Certain Hospital and Extras benefits have changed from 1 January 2024. You can learn more about the Benefit Changes and how they may apply to you here.

Can I claim for health management programs?

If you hold an eligible extras cover and have served the two month waiting period, you may be able to claim a benefit towards the cost of certain health management programs. Your Policy Summary will provide detailed information on your benefit entitlement and any limits that apply.

Health management programs can help manage the treatment of a health condition. Programs need to be recommended by a Medicare practitioner to be eligible.

What health management programs are covered?

Westfund pays a benefit towards the following programs:

  • Aquatic programs – membership and classes
  • Fitness centres – membership, classes and personal training sessions
  • Virtual gastric banding – sessions
  • Weight loss programs – joining and membership fees
  • Mental health programs – membership, joining and class fees

To claim for these programs, a Medicare Registered Practitioner, such as a GP, Medical Specialist, or Exercise Physiologist, must complete a Health Management Declaration Claim Form every calendar year to confirm the program is for the management of a health condition.

What providers can I access for this benefit?

Westfund can provide a benefit for the following providers:

Aquatic programs

Accredited with AUSTSWIM, Australian Swim School, SWIM Coaches & Teachers Australia or AUSactive

Fitness centres

Registered AUSactive personal trainers and businesses

Virtual Gastric Banding

Hypnotherapist registered with Australian Society of Clinical Hypnotherapists, Professional Hypnotherapists of Australia or Australian Hypnotherapy Association

Weight Loss Programs

Refer to our provider recognition criteria here

Mental Health Programs

Refer to our provider recognition criteria here

 

What isn’t covered?

Westfund is unable to pay a benefit for health management programs where:

  • It is not required for treatment of a specific condition or part of a Health Management Program
  • The provider does not fulfil the recognised provider requirements
  • The Health Management Program has not been recommended by a Medicare Registered Practitioner
  • The benefit is in relation to goods and services which are primarily for the purposes of sport, recreation or entertainment
  • Any meal replacement, food or drink products are charged

How can I make my claim?

The easiest and quickest way to make your claim is via the Westfund app. However, we provide several other options to submit your claim so you can select the way that suits you best.

Please ensure you include your Health Management Declaration Claim Form and receipt/s when lodging your claim.

Common questions