Home  |  Rates Quote  |  For Providers  |  Contact Us  
Your location
  Search
StlukesHealth

Waiting periods

All you need to know about waiting periods.

Waiting periods

A waiting period is the length of time you have to wait before you become eligible for benefits.

 

The following waiting periods apply to Hospital cover

Pre-existing conditions* (other than Psychiatric treatment^, Rehabilitation & Palliative care)
12 months
Obstetric related conditions (including Private Postnatal Care Services+)
12 months
All other services
2 months

The following waiting periods apply to Extras cover

Health management programs 3 months
Optical 6 months
Major Dental
(including Periodontics, Endodontics, Crowns & Bridges, Dental Implants, Dentures & 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

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. In addition to waiting periods, some benefit limitation periods apply to specific services on hospital cover.

*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 without serving a waiting period to access mental health services once per lifetime. This waiting period exemption applies for each person covered on the policy. A 2 month waiting periods applies to mental health cover (psychiatric treatment) for people new to private health insurance.

+This service is available to St.LukesHealth Members in Northern Tasmania where there is no access to private hospital postnatal services.

Mothers who deliver at the Launceston General Hospital (LGH) can access the postnatal service at the Mantra Charles Hotel regardless of where they live in Northern Tasmania. Mothers and babies will require discharge by their obstetrician from the LGH before accessing this post-discharge service. The postnatal service is available on all products with the exception of Packaged Budget 500 Level 2, Budget 500 Level 2 and Hospital Co-Pay. St.LukesHealth also offers a home based postnatal 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 fund. Members who reside in Southern or North West Tasmania are not eligible for this service, as postnatal services are provided by the private hospitals in these regions, unless they deliver at the LGH.

Benefit Limitation Periods

A benefit limitation period is an initial period of time during which only a minimum benefit is paid for some types of hospital treatment.

Benefit limitation periods apply to new members to private health insurance and to members rejoining after a lapse in cover. They do not apply to existing members changing their hospital cover or to new members transferring from another private health insurer providing their previous cover did not exclude the following services and they are transferring within 2 months of ceasing their previous cover.

A benefit limitation period of two years applies from the date of joining on the following services:

  • Joint replacements (excluding joint replacement that results from an accident)
  • Bariatric procedures (weight loss surgery, including repair, replacement, removal and adjustment)
  • Spinal surgery (excluding spinal surgery that results from an accident)
  • Dialysis for chronic renal failure
  • Assisted reproductive services including IVF and GIFT

Benefit Limitation Periods may apply to Psychiatric treatment (including drug and alcohol rehabilitation), please make contact with the health fund.

The hospital benefits payable on all hospital covers during a designated benefit limitation period will be the minimum benefit as declared by the Minister for Health and Ageing, except when a waiting period is also being served, in which case no benefit applies.

Transferring from another fund?

If you have served all your waiting periods with another fund, you can transfer to equivalent or lower cover with St.LukesHealth without having to re-serve waiting periods on benefits common to both funds, providing you transfer within 2 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.

Please Set Your Location

We need to confirm your location to show you the correct cover rates.