| St Lukes Health | |
|---|---|
| Registered insurer | St Lukes |
| 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 |
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%.
It had fewer private hospital agreements in NSW (69) and WA (17) than the largest funds, and five in Tasmania, where the most any insurer had was seven.
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 | 5 | 69 | 66 | 48 | 17 | 17 | 5 | 1 |
| Most held by any insurer | 7 | 97 | 74 | 58 | 17 | 23 | 7 | 2 |
| Day hospitals | 7 | 68 | 57 | 36 | 20 | 21 | 11 | 1 |
| Most held by any insurer | 9 | 98 | 64 | 50 | 30 | 28 | 11 | 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 WA than the big 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.
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.
