(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in All States
Closed to new members
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Pregnancy and birth |
| Cataracts | Implantation of hearing devices | Rehabilitation |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Skin |
| Dental surgery | Joint reconstructions | Sleep studies |
| Diabetes management (excluding insulin pumps) | Joint replacements | Tonsils, adenoids and grommets |
| Dialysis for chronic kidney failure | Kidney and bladder | Weight loss surgery |
| Digestive system | Lung and chest | |
| Ear, nose and throat | Male reproductive system |
| Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess on admission. This is limited to a maximum of $300 per person and $600 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
Ambulance Levy included for NSW and ACT residents. Ambulance in Tas provided free to Tasmanian residents. Unmarried dependants covered until they turn 23 and single full time student dep's covered until they turn 25 if fully dependent.
This health insurer does not operate a preferred provider scheme.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $500 per person | Periodic oral examination - $24.00 Scale & clean - $38.00 Fluoride treatment - $14.00 Surgical tooth extraction - $90.00 |
| Major dental | 12 | $1,500 per person (Sub-limits apply) | Full crown veneered - $475.00 |
| Endodontic | 12 | $550 per person | Filling of one root canal - $86.00 |
| Orthodontic | 12 | $600 per person $1,800 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge |
| Optical | 6 | $250 per person | Single vision lenses & frames - $180.00 Multi-focal lenses & frames - $250.00 |
| Non PBS pharmaceuticals | 2 | $600 per person | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $850 per person (Sub-limits apply) | Initial visit - $30.00 Subsequent visit - $25.00 |
| Chiropractic | 2 | $400 per person (combined limit for chiropractic & other services - Sub-limits apply) | Initial visit - $25.00 Subsequent visit - $25.00 |
| Podiatry | 2 | $400 per person | Initial visit - $25.00 Subsequent visit - $25.00 |
| Psychology | 12 | $350 per person | Initial visit - $50.00 Subsequent visit - $40.00 |
| Acupuncture | 2 | $400 per person (combined limit for acupuncture & other services) | Initial visit - $25.00 Subsequent visit - $25.00 |
| Remedial massage | 2 | No annual limit | Initial visit - $25.00 Subsequent visit - $25.00 |
| Hearing aids | 36 | 2 appliance(s) every 5 years | Hearing aid - $1,000.00 |
| Blood glucose monitors | 12 | 1 appliance(s) every 3 years | Per monitor - $200.00 |
| Other treatments - check with your insurer |
Other services covered include chinese medicine consultations, osteopathy, occupational therapy, eye & speech therapy, dietetics, audiology, other approved health appliances & aids and approved health management programs.
Ambulance cover is provided by the State government in Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au/). In other states concession card holders may have free cover and there are subscription services in several states (https://privatehealth.gov.au/health_insurance/what_is_covered/ambulance.htm).
https://www.stlukes.com.au/forms-brochures?tag=Information+sheet
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.