St Lukes Private Health Insurance Fund Review
St. Lukes Health is a not-for-profit health fund that has been in business since 1952. They might not have the biggest market share, but they offer top hospital coverage that falls into the new Gold tier.
The company is based out of Tasmania, created by a group of businessmen who saw a void in the Tasmanian private health insurance market and aimed to fill it.
It has since merged with several other funds, including Kelsall & Kemp and Queenstown Medical Union. Now, St.LukesHealth is dedicated to offering valuable health insurance, advice, and service to its customers across the country.
The company is a restricted non-profit health fund that has been in business since 1951. It’s member-owned and strives to provide the best health insurance for all CBA members and those who are closest to them.
- St. Lukes Health offers four different hospital products that all fall in the gold tier – covering you for all clinical categories.
- St. Lukes Health provides two extras policies: Budget and Super. Budget Extras includes a basic list of extras cover and Super Extras is more comprehensive.
- You can also package your hospital and extras cover together.
- After five years of continuous coverage on an eligible product, you will be able to receive added member benefits.
St. Lukes Health provides hospital cover, extras cover, and packaged cover to their customers. There are several tiers of each coverage option, so here’s a breakdown of what you can expect when shopping for St. Lukes health insurance.
St. Lukes Health offers four different hospital products. These are all Gold tier products: standard Superior Gold, 300, 500, and 1000. These numbers refer to how much excess applies per person on the policy.
The Gold tier covers patients for all clinical categories, so it is the most comprehensive level of cover.
In general, a higher excess means lower premiums, but it can increase your out-of-pocket charges.
You can select each of these hospital policies as standalone cover or package your choice of hospital cover with extras cover.
- Superior Gold: Top hospital cover with no excess
- Superior Gold 300: Top hospital cover with a $300 excess
- Superior Gold 500: Top hospital cover with a $500 excess
- Superior Gold 1000: Top hospital cover with a $1,000 excess
You have two extras cover options through St. Lukes and St. Lukes corporate health services. These are Super Extras and Budget Extras.
As the names suggest, Budget extras will give you the basics, while Super extras offers a bit more.
Budget Extras includes*:
- General Dental ($500 annual limit)
- Optical ($200 annual limit)
- Physiotherapy ($500 annual limit)
- Other Therapies like eye & speech therapy (included in physiotherapy limit)
- Alternative Therapies like acupuncture & remedial massage (included in physiotherapy limit)
Super Extras includes*:
- General Dental ($1000 annual limit)
- Major Dental ($1500 annual limit)
- Pharmacy ($600 annual limit)
- Optical ($200 annual limit)
- Physiotherapy ($800 annual limit)
- Other Therapies ($1000 annual limit)
- Clinical Psychology ($400 annual limit)
- Home Nursing ($500 annual limit)
- Health Appliances and Aids ($1000 annual limit)
- Diabetes Education
- Health Management Programs
- Member Rewards
- Alternative Therapies ($500 annual limit)
*Information correct as of April 2019
St. Lukes Health has four packaged cover options: Packaged Superior Gold 500, Packaged Superior Gold 300, Packaged Superior Gold, and Packaged Ultimate Gold.
- Packaged Superior Gold 500: Superior Gold 500 hospital cover with Super Extras
- Packaged Superior Gold 300: Superior Gold 300 hospital cover with Super Extras
- Packaged Superior Gold: Superior Gold hospital cover with Super Extras
- Packaged Ultimate Gold: Superior Gold hospital cover with highest level of extras cover
Although all of the package options include Super Extras cover, the benefits and annual limits are higher with the Packaged Ultimate Gold Product.
St. Lukes Health is one of the smaller health funds in Australia, but the Private Health Insurance Ombudsman (PHIO) still tracks their performance as it relates to complaints and coverage. Here is the most recent data the PHIO has for their St. Lukes insurance reviews.
Hospital Related Charges Covered
Industry average: 91.06%
Medical Services with No Gaps
Industry average: 86.6%
Medical Services with No or Known Gap
Industry average: 94.88%
General Treatment Covered
Industry average: 53.52%
There are several ways to make a claim through St. Lukes Health. Here are your options if you’re a member trying to make a claim.
Customer Care and Agents
Residents of Tasmania can claim in person by visiting a local St. Lukes Health customer care centre. Bring your membership card to one of these locations to receive help with your claim.
Download a claim form here and send it to:
St. Lukes Health
PO Box 915
Launceston, TAS 7250
Mobile Claiming App
Use the St. Lukes Health App to make claims. You will need your membership number, mobile phone number, email address, date of birth, and names of any dependants on the policy when you sign up.
Make a claim by taking a photo of your account, confirm, and process the clam.
Those who have already paid for their service can claim a refund through direct deposit. Fill out this Benefit Deposit Request Form to get started.
HICAPS and HICAPS Go
You can use the Health Industry Claims and Payment Service or the HICAPS Go app to claim your extras coverage.
Once you have held top extras cover with St. Lukes Health for five years or more, you’ll receive Member Rewards. This translates to a 5% increase in your dental benefits and annual dental limits.