What's the outpatient travel benefit and how is it calculated?

If you need to travel for outpatient medical specialist services, like a consultation with your specialist, e.g. orthopaedic surgeon, you may be able to claim a benefit.

The travel benefit is payable for outpatient medical specialist services when referred by a Medicare Registered Practitioner and when travelling more than 150 km per round trip for the service.

There are criteria which apply to the travel benefit:

• A Travel Benefit will only be paid for outpatient medical specialist services where a Medicare item number is billed for that service or;
• in the case of a Specialist Dentist, a dental consultation item number is billed for that service.
• If you're not billed for a medical service (e.g. post-operative consultation), a letter of attendance from the medical specialist is required.
• A 12 month waiting period applies.
• The provider must be a recognised specialist as per Westfund’s Recognition Criteria.
• This benefit is limited to one service per member per day.

Calculate your Travel Benefit

The Travel Benefit is based on round-trip distance. Use the table below to help estimate the benefit based on distance travelled.

Distance travelled	Benefit
0-149 km	Nil
150km-200 km	$20
201-250 km	$25
251-300 km	$30
301km-350 km	$40
351km-400 km	$50
401-450 km	$60
451 km+	$70

Common questions

How do I claim the outpatient travel benefit?

You'll need a signed and completed General Claim Form or Travel Benefit Form along with a receipt or letter of attendance from your specialist.

Am I entitled to the outpatient travel benefit?

Not sure if you're entitled to the outpatient travel benefit? You can check your policy summary to see if it's included in your cover, as well as your overall annual limit for this benefit (if applicable).