The Australian Medical Association (AMA), an advocacy group for doctors, says private health insurance no longer provides value for money, and wants the government to overhaul the industry. The association’s annual Private Health Insurance Report Card, released today, found premium prices had doubled over the past 16 years, outstripping health inflation.“Australians are paying more for their...
Increased claim costs are putting health insurers under pressure, new data shows. The latest figures from industry regulator, the Australian Prudential Regulation Authority (APRA), show $5.2 million was paid for hospital treatment claims in the September 2025 quarter – an 8.0% increase compared with the same quarter last year and much higher than the growth in...
Specialist fees for private hospital care in Australia have increased dramatically – in some cases, by as much as 9 times, new data shows. Figures from Private Healthcare Australia, the peak body for the health insurance industry, found that average out-of-pocket fees charged for treating private patients have surged by staggering amounts between 2018-19 and 2023-24. Average...
The Minister of Health has warned health insurers to focus on providing value to customers when they apply to increase their premiums over the next few weeks. Private health insurers are allowed to raise premiums once a year only, subject to government approval. Insurer applications for 2026 premium increases are due in November, with approved prices...
Some ACT residents are being hit with shock bills for public hospital treatment, new figures show. Following news this week that health insurance premiums for ACT residents may rise by at least $180 next year, an analysis of billing records has revealed the high Gaps being paid for Canberra hospital treatment. Data from Private Healthcare Australia...
With public hospitals under strain, health insurers are paying out greater sums for private patient treatment, new data shows. Quarterly health insurance statistics released by the Australian Prudential Regulation Authority, which regulates the industry, showed a significant increase in the amount paid for Hospital Cover claims in the June 2025 quarter. Health insurers paid $4.98 billion...
New data from the Australian Tax Office shows that the number of people being charged the Medicare Levy Surcharge (MLS) has almost quadrupled over 6 years. Data found 768,537 Aussies paid the MLS in the 2022-23 financial year, up from 196,807 in 2017. An article in The Australian says the increase is due to rising wages. The...
Australians treated with natural therapies may soon be able to claim rebates on Extras Cover. Following a review completed last year, the government has reinstated 7 of the 16 natural therapies that were removed from private health insurance cover in 2019. The health insurance industry is now developing framework to cover: Private Healthcare Australia, the peak body for...
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Australian government private health insurance surcharges The Australian government imposes 2 private health insurance surcharges:These are designed to encourage you to take out private health insurance.Medicare Levy Surcharge The Medicare Levy Surcharge is a levy you have to pay if you do not have Hospital Cover and earn above a certain income.The surcharge covers you and your...
Australian government private health insurance incentives The Australian government offers 2 incentives to encourage Australians to take out private health insurance:Private Health Insurance Rebate The Private Health Insurance Rebate is a rebate from the Australian government to help you pay for private health insurance.The rebate applies to Hospital Cover, Extras Cover and Ambulance Only Cover.The Private Health...
In Australia, you do not have to take out private health insurance.If you have a Medicare Card, you can receive treatment as a public patient in a public hospital.If you do not take out private health insurance, you will not receive help from an insurer to pay for:Alternatively, you can pay to be treated as...
If you have private health insurance, you may in certain situations receive treatment more quickly than someone without private health insurance.Receiving treatment at a private hospital can be very expensive.Most people who elect to go to a private hospital for surgery have Hospital Cover. This insurance helps them pay for the cost of being treated in...
Why don’t private health insurers cover the cost of appointments with my GP or specialist? In Australia, Medicare covers some or all of the cost of appointments with your General Practitioner (GP) or specialist.GPs and specialists have the legal right to run their practices as private businesses. This means they can charge whatever fees they feel...
How to decide whether you need private health insuranceWhen deciding whether you need private health insurance, consider the advantages and disadvantages to make the best decision for your situation.If you buy Hospital Cover, the main benefit is that it helps you pay for the cost of being treated as a private patient in hospital. If you...
Private health insurance works on the basis that you take out a policy and pay an insurer a monthly premium. In return, the insurer provides you with health cover.Depending on the policy you take out, private health insurance helps you pay for:If you want both Hospital Cover and Extras Cover, you can take out Combined Hospital...
In Australia, private health insurance is community rated not risk rated.Community rated means a private health insurer must offer its policies at the same price irrespective of an individual’s risk factors, such as: