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Benefits applying to all options
What you’re covered for
All the options in this brochure include the following features where relevant
to the type of cover:
Hospital Benefits
Public hospital
We’ll cover the charges for treatment in a public hospital, including a
private room.
Private hospitals
We have agreements with most private hospitals throughout Australia.
We cover the hospital costs for all procedures included in your cover
and that qualify for a Medicare benefit, less any excess that applies.
If you go to a private hospital that we don’t have an agreement with,
we’ll cover only some of the hospital costs. This means you may pay
a substantial amount of the hospital bill yourself.
Contact us before going to hospital to check if we have an agreement
in place with your chosen private hospital.
Medical Benefits
Medicare pays 75% of the Commonwealth Medical Benefits Scheme (CMBS)
fee for professional services while you’re in hospital. We cover the rest of
the CMBS fee.
Where the charge exceeds the CMBS fee, we will pay an additional benefit
that will eliminate or reduce any out-of-pocket medical gap expenses if the
doctor participates in our Access Gap Scheme.
Doctors are independent of Westfund Health and can choose whether they
take part in this scheme on a case by case basis.
Call our member number 1300 552 132 or visit www.westfund.com.au
for help in finding ‘No Gap’ doctors.
Ambulance
We cover the cost of medically necessary ambulance transport in Australia.
Non-emergency transport can be claimed if it’s medically justified.