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 Members Health Fund Alliance is the industry body for health insurers that are not-for-profit or part of a member-owned group. It differs from industry body Private Healthcare Australia, because it claims its members all share a common objective – putting members’ health and wellbeing before profits. It currently represents 24 private health insurers that...
Private Healthcare Australia is an industry body representing private health insurers. It currently represents 22 private health insurers that cover 98% (14.65 million) of people in Australia who hold Private Health Insurance: No. Insurer 1. AIA Health Insurance 2. Australian Unity 3. Bupa Health Insurance 4. CBHS Corporate 5. CBHS Health 6. Defence Health 7....
The Private Health Insurance Ombudsman (PHIO) is part of the Office of the Commonwealth Ombudsman. The Commonwealth Ombudsman protects the community when dealing with the Australian government, particularly resolving complaints about the Australian government. The Commonwealth Ombudsman also oversees some private sector organisations, including private health insurers. The Commonwealth Ombudsman protects Private Health Insurance consumers...
No. In Australia, private health insurers cannot increase their premiums whenever they choose. Instead, they have to apply to the Australian government for permission to increase premiums and must provide supporting evidence explaining why the increase is necessary. Insurers can apply to increase premiums for their private health insurance policies only once a year. The...
The Australian government regulates private health insurers in Australia. The government regulates: Private Health Insurance laws also cover what your insurer must let you know about your policy:
In Australia, many private health insurers are mutuals. A mutual is a member-owned organisation where people come together to help achieve their shared purposes. Its objective is to help members and/or the community by providing goods or services rather than returning profits to investors. The underlying concept behind a mutual is that a group of...
About not-for-profit insurers A not-for-profit health insurer uses its revenue to: In Australia, not-for-profit health insurers are mutual organisations rather than corporations. Most not-for-profits claim to be focused on people rather than profits. Most of the restricted insurers are not-for-profit insurers. How many not-for-profit health insurers are there in Australia? In Australia, 22 private health...
About for-profit insurers A for-profit insurer focuses on returning profits to shareholders from premiums paid by members after it has: How many for-profit health insurers are there in Australia? In Australia, there are 8 private health insurers that operate on a for-profit basis. Insurer Status ahm (a subsidiary of Medibank) Open 1. AIA Health Insurance...