St.LukesHealth Members Own Health Fund review and comparison
St.LukesHealth is a non-profit health fund that focuses on offering the products and services its members need. Founded in Tasmania in 1952, St.LukesHealth offers an extensive selection of hospital cover, extras cover and combined policies to meet the unique insurance needs of a variety of Australians.
St.LukesHealth Insurance Cover Options
As a Members Own Health Fund, St.LukesHealth aims to offer its members cover at an affordable price. With cover for singles, couples and families, it has cover options to suit everyone from the young, fit and healthy who only want basic protection right through to families that want the highest level of cover available.
It offers budget and comprehensive hospital cover with optional excesses, two levels of extras cover to suit various budgets, and seven different packaged cover options to give all-round protection.
Joining St.LukesHealth can be done so quickly and easily online. All you'll need to know in order to apply is:
- Your Medicare number
- Your bank account or credit card details
- Your previous health fund details.
St.LukesHealth Insurance Levels of Cover
- Hospital Platinum. This hospital-only cover can be purchased on its own or paired with an extras cover option listed below. Offering top hospital cover with no excess, Hospital Platinum covers your hospital accommodation and theatre fees in contracted private hospitals and day hospitals around Australia. This means that you are covered for the cost of everything from surgically implanted prostheses to knee reconstructions, obstetrics and more.
- Hospital 300, 500 and 1000. These three products offer the same top hospital cover as the above policy, but require you to pay an excess of either $300, $500 or $1,000 when you are admitted to hospital. Each policy can be purchased to provide standalone cover or combined with an extras cover option.
- Budget 500 Level 1. This standalone hospital cover is designed for those who are young and healthy and do not have any major health concerns. It features a $500 excess and restricts some high-cost services (such as joint replacements and psychiatric services) in order to keep your premiums down.
- Budget 500 Level 2. With an excess payable when you are admitted to hospital, this policy covers a wide range of hospital procedures but restricts some of them (for example pregnancy services and dialysis for chronic renal failure) to treatment in a public hospital shared ward. This helps make cover more affordable for members on a limited budget.
- Super Extras. Super Extras is the top standalone extras cover option from St.LukesHealth. It offers gap free preventative dental cover and also covers the cost of general and major dental, orthodontics, pharmacy, optical, chiro, osteopathy, acupuncture, natural therapies, clinical psychology, home nursing, health appliances and aids, audiology and more.
- Budget Extras. This entry-level policy offers a basic level of extras cover. It covers general dental, optical, physio, acupuncture and natural therapies.
- Packaged Platinum Plus. This premium packaged option offers the highest level of both hospital and extras benefits from St.LukesHealth. No excess is payable when you are admitted to hospital under this policy.
- Packaged Platinum. This option combines top hospital cover (with no excess) with a wide range of extras services. Covered extras include everything from major dental to optical, physio, podiatry, speech therapy and more.
- Packaged Gold. Packaged Gold Cover from St.LukesHealth offers top hospital cover that requires an excess of $300 per person per year, as well as a comprehensive range of general treatment covers.
- Packaged Silver. Offering top hospital cover with a $500 excess per person each year, Packed Silver also covers a long list of extras including general and major dental, orthodontics, pharmacy, optical, physio, podiatry, occupational therapy, speech therapy, chiro, acupuncture and more.
- Packaged Bronze Plus. Enjoy top hospital cover with a $500 excess, plus extras cover for general dental, optical, physio, eye therapy, speech therapy, acupuncture and natural therapies.
- Packed Budget 500 Level 1. This policy combines Budget 500 Level 1 Hospital Cover with extras cover for general dental, optical, physio, eye therapy, speech therapy, acupuncture and natural therapies.
- Packaged Budget 500 Level 2. This policy combines Budget 500 Level 2 Hospital Cover with extras cover for general dental, optical, physio and more.
Are there any additional benefits?
- Gap free preventative dental. Members can enjoy 100% cover for their dentist’s regular service fee for preventative dental.
- Family cover. Your dependent children are covered up to 23 years of age under your policy, or up to 25 years of age if they are single and a full-time student.
- No excess for children. You won’t have to pay an excess when a dependent child is admitted to hospital.
- Member Rewards. Members who have held St.LukesHealth top extras cover for five years or more receive a 5% increase in their dental benefits and annual dental limits.
- Australia-wide. St.LukesHealth offers cover to members Australia-wide and premium amounts are the same in every state.
- Optical discounts. Members can enjoy a range of optical and eyewear discounts thanks to St.LukesHealth’s partnerships with Specsavers, Eyelines, OPSM and Look! of Australia.
- Insurance discount. Thanks to St.LukesHealth’s partnership with MyState, memberscan enjoy a 10% discount on home and contents insurance.
What general exclusions and waiting periods do I need to know about?
There are certain circumstances under which St.LukesHealth will not pay your claim, including:
- If it is for services received more than two years prior to the date you lodge your claim
- It is for services and treatments obtained overseas
- It is for cosmetic surgery and other surgical procedures that Medicare does not cover
- It is for services received while you are serving a waiting period
- It is for a procedure or treatment that is listed as excluded on your policy.
Before you sign up for a health fund membership you should also make sure you’re aware of all the relevant waiting periods that apply. For most benefits there's a two-month waiting period, while certain services such as, optical, major dental and clinical psychology, have extended waiting period.
If you transfer to St.LukesHealth from another health fund, any waiting periods you have already served for an equivalent or higher level of cover will be recognised by your new health fund.
St.LukesHealth Insurance excess
Depending on the hospital option, you may be required to pay an excess when you are admitted to hospital. This is effectively your contribution to help cover the cost of your treatment and hospital accommodation. While a Hospital Platinum policy does not require you to pay an excess, many other options will require you to contribute a certain amount. For example, Hospital 300, Hospital 500 and Hospital 1000 offer a $300, $500 and $1,000 excess respectively, with a higher excess resulting in lower premiums.
Finally, it’s important to point out that you will not need to pay an excess when a dependent child who is covered on your policy is admitted to hospital. St.LukesHealth also offers hospital covers that do not charge any excess when you receive same-day treatment.
How do I make a claim?
There are several options at your disposal when you need to make a claim with St.LukesHealth. Hospital claims and inpatient medical claims should be sent straight to St.LukesHealth by your provider, but when you need to make an extras claim you can choose from the following options:
- Can I make a claim online? Swipe your St.LukesHealth at the provider to have your benefits automatically deducted from your health care bill.
- Can I make a claim using my mobile? The St.LukesHealth Health mobile app allows you to enter your details, take a photo of your receipt and then submit your claim.
- Can I make a claim in person? Visit a St.LukesHealth office or claims agent to have your benefit paid in person. You’ll need to present your membership card.
- Where can I get a claim form? You can download this form from the health fund’s website, fill it out and submit it by mail.
- How do I receive my benefit payment? In cases where you have already paid a provider, you can have your benefit deposited directly into your bank account.
Use the St.LukesHealth Health mobile app
Frequently asked questions
Q. What are my options when it comes to private health insurance?
- A. There are three main health cover options:
- Hospital cover, which covers you for a wide range of services and treatments when you are admitted to hospital
- Extras cover, which helps pay the cost of general treatments like optical, dental and physio services
- Combined cover, which groups hospital cover and extras cover together in one policy.
Q. Does private health insurance mean I will receive a different level of care at a public hospital?
- A. No. You will still receive the same level of care regardless of whether you have private health cover or not, however health insurance allows you to choose your doctor and access a private room (if one is available).
Q. How can I transfer to St.LukesHealth from another fund?
- A. This process is quite straightforward. All you need to do is sign up online or complete a clearance request along with your application form. St.LukesHealth will contact your previous fund on your behalf to arrange the rest.
Q. Which private hospitals have a contract with St.LukesHealth?
- A. You can find a full list of St.LukesHealth’s contracted hospitals around Australia on the health fund’s website.
Q. What options do I have to pay my premiums?
- St.LukesHealth allows you to pay your health cover premiums by direct debit, BPAY, POSTbillpay, credit card and payroll deduction. Over the counter payments are also available at any St.LukesHealth office or agent.
Do St.LukesHealth benefit payments vary between treatments?
Yes, each claim lodged by St.LukesHealth members will be assessed depending on the treatment type and this will determine the amount of benefit that they are entitled to. This will increase in proportion to the seriousness of the medical service claimed for.
You can use the table below to view some commonly claimed for treatments and the corresponding dollar amount St.LukesHealth members will receive for each, along with the equivalent Medicare (MBS) benefit for comparison:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genetalia||$221.35||$311.85|
|Breast, benign lesion surgical biopsy of excision||$260.05||$367.25|
|Carpal Tunnel Release||$276.80||$426.80|
|Complicated Delivery (of baby)||$1,629.35||$2,307.90|
|Coronary Artery Bypass||$2,200.00||$3,404.40|
|Femoral on Inguinal Hernia||$464.50||$657.50|
|Overnight investigation for sleep apnoea||$588.00||$707.85|
|Tonsils or Tonsils and Adenoid||$295.70||$493.85|
|Uncomplicated Delivery (of baby)||$693.95||$1,979.05|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health