Reviewed and updated 9 December 2024
About Private Health Insurance premiums
A Private Health Insurance premium is the amount you pay each month or year for:
How do increases in health insurance premiums work?
Your Private Health Insurance premium may increase when hospital, medical or other health costs rise. They can also increase if health insurer members increase their use of health services.
If your insurer experiences or expects an ongoing increase in costs, it may increase your premium to remain financially viable.
Your insurer needs government approval to increase premiums
Your insurer must take these steps before increasing premiums:
Step 1:
Before increasing premiums, your insurer must submit details of the proposed increase to the Australian Government. In any submission, your insurer must provide detailed financial information and benefit projections to justify any increase. An accredited professional actuary must certify this information.
Step 2:
The Australian Department of Health and Aged Care along with the Australian Prudential Regulation Authority (APRA) examine the proposed increase.
Step 3:
The Minister of Health approves the rate increase. If your insurer cannot provide sufficient information to show the Minister that an increase is necessary to meet its obligations to pay benefits to members, there is no change to the premium.
What can you do if you can no longer afford your health insurance premium?
If your insurer informs you your health insurance premium is increasing and you feel you cannot afford the increase, you have 3 options:
Option 1:
Talk to your insurer or other insurers about a cheaper policy that still meets your needs.
Option 2:
Increase your excess or your co-payment if you are admitted as a private patient to hospital.
Option 3:
Reduce the number of benefits you receive as part of your Extras Cover.