| St Lukes Health | |
|---|---|
| Registered insurer | St Luke's Medical and Hospital Benefits Association (St Lukes Health) |
| Who can join | Open to anyone |
| Business structure | Member-owned mutual, not-for-profit |
| Hospital policies (30 June 2025) | 41,432 (0.7% of all hospital policies), covering 83,366 people |
| Hospital tiers on sale (1 September 2026) | Gold, Silver Plus, Bronze Plus, Bronze, Basic Plus |
| Excess options on open hospital policies | $150, $250, $300, $500, $750 |
| Age-based discount (18-29) | Not offered on its open hospital policies |
| Ambulance | Ambulance is not part of its open hospital policies |
| Question | What the official data shows |
|---|---|
| Out-of-pocket costs in hospital | 87.0% of in-hospital medical services had no gap for the member (industry 87.1%), and 90.6% of hospital charges were covered (industry 89.0%), 2024-25 |
| Waiting periods and pre-existing conditions | The legal maximums apply: 12 months for a pre-existing condition (signs or symptoms in the 6 months before you joined or upgraded) and for pregnancy and birth, 2 months for other hospital treatment. Every hospital policy open to new members in the Government's data at 1 October 2026, at every fund, used the 12-month pre-existing wait |
| Switching from another fund | Waits you've already served on the same or a lower level of cover carry across to St Lukes Health, and from it. Ask your old fund for a clearance certificate and keep the break between policies short |
| The Medicare Levy Surcharge | Excess options on its open hospital policies go up to $750, so all are within the $750 singles limit, and every policy was flagged as meeting the surcharge rules in the Government's data at 1 October 2026 |
| Adult children (dependants) | Up to age 24, studying or not, in the fund's own record (Government data, 1 October 2026). Adult dependants often need an extended family option |
| Claims experience | 0.2% of Ombudsman complaints about insurers on a 0.6% market share (ratio 0.33), and 0.9% of the complaints the Ombudsman investigated, 2024-25 |
General advice only. This information doesn't take into account your objectives, financial situation or needs. Consider whether the product is right for you and read the Product Disclosure Statement (PDS) and Target Market Determination (TMD) before you decide. We don't compare every product in the market, and we may earn a commission if you take up a product through our links.
Structure
PrivateHealth.gov.au describes St Lukes as a mutual organisation operating on a not-for-profit basis, and lists Astute Simplicity Health as one of its brands. The fund says it has provided cover since 1952 and that it has no call centres, so calls go to its own customer care staff. It sells corporate products but not overseas visitors or student cover.
Complaints and retention
St Lukes accounted for 0.2% of Ombudsman complaints about insurers in 2024-25, a third of its 0.6% market share, and 0.9% of investigated complaints. Retention was 87.9%, above the industry's 85.0%.
Benefits and gaps
St Lukes paid 84.8% of premium income as benefits, slightly above the industry's 84.5%, with management expenses of 13.7% (industry 10.9%). 90.6% of hospital charges were covered (industry 89.0%) and 87.0% of in-hospital medical services had no gap (industry 87.1%). Extras paid 54.5% of charges on average, above the industry's 50.7%.
In the Government's agreement-hospital data at 1 October 2026, St Lukes had agreements with all seven of Tasmania's private hospitals, but with fewer private hospitals than the five largest funds in NSW (73, against 86 to 95) and Queensland (47, against 50 to 56); our guide to private health insurance in Tasmania compares every fund's Tasmanian agreements.
What St Lukes sells
Its open hospital policies at 1 September 2026 cover Gold, Silver Plus, Bronze Plus, Bronze and Basic Plus, across the St Lukes and Astute brands, with excesses from $150 up to $750. None were listed with the age-based discount. Ambulance isn't part of its open hospital policies in the product data, so check how you'd be covered: Tasmanian residents have state ambulance arrangements, and people in other states may need separate ambulance cover.
St Lukes Health against the industry: 2024-25 data
Every year the Private Health Insurance Ombudsman compares all insurers on the same measures, and PrivateHealth.gov.au republishes the results on each insurer's profile. The table below is St Lukes Health's, with the industry result beside each figure. Its complaints-to-market-share ratio was 0.33: a figure of 1.00 means complaints exactly in proportion to size.
| Measure | St Lukes Health | Industry | Reading |
|---|---|---|---|
| Share of all Ombudsman complaints | 0.2% | Market share 0.6% | Fewer complaints than its size |
| Share of investigated complaints | 0.9% | Market share 0.6% | |
| Member retention (hospital cover) | 87.9% | 85.0% | Better than industry |
| Benefits paid as % of premiums | 84.8% | 84.5% | In line with industry |
| Management expenses % of premium income | 13.7% | 10.9% | Weaker than industry |
| Hospital charges covered | 90.6% | 89.0% | Better than industry |
| Medical services with no gap | 87.0% | 87.1% | In line with industry |
| Medical services with no gap or a known gap | 98.5% | 97.1% | Better than industry |
| Extras (general treatment) charges covered | 54.5% | 50.7% | Better than industry |
How to read it: complaint share is the fairest single comparison of service across funds of different sizes, because it's measured against market share. Benefits as a % of premiums shows how much of the premium pool went back to members as claims; a mutual that returns more is not necessarily cheaper, and a fund can move this figure by changing prices. The gap measures show how often members avoided an out-of-pocket medical bill after a hospital stay, which is what most people mean by "good cover".
Hospital agreements
| ACT | NSW | VIC | QLD | SA | WA | TAS | NT | |
|---|---|---|---|---|---|---|---|---|
| Private hospitals | 4 | 73 | 64 | 47 | 15 | 21 | 7 | 1 |
| Most held by any insurer | 7 | 95 | 73 | 63 | 17 | 23 | 7 | 1 |
| Day hospitals | 7 | 68 | 56 | 37 | 21 | 21 | 11 | 1 |
| Most held by any insurer | 11 | 109 | 73 | 58 | 35 | 28 | 12 | 2 |
What to check before you join St Lukes Health
- Ambulance isn't included in its open hospital policies. Arrange it separately if your state doesn't cover you.
- Fewer hospital agreements in NSW and Queensland than the five largest funds.
- No age-based discount on its open hospital policies.
- Over 31 and joining for the first time? Work out your Lifetime Health Cover loading first, and if you earn over the threshold, check the Medicare Levy Surcharge you'd avoid.
Common questions about St Lukes Health
Is St Lukes Health not-for-profit?
Yes. PrivateHealth.gov.au lists St Lukes as a mutual organisation operating on a not-for-profit basis.
Is Astute Simplicity Health part of St Lukes?
Yes. PrivateHealth.gov.au lists Astute Simplicity Health as a brand of St Lukes.
Can you join St Lukes outside Tasmania?
Yes. St Lukes is an open fund and operates in all states and territories.
Other fund reviews
See every registered health insurer compared on complaints and benefits, or read how the private health insurance rebate and hospital cover tiers work.
General advice only. It doesn't consider your circumstances. Read the PDS and TMD before you decide.
This review is general information based on published government and regulator data. We don't rate or rank funds, and it doesn't consider your circumstances. Check a policy's Private Health Information Statement before you buy.