St Lukes
Packaged Ultimate Gold Extended
St Lukes
How $1,085.68 is worked out
- Premium as filed - $1,430.75 a month (hospital share $1,016.81)
- Government rebate - 24.1% of the premium (never of the loading): -$345.07
- A month - $1,085.68
Go to insurer no commission on this policy
Hospital: what is covered
Covered (38)
- Assisted reproductive services
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Dialysis for chronic kidney failure
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Heart and vascular system
- Hernia and appendix
- Hospital psychiatric services
- Implantation of hearing devices
- Insulin pumps
- Joint reconstructions
- Joint replacements
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Pain management with device
- Palliative care
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Rehabilitation
- Skin
- Sleep studies
- Tonsils, adenoids and grommets
- Weight loss surgery
Restricted (0)
None.
Not covered (0)
None.
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Gold
- Hospital - Private or public hospital
- Excess - No excess.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Not offered
- Accident cover - No
- Travel and accommodation benefits - No
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Pregnancy and birth - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: Ambulance Levy included for NSW/ACT residents. Ambulance is provided free to Tas residents. Unmarried dependants covered until they turn 23 and single F/T students covered until they turn 25.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental * | 2 months | Check-up (item 012): 100% back; Scale and clean (item 114): 100% back; Fluoride treatment (item 121): $36.00; Tooth extraction (item 322): $208.00 | $1,250 per person a year |
| Major dental | 12 months | Crown (item 615): $1040.00 | $2,000 per person a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $203.00 | $2,000 per person a year (shared with other services) |
| Braces | 12 months | Braces, upper and lower, with a retainer (item 881): 100% back | $1,200 per person a year, $3,000 lifetime |
| Glasses and contact lenses | 6 months | Single vision glasses: $350.00; Multifocal glasses: $350.00 | $350 per person a year |
| Prescriptions not on the PBS | 2 months | Prescription: $90.00 | $600 per person a year |
| Physiotherapy | 2 months | First visit: $61.00; Follow-up visit: $56.00 | $1,000 per person a year (shared with other services) |
| Chiropractic | 2 months | First visit: $46.00; Follow-up visit: $34.00 | Combined limit of $1000 per person for chiropractic/osteopathy, acupuncture and other services. $500 sub-limit applies per person, per service. (shared with other services) |
| Podiatry | 2 months | First visit: $55.00; Follow-up visit: $45.00 | $1,000 per person a year (shared with other services) |
| Psychology | 2 months | First visit: $160.00; Follow-up visit: $125.00 | Benefits payable towards counselling services - Initial consultation $85/subsequent consultation $80 included in $700 Psychology Limit |
| Acupuncture | 2 months | First visit: $40.00; Follow-up visit: $35.00 | Combined limit of $1000 per person for chiropractic/osteopathy, acupuncture and other services. $500 sub-limit applies per person, per service. (shared with other services) |
| Remedial massage | 2 months | First visit: $40.00; Follow-up visit: $35.00 | $500 per person a year (shared with other services) |
| Hearing aids | 36 months | Hearing aid: $1250.00 | 2 appliances every 5 years |
| Blood glucose monitors | 12 months | Blood: $200.00 | Overall limit of $1500 per person applies to Health Appliances and Aids**. $250 sub-limit applies to foot orthotics (shared with other services) |
| Audiology | 2 months | First visit: $55.00; Follow-up visit: $55.00 | 2 services every year |
| Antenatal and postnatal | 2 months | First visit: $56.00; Follow-up visit: $56.00 | $1,000 per person a year (shared with other services) |
| Chinese herbal medicine | 2 months | First visit: $37.00; Follow-up visit: $33.00 | $500 per person a year (shared with other services) |
| Dietitian | 2 months | First visit: $80.00; Follow-up visit: $50.00 | $1,000 per person a year (shared with other services) |
| Exercise physiology | 2 months | First visit: $60.00; Follow-up visit: $45.00 | $1,000 per person a year (shared with other services) |
| Eye therapy (orthoptics) | 2 months | First visit: $70.00; Follow-up visit: $43.00 | $1,000 per person a year (shared with other services) |
| Home nursing | 2 months | First visit: $55.00 | $500 per person a year |
| Occupational therapy | 2 months | First visit: $85.00; Follow-up visit: $60.00 | $1,000 per person a year (shared with other services) |
| Orthotics | 12 months | Benefit: $250.00 | Overall limit of $1500 per person applies to Health Appliances and Aids**. $250 sub-limit applies to foot orthotics (shared with other services) |
| Osteopathy | 2 months | First visit: $60.00; Follow-up visit: $50.00 | Combined limit of $1000 per person for chiropractic/osteopathy, acupuncture and other services. $500 sub-limit applies per person, per service. (shared with other services) |
| Speech therapy | 2 months | First visit: $130.00; Follow-up visit: $82.00 | $1,000 per person a year (shared with other services) |
Not covered: Health management programs, Vaccinations.
* Under Preventative Dental, we pay up to 100% of the average fee charged Australia wide up to the maximum benefit for each eligible service. This applies to examinations, x-rays, scale and clean and fissure sealing. If your dentist charges above the maximum benefit, or in excess of the average fee, a gap or out of pocket may apply. Annual limits, fund rules and waiting periods apply. A 2-month waiting period applies to Psychology with the exception of functional assessment for the purpose of diagnosing ADHS and/or autism spectrum disorders diagnosis which has a 12-month waiting period.
Other services, as filed: Acupuncture, Remedial massage, Western herbal medicine, Alexander Technique, Myotherapy, Naturopathy and Shiatsu are included in the Alternative Therapies annual limit.
Orthodontic limit included in annual Major Dental limit. Diabetes Education & Nutrition benefits included in Dietetics sub-limit. Member rewards apply after 5 years continuous membership. Other services covered: include laser eye surgery, neuropsychology and approved health management programs. **Limits apply to individual Health Appliances & Aids
Ambulance
No ambulance cover.
Agreement hospitals in South Australia
St Lukes has agreements with 35 private hospitals here, as filed with the Ombudsman.
The list
- Adelaide Day Surgery - Adelaide (day hospital)
- Adelaide Surgicentre - Kent Town (day hospital)
- Ashford Hospital - Ashford
- Brighton Day Surgery - Brighton (day hospital)
- Brighton Dialysis Clinic - Hove (day hospital)
- Burnside Hospital Stepney - Stepney
- Burnside Hospital Toorak Gardens - Toorak Gardens
- Calvary Connery Centre - Elizabeth Vale (day hospital)
- Calvary North Adelaide Hospital - North Adelaide
- Dextra Surgical - Norwood (day hospital)
- Eastwood Private Hospital - Eastwood
- Flinders Private Hospital - Bedford Park
- Genesiscare Western Hospital - Henley Beach (day hospital)
- Glen Osmond Surgicentre - Eastwood (day hospital)
- Glenelg Community Hospital Inc - Glenelg South
- Glenelg Day Surgery - Glenelg (day hospital)
- Griffith Rehabilitation Hospital - Hove
- Hamilton House Day Surgery - Cumberland Park (day hospital)
- Icon Cancer Centre Adelaide - Kurralta Park (day hospital)
- Icon Cancer Centre Windsor Gardens - Windsor Gardens (day hospital)
- Memorial Hospital - North Adelaide
- North Adelaide Day Surgery Centre - North Adelaide (day hospital)
- North Eastern Community Hospital - Campbelltown
- Parkview Day Surgery - Eastwood (day hospital)
- Payneham Dialysis Clinic - Payneham (day hospital)
- Ramsay Clinic Adelaide - Gilberton
- Ramsay Day Clinic Kahlyn - Magill (day hospital)
- Repromed Day Surgery - Dulwich (day hospital)
- Seaford Day Surgery - Seaford Heights (day hospital)
- St Andrew's Hospital Inc - Adelaide
- Stirling Hospital Inc - Stirling
- The Tennyson Centre Day Hospital - Kurralta Park (day hospital)
- Vista Day Surgery - Wayville (day hospital)
- Western Hospital - Henley Beach
- Windsor Gardens Day Surgery - Windsor Gardens (day hospital)
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
87.9% is the Commonwealth Ombudsman's figure for St Lukes in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement J3/NCCQ2Y, filed by St Lukes, issued 1 Apr 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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