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 from Westfund for Medical Imaging?

Generally, diagnostic imaging services such as MRIs, CT Scans and PET scans are considered outpatient services. Unfortunately, legislation prevents private health insurers from paying a benefit on these services; where eligible, they’re claimable through Medicare only. However, if you have medical imaging services performed whilst you are an inpatient in hospital and the service has a Medicare Benefit Schedule (MBS) item number, then you may be able to claim a benefit from Westfund. We recommend reaching out to our team if you’d like to find out more.

In some instances, Medicare places certain conditions on benefit entitlements for medical imaging services. We suggest that you speak directly with your referring doctor and radiology provider to check if your diagnostic medical imaging services will be eligible for a Medicare rebate and if there may be any out-of-pocket expenses.