Waiting periods
A waiting period is the length of time you must wait before you become eligible for benefits. Waiting periods apply to new members and to members rejoining after a lapse in cover. Waiting periods may also apply to additional benefits when you change your level of cover.
The following waiting periods apply to Hospital cover:
- Pre-existing condition* (other than psychiatric treatment^, rehabilitation and palliative care): 12 months.
- Obstetric related conditions (including private post-natal care services+): 12 months
- All other services: 2 months
*For more information on waiting periods and the pre-existing condition, refer to the membership conditions.
^Insured people with limited or restricted mental health cover (psychiatric treatment) may upgrade to a higher level of cover providing you have held any level of hospital cover for 2 months with your current insurer to access mental health services. This exemption applies once per lifetime. This waiting period applies for each person covered on the policy. A two month waiting period applies to mental health cover (psychiatric treatment) for people new to health insurance.
+ This service is available to St Lukes members in Northern and North West Tasmania where there is no access to private hospital post-natal services. For more information, refer to membership condition 7.
Mothers who deliver at the Launceston General Hospital (LGH) or the North West Regional Hospital (NWRH) can access the post-natal hotel service regardless of where they live in North or North West Tasmania. Mothers and babies will require discharge by their obstetrician from the LGH or NWRH before accessing this pos-discharge service. The post-natal service is available on selected products where the pregnancy and birth clinical category is covered. St Lukes also offers a home based post-natal service, for further details contact 1300 651 988 or visit www.stlukes.com.au. A 12 month waiting period applies to new members and members transferring from another private health insurer. Members who reside interstate of in Southern Tasmania are not eligible for this service, as post-natal services are currently proved by private hospitals in these regions, unless they deliver as the LGH or NWRH.
The following waiting periods apply to Extras cover:
- Health management programs: 3 months
- Optical: 6 months
- Major dental (including periodontics, endodontics, crowns and bridges, dental implants, dentures and orthodontics): 12 months
- Orthotic appliance and other health appliances and aids: 12 months
- Clinical psychology: 12 months
- Hearing aids: 36 months
- All other services: 2 months
If you have served all your waiting periods with another fund, you can transfer to an equivalent or lower cover with St Lukes without having to reserve those waiting periods on benefits common to both funds, providing you transfer within two months of ceasing to be covered by your previous fund. If you transfer to a higher level of cover, some waiting periods may apply for the higher benefits.