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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Yes. The most recent Medical Benefits Schedule (MBS) Review ran from 2015–2020. The MBS Review Taskforce looked at more than 5,700 MBS items to see whether they needed to be amended, updated or removed. The objectives of the review were to: The review collected feedback from thousands of stakeholders, which helped shape its final recommendations...
The Medical Benefits Schedule (MBS) does not include a wide range of medical and health services:
Services from doctors included on the MBS MBS Benefits are payable for these types of services from doctors: Services from allied health professionals included on the MBS MBS Benefits are payable for some services from allied health workers, including: How services from allied health services for patients with a chronic disease are funded under the...
The Medicare Benefits Schedule (MBS) Fee is the amount the Australian government sets as appropriate to pay a health professional for a particular service. The fee is listed in the Medicare Benefits Schedule (MBS). The MBS also lists the rates for calculating the benefit payable by the government: Type of service Amount General practitioner (GP)...
The Medicare Benefits Scheme and the Medicare Benefits Schedule (MBS) are terms that sound similar but refer to completely different parts of the Australian Health System. The Medicare Benefits Scheme is the official name for Medicare, which is Australia’s universal health scheme. In contrast, the Medicare Benefits Schedule (MBS) is the list of all medical...
The Medicare Benefits Schedule (MBS) is a vital part of Medicare, Australia’s universal healthcare system. It lists all the medical services that the Australian government subsidises and pays a Medicare Benefit for. The MBS lists each service with: Generally, the MBS includes these types of services: The Australian Government Department of Health manages the MBS...
In this Guide, we outline how the Medicare Benefits Schedule (MBS) operates, as well as answer your most common questions. The Medicare Benefits Schedule (MBS) lists all the medical services where the Australian government subsidises and pays a Medicare Benefit. This Guide explains how the Medicare Benefits Schedule (MBS) works, as well as what services...