A message from the CEO | Vital Signs

It certainly is an interesting time that we live in and while there is a feeling of uncertainly and vulnerability in the community, I want to give you peace of mind that St.LukesHealth remains open for business online and through our phone centres and we are here to continue to help you on your health journey.

In recent weeks, we have worked with Members Health Fund Alliance, Government and Industry in an endeavor to provide some relief to the pressures that Coronavirus (COVID-19) is placing on you and your loved ones.

As a result, St.LukesHealth will postpone the April 1 premium increase for up to six months. But we know the impacts of COVID-19 pandemic may be felt longer than this and as a result we will continue to monitor and reassess the length of this extension appropriately.

I commend the Australian and state governments for acting on COVID-19 by shutting borders and enforcing restrictions on areas where groups of people gather so that individuals don’t inadvertently spread the virus.

In the words of Prime Minister Scott Morrison, “this is an absolutely critical time” to ensure that we protect our country, our health system and look out for each other. For ways that you can do this, please read our article on what can you do to stay safe.

As you would be aware, St.LukesHealth has taken the precautionary measure to temporarily close its face-to-face customer care centres throughout Tasmania. While this will not affect those who already interact with us online, through our phone centres or by email, it does impact on those older and perhaps more vulnerable Tasmanians who prefer to interact with us in person.

If you do normally interact with us face-to-face, I encourage you to contact us by calling 1300 651 988 so that we can discuss the most convenient ways we can communicate with you and service your needs.

We are receiving calls from our members regarding their policies and what happens with advanced bookings of surgeries as a result of COVID-19. I thought I would answer some of your questions about COVID-19 and its impacts on your private health insurance.

What will happen with elective surgery?
With the rapid onset of COVID-19, there are mixed messages concerning access to private health care in a private hospital setting.

On Wednesday, March 25, the Prime Minister, Scott Morrison enforced that all elective surgeries would be suspended except for those individuals that fall within category 1 and those urgent category 2 cases. This action was taken to ensure that our health system - both private and public - is able to prepare and handle for the predicted influx of COVID-19 patients by freeing up beds and health workers. It also allows hospitals to equip themselves with personal protective equipment such as masks, gowns, gloves and goggles.

Category 1 patients are defined as those who need treatment within 30 days while category 2 is defined as those who should be seen within 90 days. If your surgery has been postponed, you will to notified by your treatment provider and it will be rescheduled. If you have not heard from your treatment provider and your surgery is planned shortly, it is best to touch base with them to find out if plans have changed.

It is important to remember that while private hospitals are restricting some services, emergency surgery is still being undertaken. The types of surgery that are still being undertaken are:

  • Surgery related to breast lumps including removal and biopsy;
  • Mastectomy;
  • Removal of malignant skin lesions;
  • Surgery related to the brain;
  • Neonatal surgery;
  • Biopsy of the prostate;
  • Removing of kidney stones;
  • Amputation of limbs;
  • Other emergency surgery (broken bones, lacerations etc.)

There are a raft of other surgeries that fall into category 2 and will continue to occur where a delay in surgery would put patients at risk.  Your surgeon will be able to define this further and we recommend that you discuss your planned surgery with your surgeon.

There is no clear answer on when non-urgent elective surgeries will resume. When COVID-19 is brought under control, it will be likely that waiting lists for elective surgery in the public system will dramatically increase – meaning longer waits than those that already exist. We know that the ability to have elective surgery undertaken in a private hospital is significantly quicker than being on a public waiting list so keep your cover.

Will St.LukesHealth pay benefit for telehealth consultations?
St.LukesHealth has been working with Members Health Fund Alliance and industry to provide innovative approaches to ensure there is value for members during the COVID-19 pandemic.  

Maintaining physical and mental health is critical during this time and to assist our members, St.LukesHealth is introducing payment of benefits for telehealth consultations for a number of general treatment services. 

Claims will need to be submitted to St.LukesHealth for payment of benefit as HICAPS services are currently not available for telehealth services.

St.LukesHealth will amend its fund rules to allow for the payment of clinical psychology (From March 30, 2020 until September 30, 2020) and counselling services (from April 1, 2020 until September 30, 2020) via telehealth where:

  • A member is undergoing an existing course of treatment, and has seen the psychologist providing telehealth consultations over the past six months, or
  • For new patients, where a telehealth service has been recommended by their general practitioner, 
  • The service is delivered before September 30, 2020, and
  • The service is undertaken in accordance with psychology and counselling industry guidelines.

St.LukesHealth will also amend its fund rules to allow for payment of physiotherapy consultations From Tuesday, April 14, 2020 until September 30, 2020, via telehealth where:

  • A member is undergoing an existing course of treatment and our has seen the physiotherapist over the past six months, or
  • For new patients, where a tele-physiotherapy service has been recommended by your general practitioner or relevant medical specialist, and
  • The primary condition being treated is one of:
    • Post orthopaedic surgery rehabilitation (e.g. total hip or knee replacement)
    • Chronic musculoskeletal condition (e.g. osteoarthritis)
    • Cardiac rehabilitation
    • Pulmonary rehabilitation, or
    • Pelvic floor muscle training,
  • The service is delivered before September 30, 2020, and
  • The service is undertaken in accordance with Australian Physiotherapy Association guidelines.

St.LukesHealth will continue to consider other services that can be delivered via telehealth consultations. Extras services will return to business as usual as soon as it is deemed appropriate.

If I present at hospital as a private patient with COVID-19, will my private health insurance cover this?
If you are admitted as a private patient in a public hospital for COVID-19, you will be covered on all St.LukesHealth products.  The government has determined that COVID-19 is to be covered under the clinical category Lung and Chest.  All St.LukesHealth products, regardless of whether they are Bronze, Silver or Gold include cover for this clinical category. 

Will there be changes to the St.LukesHealth Post Natal Service offered Northern Tasmania?
Due to the onset of COVID-19, we have temporarily modified our post-natal program to Northern Tasmanian families. St.LukeHealth has made the decision to suspend its hotel service for the safety of our members, but will modify the home service so that no one misses out.

The home service will include:

  • Welcome pack
  • A grocery voucher
  • Midwife telephonic support. To mitigate any risk of COVID-19 spreading, midwives will no longer be entering our members’ homes unless absolutely required. 

For members new to this service, this is the only option available for the time until normal service recommence. However, from April 1, St.LukesHealth will unveil the Nourish Baby program that can assist you on your parental journey. For more information about this, please see the article below.

Should I get the flu vaccine and does this cover me for Coronavirus?
There is currently no vaccination against coronavirus and the annual flu vaccine will not protect you against this. The schedule and 2020 flu vaccine is not yet available. St.LukesHealth suggests that you follow the Department of Public Health’s guidelines on flu vaccinations and take action according to these guidelines.

How do I claim if I can't access one of your customer care centres?
The easiest way to make a claim is to use our mobile claiming app.

St.LukesHealth recently improved how you can claim online at a time and place that suits you. The new claiming app makes it easy to submit a claim in three simple steps. Simply:

  1. Take a picture of your receipt or upload a picture of your receipt from our phone’s picture library.
  2. Select who the claim is for.
  3. Press submit.

For a full list of claiming options, we suggest you look at our how to claim page on our website.

What happens if I can't pay my premium?
For some individuals and families, we know the support mechanisms we have put in place will not be enough – especially for those who may have lost their job or are depending on government assistance. If you are in this position, we urge you to contact us to discuss a range of options that may be available to you.

Finally at this time remember, the best course of action you can take is to wash your hands with soap and water, practice social distancing and work at home if possible, ensure you eat healthily, exercise and rest and if you are unwell do not go to work or out in public until you feel better. If you are fearful that you have contracted COVID-19, please call the National Coronavirus Health Information Line on 1800 020 080. 

Please stay safe during this unprecedented time.

- Paul Lupo

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