventative health check as long, as it’s completed by a recognised provider and isn’t claimable through Medicare. There’s no change to your existing limits or benefit amounts.

Read FAQ

This change applies to Ultimate Pro Extras, Ultimate Extras, High Extras, High Extras Over 50s, Mid Extras, Choice Extras, Essential Pro Extras, Starter Extras, Gold, Gold 500, Gold Classic, Gold Classic 500, Overseas Top Plus Hospital with Extras, Overseas Top Hospital with Extras, Athlete Protect Extras, Athlete Shield Extras, Athlete Defend Extras, Athlete Vital Extras and Athlete Core Extras.

You can now claim optical repairs under your Optical benefit

Your cover prior to 1 January

Optical repairs were not claimable under your Optical benefit.

Your cover from 1 January

Optical repairs are now claimable under your Optical benefit.

What this means for you

You can use your Optical benefit to claim the cost of an optical repair. This brings you extra flexibility and convenience, letting you cover repair expenses for your glasses or lenses under your regular Optical benefit. There’s no change to your existing annual group limit.

We’ve expanded your Ear and Eye Health Checks benefit to include Optical Digital Centration

Your cover prior to 1 January

Optical Digital Centration was not claimable under your Ear and Eye Health Checks benefit.

Your cover from 1 January

You can now receive $20 per member, per calendar year for these assessments at Westfund Eye Care Centres.

What this means for you

Ensuring your glasses fit correctly is essential for optimal eye care. That’s why members who visit a Westfund Eye Care Centre in Dubbo, Orange, Lithgow or Mackay can now claim a $20 benefit for assessments performed with our advanced digital centration technology. This initiative makes quality eye care more accessible and affordable for members living near a Westfund Eye Care Centre. There’s no change to your existing Audiology or Eye Health Tests benefit.

We’ve changed our dental benefit structure at Westfund Dental Care

Your cover prior to 1 January

You received a fixed benefit per dental item, up to your annual group limit at Westfund Dental Care in Lithgow.

Your cover from 1 January

You’ll now receive a percent based benefit on dental services at Westfund Dental Care, up to your annual limit.

What this means for you

We will be transitioning from a per item benefit structure to a percentage-based benefit for all dental services at Westfund Dental Care. This means that instead of receiving a set amount for each dental item, Westfund will cover a percentage of the service cost, up to any applicable limits. It's important to note the following:

Members on Starter Extras, Mid Extras, Essential Pro Extras, Athlete Vital Extras or Athlete Core Extras cover will receive 55%
Members on High Extras, High Extras over 50s, Gold, Gold 500, Gold Classic, Gold Classic 500, Athlete Protect Extras, Athlete Defend Extras, Athlete Shield Extras, Athlete Guard Extras, Overseas Top Plus Hospital with Extras, Overseas Top Hospital with Extras or Ultimate Extras cover will receive 70%
Members on Ultimate Pro Extras cover will receive 85%
Your current overall dental limits will remain the same.
Any preventative dental items you currently receive 100% back on, will still receive 100%, subject to any limits that may apply.
You will continue to receive 100% back on eligible Orthodontic item numbers, up to your lifetime limit.

This change applies to Ultimate Pro Extras, Ultimate Extras, High Extras, High Extras Over 50s, Mid Extras, Essential Pro Extras, Starter Extras, Gold, Gold 500, Gold Classic, Gold Classic 500, Overseas Top Plus Hospital with Extras, Overseas Top Hospital with Extras, Athlete Guard Extras, Athlete Protect Extras, Athlete Shield Extras, Athlete Defend Extras, Athlete Vital Extras and Athlete Core Extras.

Transitional Measures
From 1 January 2025 to 31 March 2025, transitional measures will be implemented. During this period, we will honour the higher benefit amount for treatments if:

You received a dental quote for services to be performed during this timeframe; or
You are already booked in for services during this timeframe.

It's important to remember that this change only applies to dental services at our Westfund Dental Care centre in Lithgow.

We’ve increased the percentage you can claim back on dental services at Westfund Dental Care

Your cover prior to 1 January

You receive 50% benefit back on dental services at Westfund Dental Care, up to your annual group limit.

Your cover from 1 January

You'll receive 55% back on dental services at Westfund Dental Care, up to your annual group limit.

What this means for you

This change means you will receive more value from your membership, while still providing you with the same level of overall coverage. It's important to note the following:

Any preventative dental items you currently receive 100% back on, will still receive a 100% benefit up to your annual group limit, subject to any service limits that may apply.

It's important to remember that this change only applies to dental services at our Westfund Dental Care centre in Lithgow.

This change applies to Choice Extras.