Frequently Asked Questions

A Hospital excess is the amount of money you agree to pay if you are admitted to hospital as a private patient for treatment, similar to the excess you have on your car or home insurance.

An excess applies to your hospital accommodation and theatre costs. It does not apply to any doctors’ fees you may incur during your stay. The hospital may request payment of the excess amount either before you are admitted or at the time of admission.

Your excess is chosen when you determine your level of private health insurance cover and can range from $0 to $1000.

The good news is there is no excess on child dependants covered on your policy (with the exception of Gold Hospital 1000), meaning if your child goes to hospital for treatment, you do not have to pay this amount. An excess does not apply to General Treatment services like dental, optical or physiotherapy appointments.

For more information about what excess applies to your Hospital product, please refer to your policy document. 

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 re-joining after a lapse in cover. Waiting periods may also apply to additional benefits when you change your level of cover or transfer from another private health insurer.

There is a 12-month waiting period for pregnancy and obstetric-related services on applicable St.LukesHealth Hospital products. To be eligible for inpatient hospital treatment for your pregnancy and birth your estimated due date must be 12 months or more from the date you took out an appropriate health insurance product.
 

Health insurance provides you with peace of mind knowing that you have the support when you need it. It also allows you to:

• Have your choice of obstetrician;
• Receive your check-ups in a private consultation room with your chosen obstetrician or midwife (no benefit payable toward this service);
• Your choice of hospital;
• A private room while in hospital, subject to availability;
• Your health insurance will cover your hospital accommodation.

Here at St.LukesHealth, we understand that the journey to parenthood is not always easy, and we are here to support you. We understand that there is a range of reasons as to why you may require help conceiving and we want you to know that you are not alone.
 
Infertility affects approximately 1 in 6 Australian couples of reproductive age. If you have been trying to conceive for longer than a year, or for six months if you are over the age of 35, it is recommended that you seek medical advice. St.LukesHealth covers members for inpatient obstetric-related services providing the 12-month waiting period has been served.
 

You will be charged for your obstetrician and midwife appointments, including a pregnancy management fee. You will also be charged for tests and scans, which are partly covered by Medicare.

Hospital accommodation, including theatre or labour ward fees will be covered by your health insurance depending on your level of cover. You will need to pay for personal items such as newspapers, TV or medication provided to you on discharge or unrelated to the birth of your baby.

If your doctor’s fees are outside the Medicare Benefit Schedule fee, you may also need to pay for those.

For more information on going to Hospital, click here.
 

Pregnancy and birth related services are covered in both a public and private hospital on most St.LukesHealth hospital products, after a 12-month waiting period has been served.  A newborn may be added to a family membership from its date of birth provided the application is received by St.LukesHealth within 90 days of the date of birth. Only those waiting periods applying to the policy holder at that time will apply to the newborn child (with the exception of the 12-month pre-existing condition waiting period), provided the membership commenced no later than the baby’s date of birth.

If you have a single policy for Hospital cover for more than 12 months, St.LukesHealth suggests that you upgrade your cover to a family policy from the baby’s date of birth so that they are covered by your health insurance. No waiting periods will be applied if you upgrade your cover to a family policy, providing all waiting periods have been served and the newborn baby is added within 90 days of their date of birth.
If you are not currently insured and are already pregnant, unfortunately you will not be covered for any hospital treatment related to your pregnancy.

You should take out an eligible hospital product at least 3 months before you are pregnant so that you have served the 12-month waiting period prior to being admitted for your delivery.

If you currently hold a Protector Silver Plus Hospital, Silver Plus Hospital , Bronze Plus Hospital, Bronze Hospital or Basic Plus Hospital you will not be covered for pregnancy or related services. If you are planning on starting a family, you should contact St.LukesHealth to discuss alternative products that may better suit your needs. Keep in mind that a 12-month waiting period for pregnancy and related services will apply when upgrading your cover.