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Aussies paying steep Gaps for specialist care, data shows

Specialist fees for private hospital care in Australia have increased dramatically – in some cases, by as much as 9 times, new data shows. Figures from Private Healthcare Australia, the peak body for the health insurance industry, found that average out-of-pocket fees charged for treating private patients have surged by staggering amounts between 2018-19 and...

Govt warns insurers about premium increases

The Minister of Health has warned health insurers to focus on providing value to customers when they apply to increase their premiums over the next few weeks. Private health insurers are allowed to raise premiums once a year only, subject to government approval. Insurer applications for 2026 premium increases are due in November, with approved...

ACT residents paying high Gaps, as premiums set to rise

Some ACT residents are being hit with shock bills for public hospital treatment, new figures show. Following news this week that health insurance premiums for ACT residents may rise by at least $180 next year, an analysis of billing records has revealed the high Gaps being paid for Canberra hospital treatment. Data from Private Healthcare...

Hospital Cover claims jump 11.6% amid public hospital strain

With public hospitals under strain, health insurers are paying out greater sums for private patient treatment, new data shows. Quarterly health insurance statistics released by the Australian Prudential Regulation Authority, which regulates the industry, showed a significant increase in the amount paid for Hospital Cover claims in the June 2025 quarter. Health insurers paid $4.98...

Four times more Australians paying Medicare Levy Surcharge, data shows

New data from the Australian Tax Office shows that the number of people being charged the Medicare Levy Surcharge (MLS) has almost quadrupled over 6 years. Data found 768,537 Aussies paid the MLS in the 2022-23 financial year, up from 196,807 in 2017. An article in The Australian says the increase is due to rising...

Yoga, Pilates and other natural therapies return to Extras Cover

Australians treated with natural therapies may soon be able to claim rebates on Extras Cover. Following a review completed last year, the government has reinstated 7 of the 16 natural therapies that were removed from private health insurance cover in 2019. The health insurance industry is now developing framework to cover: Private Healthcare Australia, the...

Bupa paying millions in compensation for claims error

Bupa members who had Hospital Cover claims rejected between 1 May 2018 and 31 August 2023 may be entitled to compensation. The health insurer has announced it incorrectly rejected “mixed coverage” claims – claims for 2 or more treatments at a time – and certain other types of claims during this period. Bupa has apologised...

Teachers Health and TUH merge to form larger health insurer

Members of Teachers Health and TUH are about to become part of the sixth largest health insurer in Australia. The two not-for-profit insurers have announced they will merge next week on 1 July, forming a combined insurer that will cover 500,000 people, Teachers Health said. TUH said the merger will bring some small benefits to...

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Explore Overview

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Australian Health System (25 articles) Health Insurance Prices (20 articles) Private Health Insurance (33 articles) Private Health Insurers (15 articles) Medicare (28 articles) Medicare Benefits Schedule (MBS) (6 articles) Pharmaceutical Benefits Scheme (PBS) (8 articles) Public Hospitals (6 articles) Private Hospitals (7 articles) Medicare Levy (7 articles) Private Health Insurance Rebate (7 articles) Age-based Discount (5 articles) Lifetime Health Cover Loading (11 articles)

Hospital Cover (9 articles) Extras Cover (6 articles) Ambulance Cover (5 articles) Excluded Treatments

Insurers Overview

AAMI Health Insurance

AIA Health Insurance

Allianz Care Australia

APIA Health Insurance

Astute Simplicity Health

Australian Unity

Bupa Health Insurance

CBHS International Health

Doctors’ Health

Emergency Services Health

Health Partners

Hunter Health Insurance (by CDH Benefits Fund)

ING Health Insurance

Latrobe Health Services

Mildura Health Fund

Nurses & Midwives Health

Phoenix Health Fund

Priceline Health Insurance

Qantas Insurance

Queensland Country Health Fund

Real Health Insurance

Reserve Bank Health Society (RBHS)

Seniors Health Insurance

St Lukes Health

Suncorp Health Insurance

Teachers Health

Territory Health Fund

Transport Health

Westfund

Aussies paying steep Gaps for specialist care, data shows Govt warns insurers about premium increases ACT residents paying high Gaps, as premiums set to rise Hospital Cover claims jump 11.6% amid public hospital strain Four times more Australians paying Medicare Levy Surcharge, data shows Yoga, Pilates and other natural therapies return to Extras Cover Bupa paying millions in compensation for claims error Teachers Health and TUH merge to form larger health insurer

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Calculate Rebate Discount & Loading Check if your health insurance premium decreases or increases by calculating your Government Rebate, Age-based Discount and Lifetime Health Cover Loading.

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Home Explore Guides Medicare Benefits Schedule (MBS)

Medicare Benefits Schedule (MBS)

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What is the difference between the Medicare Benefits Schedule (MBS) and the Medicare Benefits Scheme?

Reviewed and updated 13 November 2024

The Medicare Benefits Scheme and the Medicare Benefits Schedule (MBS) are terms that sound similar but refer to completely different parts of the Australian Health System.

The Medicare Benefits Scheme is the official name for Medicare, which is Australia’s universal health scheme.

In contrast, the Medicare Benefits Schedule (MBS) is the list of all medical services subsidised by the Australian government under Medicare.

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