Frequently Asked Questions

Need help understanding private health insurance? We’ve got the answers you need.

What is Private Health Insurance?
Private health insurance is divided into three types of cover – hospital, general treatment (or Extras cover) or a combination of both products. In Australia, private health insurance is community rated. This means that all Australians are provided with equal health care regardless of age, sex or their state of health. Because of this, private health funds cannot refuse to insure an individual or refuse to sell a policy based on a person’s health and how likely they are to claim. For example, it means a single 20-year-old in good health will pay the same health insurance premium as a single 35-year-old receiving cancer treatment if they are on the same policy. For more information about private health insurance, visit www.privatehealth.gov.au
What is the Australian Government Rebate?
Most Australians with private health insurance receive a rebate from the Australian Government to assist with the cost of their private health insurance. The rebate received depends on your level of income. For more information, visit our Help and Advice page.
What is Lifetime Health Cover?
Lifetime Health Cover was introduced by the Australian Government on July 1, 2000 and is designed to encourage people to take out hospital cover earlier in life and to maintain their hospital cover. For more information, visit our Help and Advice page.
What is Medicare?
Medicare is Australia’s public health system. It covers all Australian citizens and permanent residents. Medicare is partly funded by a levy on a taxable income. It covers public hospital treatment and doctors’ services.
 
What is the Medicare Levy Surcharge?
The Medicare Levy Surcharge is an additional surcharge imposed on people earning above defined income thresholds, who are eligible for Medicare but do not hold an appropriate level of private hospital cover. For more information, visit our Help and Advice page.
What is the Pharmaceutical Benefits Scheme?
The Pharmaceutical Benefits Scheme provides timely, reliable and affordable access to medicines for all Australians and is part of the Australian Government’s National Medicines Policy. The aim of this policy is to meet medication and related service needs so that both optimal health outcomes and economic objectives are met. Under the PBS, the government subsidises the cost of medicine for most medical conditions. The scheme is available to all Australian residents who hold a current Medicare card. For more information, visit www.pbs.gov.au
 
What are 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. 
What is the Private Health Insurance Code of Conduct?
St.LukesHealth is a signatory to the Private Health Insurance Code of Conduct, a self-regulatory code that aims to promote the partnerships between private health insurers, consumers, agents and brokers.  For more information, visit our Code of Conduct page.
What is St.LukesHealth Gap Cover?
St.LukesHealth Medical Gap Cover is designed to eliminate or reduce the gap between the Medicare Benefits Schedule fee and the fee a doctor charges for hospital inpatient medical service, provided your doctor is participating in the St.LukesHealth Medical Gap Cover arrangement. For more information, visit our Going to Hospital page.
 
What is Surgically Implanted Prosthesis?
A surgically implanted prosthesis is a piece of equipment that is surgically implanted into the body during a hospital procedure to replace or assist the body function. For more information, visit our Going to Hospital page.
How do I claim?
St.LukesHealth has a variety of ways you can claim benefit with us. For more information, visit our How to claim page.
 

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