The government has announced it will investigate health insurers for using a loophole to raise their prices. In December last year, Minister of Health Mark Butler warned health insurers to stop ‘phoenixing’ policies after a Commonwealth Ombudsman report brought the practice to light. By law, health insurers can only raise prices once a year, but...
Most Australians will pay more for health insurance next week due to a reduction in a rebate designed to make health cover cheaper. Cuts to the Private Health Insurance Rebate take effect on April 1 at the same time as most policies are increasing in price by an average of 3.7% – which adds up...
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...
Health insurance will increase by an average of 3.7% in April – the highest premium increase since 2018. Every year health insurers are allowed to raise their premiums only once. This year, Minister of Health Mark Butler rejected insurers’ proposed increases (reportedly up to 6%) at least twice before agreeing on an average premium increase...
Australian private health insurers have been criticised for using a loophole to raise the prices of Gold Cover policies. This week the Commonwealth Ombudsman found evidence some insurers have been raising prices through ‘product phoenixing’ – closing existing policies to new customers, and creating almost identical policies at a higher price. As a result, new...
Australians with Private Health Insurance are paying higher out-of-pocket payments for hospital treatment than a year ago, new data shows. The latest statistics from Australian Prudential Regulation Authority (APRA), which regulates the health insurance industry, show out-of-pocket fees for private hospital treatment increased by 8% in the 12 months from October 2023 to September 2024....
If you’ve used health insurance to pay for surgery in a private hospital or clinic, check your bill to make sure you haven’t been charged a Gap incorrectly. That’s the advice from Private Healthcare Australia, the peak body for the health insurance industry, after allegations that some specialists (including surgeons and anaesthetists) have been ‘double...
A ‘health tax’ passed by NSW government last week means NSW residents could face higher premiums for health insurance in 2025. The new legislation means the state government can increase its existing tax on private health insurance if insurers do not agree to pay a higher ‘bed rate’ of $892 for private patients in public...
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What is covered under Pain Management? Hospital Cover for Pain Management includes hospital treatment for pain management that does not require the insertion or surgical management of a device. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Pain Management...
What is covered under Pain Management with Device? Hospital Cover for Pain Management with Device includes hospital treatment to implant, replace or surgically manage a device needed to manage pain. Examples include implanting: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the...
What is covered under Palliative Care? Hospital Cover for Palliative Care includes hospital treatment to provide quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain. This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Treatments covered under the Palliative Care category are meetings...
What is covered under Plastic and Reconstructive Surgery (medically necessary)? Hospital Cover for Plastic and Reconstructive Surgery (medically necessary) includes hospital treatment to investigate and treat any physical deformity, whether acquired as a result of illness, accident or from birth. Examples include: It does not include Cosmetic Surgery. This clinical category includes these treatments listed...
What is covered under Podiatric Surgery? Hospital Cover for Podiatric Surgery includes hospital treatment for foot and ankle surgery when performed by an accredited Podiatric Surgeon. Examples include: Treatments for this clinical category are not covered in the Medicare Benefits Schedule (MBS). This means your health insurer does not have to pay fees for your...
What is covered under Pregnancy and Birth? Hospital Cover for Pregnancy and Birth includes hospital treatment to investigate and treat conditions associated with pregnancy and childbirth. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Pregnancy and Birth clinical category...
What is covered under Rehabilitation? Hospital Cover for Rehabilitation includes hospital treatment to help people recover from surgery, illness or injury. Examples include: Treatments for this clinical category are not covered in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Rehabilitation? Tier Clinical category covered? Can insurers offer restricted cover? Basic Yes Yes...
What is covered under Skin Conditions? Hospital Cover for Skin Conditions includes hospital treatment to: Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Skin clinical category are under other clinical categories. For example: Which Hospital Cover tiers include Skin...