St.LukesHealth Fund Review

St.LukesHealth is a not-for-profit fund designed with the community in mind. Since it was established in 1952, St.LukesHealth has merged with a number of like-minded funds.

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by Gary Andrews

Last update 15 Apr 2021

Overview

From 2016 to 2019 it was voted number one Australia-wide for customer satisfaction by Roy Morgan Research.

St.LukesHealth offers seven hospital plans, starting with a Basic Plus policy through to premium Gold plan with tiered levels of excess.

Three straightforward extras policies are also available.

Members who remain on top extras cover for five years receive a 5% increase on dental benefits and annual limits as a reward for their loyalty.

Key Points

Multiple awards for customer satisfaction from Roy Morgan.
Gap-free preventative dental for families.
An additional 5% on dental benefits after 5 years on top cover.

St.LukesHealth isn't on our panel but we're confident we can get you a great deal on your health cover.

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Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

St.LukesHealth offers seven hospital plans at a variety of costs, with flexible excess options to choose from.

From Basic Plus plans to Gold cover with no exclusions, the Tasmanian fund offers a wide range of options.

Basic Plus Hospital

St.Lukes' budget option is more expensive than many other funds' basic policies but also includes many items you'd find in a Bronze package, but for a slightly lower price.

$500 excess applies to all adults covered on the policy.

Key inclusions:

  • Tonsils, adenoids and grommets.
  • Rehabilitation
  • Miscarriage and termination of pregnancy

Bronze Hospital

A straightforward Bronze plan that comes with a large number of inclusions.

You can choose from a $250, $500 or $750 excess.

Key inclusions:

  • Male reproductive system.
  • Skin
  • Diabetes (excluding insulin pumps)

Bronze Plus Hospital

A more advanced version of the Bronze policy, with a number of extra inclusions for only a few dollars extra each week.

As with other policies, $250, $500 or $750 excess is available.

Key inclusions:

  • Dental surgery
  • Blood
  • Lung and chest

Silver Plus Hospital

St.Lukes' lowest cost silver policy covers more than the bronze package, such as podiatric surgery, but excludes high cost items such as cataracts and pregnancy.

Key inclusions:

  • Podiatric surgery
  • Heart and vascular system
  • Insulin pumps

Planner Silver Plus Hospital

The Planner policy is specially designed for young couples planning a family.

It includes all the family-planning items usually found in Gold policies and removes some items such as insulin pumps and sleep studies that are in the Silver Plus Hospital policy.

Key inclusions:

  • Assisted reproductive services
  • Pregnancy and birth
  • Back, neck and spine

Protector Silver Plus Hospital

The Protector policy is designed for the health needs of older Australians.

It doesn't include any pregnancy items or weight-loss, but all other common items are included.

Key inclusions:

  • Cataracts
  • Joint replacements
  • Dialysis for chronic kidney disease

Gold Hospital

St.Lukes' top tier policy covers all items.

There's also the option to have no excess.

For an additional cost, you can keep your children on this gold policy until they're 25.

Key inclusions:

  • Weight-loss surgery
  • Joint reconstruction and replacement
  • Pain management

Ambulance Cover

Emergency ambulance cover is included on all hospital policies after a one-day waiting period.

Extras cover

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with the health fund.

Take the time to work out what you need and what you're prepared to pay.

If this feels a bit overwhelming, you can speak to one of our experts who can talk you through what's included in each extras policy.

St.LukesHealth offers a choice of three extras policies -- from basic plans to cover common procedures and a comprehensive plan to cover an extensive range of services.

All extras packages can be combined with hospital cover policies.

Starter Extras

This policy gives members 50% back on general and preventative dental treatments.

Benefits are also available for a range of additional services including physiotherapy, psychology, audiology and chiro and osteo visits.

Wellbeing Extras

A comprehensive extras package that includes most items -- although orthodontics and hearing aids are excluded.

Gives 60% back on covered dental services and 100% back on optical up to a $200 limit.

Super Extras

Top standalone extras cover with the highest annual limits to protect you and your family.

Includes major dental, orthodontics, home nursing, mental wellness and much more.

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Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

St.LukesHealth Hospital cover policies:

  • 12 months -- Pre-existing conditions, other than psychiatric treatment, rehabilitation and palliative care
  • 12 months -- Obstetric related conditions, including private postnatal care services to members in Northern Tasmania
  • 2 months -- ​All other services

Extras cover:

  • 3 months -- Health management programs
  • 6 months -- Optical
  • 12 months -- Major dental and orthodontics
  • 12 months -- ​Orthotic appliance and other health appliances and aids
  • 12 months -- Clinical psychology
  • 36 months -- Hearing aids
  • 2 months -- ​All other services

Member benefits

St.LukesHealth offers a loyalty incentive for members who have held top extras cover for five years.

They receive a 5% increase in dental benefits and annual dental limits.

How to claim

Claim on the spot through the HICAPS app or payment system at your provider.

You can also claim through the St.LukesHealth Connect app or online hub.

Or drop your claim form into any Customer Care Centre or send by post.

Hospital agreements

St.LukesHealth has agreements with most private hospitals and day clinics across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

  • NSW -- 134
  • VIC -- 137
  • QLD -- 85
  • SA -- 38
  • WA -- 38
  • ACT -- 11
  • NT -- 11
  • TAS -- 15

Customer service

St.LukesHealth received 3 complaints from 1 January to 30 March 2020.

That's 0.4% of complaints vs 0.5% market share.

The company has won four consecutive Roy Morgan awards for customer satisfaction.

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FAQs

Is St.LukesHealth a not-for-profit fund?

Yes, StLukesHealth is a not-for-profit fund.

Who can apply? Are there any restrictions?

There are no restrictions.

Is it easy to switch to St.LukesHealth?

St.LukesHealth isn’t on our panel but we’re confident we can find you a great deal on your health insurance.

You’ll need to contact St.LukesHealth directly if you’re interested in switching to one of their policies.

Do I need to re-serve waiting periods?

You can switch to an equivalent or lower level of cover without re-serving waiting periods.

You will only be required to serve waiting periods if you have upgraded to a higher level of cover.

Can I change my level of cover?

Yes, you can choose a lower or higher level of cover to suit your different life stages.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services and/or higher benefits.

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income).

When do extras reset?

Extras reset on 1 January each year.

Do I have to pay the Lifetime Health Cover loading?

If you're joining for the first time and you're 31 or over, you usually need to pay 2% loading for each year you've gone without health cover since your 31st birthday.

You can find out more here.

How do I contact St.LukesHealth?

Visit stlukes.com.au, email general@stlukes.com.au or call 1300 499 260

Who underwrites St.LukesHealth?

St. LukesHealth is an Australian registered health insurer.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.