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Is private health insurance community rated or risk rated?

Reviewed and updated 22 July 2025

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:

  • age (except the Lifetime Health Cover Loading, a surcharge imposed by the Australian government, and the Age-based Discount, an incentive introduced by the Australian government)
  • health status
  • previous claim history
  • how frequently a person needs healthcare. 

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