Gap payments continue to rise, report finds 

Out-of-pocket payments for Private Health Insurance claims continue to rise, putting more pressure on Australian households during the cost-of-living crisis. 

New data from Australian Prudential Regulation Authority (APRA), which regulates the health insurance industry, found a 7% increase in Gaps paid for Hospital Cover claims for the quarter finishing December 2024, compared with the same quarter in 2023. The average out-of-pocket fee for hospital treatments is now $439.16, compared to $410.52 for the same quarter in 2023. 

The largest average Gap was $730 for orthopaedic treatments and services.  

And Australians are continuing to value their Hospital Cover, retaining policies despite financial pressures. Rather than dropping cover, around 59,279 people took up a new Hospital Cover policy in the last quarter of 2024 – a slight increase compared to the July to September 2024 quarter, APRA data shows.  

The highest increase was for people aged 40 to 44. 

Access the full report here. 

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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