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 Sleep Studies? Hospital Cover for Sleep Studies includes hospital treatment to investigate sleep patterns, problems with sleeping and other anomalies. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Sleep Studies? Tier Clinical category covered? Can insurers offer restricted cover?...
What is covered under Tonsils, Adenoids and Grommets? Hospital Cover for Tonsils, Adenoids and Grommets includes hospital treatment to: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Tonsils, Adenoids and Grommets clinical category are under different clinical categories. For example, treatments...
What is covered under Weight Loss Surgery? Hospital Cover for Weight Loss Surgery includes hospital treatment for surgery to: Weight loss surgery is usually performed on people who are morbidly obese. This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Weight Loss Surgery? Tier Clinical category...
What is covered under Implantation of Hearing Devices? Hospital Cover for Implantation of Hearing Devices includes hospital treatment to correct hearing loss, including implants of a prosthetic hearing 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 Implantation of...
What is covered under Dialysis for Chronic Kidney Failure? Hospital Cover for Dialysis for Chronic Kidney Failure includes hospital treatment for chronic kidney failure. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Scheme (MBS). Which Hospital Cover tiers include Dialysis for Chronic Kidney Failure? Tier Clinical category covered? Can insurers...
What is covered under Back, Neck and Spine? Hospital Cover for Back, Neck and Spine is for hospital treatment to investigate and treat the: Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Back, Neck and Spine clinical category are...
What is covered under Blood? Hospital Cover for Blood is for hospital treatment to investigate and treat blood and blood-related conditions. Examples include: Some treatments you might expect to be in the Blood clinical category, such as treatment for cancers of the blood, are under the Chemotherapy, Radiotherapy and Immunotherapy for cancer clinical category. This...
What is covered under Bone, Joint and Muscle? Hospital Cover for Bone, Joint and Muscle is for hospital treatment to investigate and treat diseases, disorders and injuries of the musculoskeletal system. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the...