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 Brain and Nervous System? Hospital Cover for Brain and Nervous System is for hospital treatment to investigate and treat: Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Brain and Nervous System clinical category are under...
What is covered under Breast Surgery (medically necessary)? Hospital Cover for Breast Surgery (medically necessary) covers hospital treatment to: Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). You should be aware that this category does not cover Cosmetic Surgery or Cosmetic Breast Surgery that is not medically necessary....
What is covered under Cataracts? Hospital Cover for Cataracts includes hospital treatment for a specific eye problem known as a cataract. This condition causes clouding of the lens that makes it difficult for people to read, drive at night or see true colours. This clinical category includes these treatments listed in the Medicare Benefits Schedule...
What is covered under Chemotherapy, Radiotherapy and Immunotherapy for Cancer? Hospital Cover for Chemotherapy, Radiotherapy and Immunotherapy for Cancer includes hospital treatment of cancer or benign tumours. Treatments include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Chemotherapy, Radiotherapy and Immunotherapy...
What is covered under Dental Surgery? Hospital Cover for Dental Surgery includes hospital treatment for surgery to the teeth, gums and jaw. Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Dental Surgery? Tier Clinical category covered? Can insurers offer restricted cover? Basic Optional...
What is covered under Diabetes Management? Hospital Cover for Diabetes Management includes hospital treatment to investigate and manage diabetes. Examples include: There is only one treatment for this clinical category listed in the Medicare Benefits Schedule (MBS). This is liposuction for skin contour problems because of repeated insulin injections. It does not include insulin pumps....
What is covered under Assisted Reproductive Services? Hospital Cover for Assisted Reproductive Services includes hospital treatment for fertility treatments or procedures. Examples are: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Assisted Reproductive Services clinical category are in other clinical categories....
What is covered under Digestive System? Hospital Cover for Digestive System includes hospital treatment to investigate and treat the digestive system, including the: Examples include: This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Examples include: Some treatments you might expect to be in the Digestive System clinical category are in...