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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The Australian government funds the Pharmaceutical Benefits Scheme (PBS). During 2022-2023, the PBS cost $17 billion and 223.1 million PBS services were processed.
The Repatriation Pharmaceutical Benefits Scheme (RPBS) is an Australian government initiative that offers eligible people a wide range of medicines and wound care items at a concessional rate. Who is eligible for the RPBS? You may get prescribed medicines and wound care items at a concessional rate through the RPBS if you have an assessed...
The Pharmaceutical Benefits Scheme (PBS) Safety Net provides extra discounts on the price of medicines for pensioners and concession card holders. You are eligible for an extra discount under the PBS if you hold a Medicare Card and one of these cards: The further discount means you pay only up to $7.70 for PBS medicines.
The Pharmaceutical Benefits Scheme (PBS) Safety Net is designed to protect patients and families who require many PBS items. How the PBS Safety Net works for general patients From 1 January 2024, the safety net for general patients is currently $1,647.90 in the calendar year. If your and/or your family’s total co-payments reach $1,647.90, you...
How do I claim a PBS refund if I have my Medicare Card? If you have your Medicare Card, you can claim your PBS refund when you collect your medicines from the pharmacy with the prescriptions from your general practitioner (GP). How do I get a PBS refund if I don’t have my Medicare Card?...
Who is eligible for the Pharmaceutical Benefits Scheme (PBS)? Australian residents You are eligible for subsidised medicines under the PBS if you are an Australian resident and have a Medicare Card. Aboriginal and Torres Strait Islander Australians You can get more help to buy medicine under the PBS if you are an Aboriginal or Torres...
The Pharmaceutical Benefits Scheme (PBS) covers medicines for most medical conditions. If you have a medical condition and need medicine, the PBS will likely subsidise the cost of that medicine. The PBS does not cover the cost of over-the-counter medicines unless available on a prescription. The decision on which medicines to include in the PBS...
The Pharmaceutical Benefits Scheme (PBS) is an Australian government program that subsidises medicines to offer all Australians prompt, reliable and affordable access to medicines. It is a vital part of Australia’s health system. The PBS is part of the Australian government’s broader National Medicines Policy. It means you can access a wide range of prescribed...