Health insurance regulations mean top-level cover has increasingly become unaffordable for many Australians. That’s the finding in an Actuaries Digital article, which suggests that the 4 tiers – Basic, Bronze, Silver and Gold – should be restructured. The number of Australians with Gold tier policies has dropped from 95% in 2005 to just 30% in 2026, due to younger claimers being concentrated on expensive Gold policies. This means many people do not have access to services such as private maternity cover, assisted reproductive services...
Australians with health cover are paying larger out-of-pocket costs for private treatment than ever, new data shows. The average Gap for private hospital treatment has climbed to $511.02 – an increase of 8.4% from the previous quarter, according to the latest statistics from government regulator APRA (the Australian Prudential Regulation Authority). Average Gaps for Extras Cover have increased to $65.02 – a 3.4% rise. Orthopaedic procedures remain the most expensive when it comes to out-of-pocket costs, with...
The cost of raising children continues to rise, with policies for families among the hardest hit in the latest health insurance premium increases.Analysis by health insurance comparison site healthslips.com.au found increases to Family and Single Parent policies have risen higher than policies that don’t include children.The government announced health insurance premiums would rise by an...
Senior Australians are facing a double whammy of health insurance cost rises, putting extra pressure on wallets during the cost-of-living crisis. Changes to the Private Health Insurance Rebate, coupled with high premium increases to policies that meet health needs of people over 65, mean senior Australians will be hit doubly hard by new health insurance changes. Currently the Private Health Insurance Rebate reduces premiums for people on low incomes by up to 24.288%, with reductions...
Health insurance premiums will increase by an average of 4.41% on 1 April, but some Australians are already experiencing bill shock after finding their policies will increase by as much as 10.74%. In the past few weeks policyholders have been notified by health insurers about their premium rises on 1 April 2026 and in some cases, the increases are significantly higher than 4.41%. Analysis by health insurance comparison...
Out-of-pocket fees for Australians with health insurance have risen, new data shows. Statistics from health insurance industry regulator APRA reveal average Gaps for hospital treatment rose by 7.7% in 2025, from an average of $437.61 to $471.29. Gaps for Extras Cover claims were up 5.6% from an average $59.53 to $62.87. Despite the increased Gaps and the cost-of-living crisis, Australians are holding onto their health insurance policies. There was no change to...
The government has approved a 4.41% average health insurance premium rise for 2026 – the highest increase in 9 years. Every year, health insurers must apply to the Minister for Health and Ageing to raise premiums. Last year’s average increase was 3.73%, while the 2017 average was 4.84%. Policyholders will be advised of their premium change over the coming weeks, with new premiums effective from 1 April. The Private Health Insurance Rebate will also be reduced from 1 April...
Increased out-of-pocket costs for specialists are leading many Australians to delay or cancel specialist care, a recent study has found. A survey of 4,000 people by Private Healthcare Australia – peak body for the health insurance industry – found that 55% of people received a higher specialist bill than expected in the past 3 years, and almost one in 3 people had delayed or cancelled specialist care due to costs. The survey – which included 2,300 people...
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If you’ve got Extras Cover, you might be covered for the cost of vaccinations, but the type of shots you can claim and the amount can be wildly different. Let’s look more closely at cover for vaccinations on health insurance. Are vaccinations covered by Medicare? Yes, if a vaccination is recommended for your age group...
If you’re looking for a new Hospital Cover policy or upgrading your current policy, you’ll need to decide what private health insurance tier you need. There are 4 tiers of Hospital Cover: Here are the 3 steps to choose your Hospital Cover tier. 1. Decide on your healthcare needs Make a list of the hospital...
If you’ve found yourself googling ‘How much do dentures cost?’, you’ll know that dentures in Australia are not cheap. Fortunately, you can use health insurance for denture costs, although there are some conditions. Here’s what you need to know about claiming dentures on private health insurance. How much do dentures cost? The cost of dentures...
Waiting for hernia surgery can be a long, and potentially painful, process. The latest data from the Australian Institute of Health and Welfare shows that the median wait time for hernia surgery was 77 days (around 2.5 months). But that’s only an average – around 6% of people waited more than a year for their...
There are literally thousands of health insurance policies available in Australia (68,538 open policies as at 7 April 2026, to be exact). So if you think your health cover isn’t quite hitting the mark, you have tonnes of alternatives. Staying with a policy that isn’t right for you means you’re throwing money down the drain, and potentially leaving yourself without sufficient cover when you need to claim for health treatments. So, how do you know if you’ve got the...
If you’re likely to need surgery this year, you could be in for a long wait. Although your surgery will be free under Medicare in the public health system, there may be a lengthy wait for non-urgent procedures. Of course, if you have health insurance, you can be seen quicker as a private patient, but that doesn’t necessarily mean your surgery will be free. Depending on your policy, and the doctors...
If you wear glasses or use contact lenses, you’ll know Extras Cover can be a handy way to bring down those costs. And even if you don’t need glasses right now, having optical cover can be useful as you age. Optometry Australia says our eyes lose the ability to focus on near objects from around...
If you’re confused about which natural therapies are covered by health insurance and which aren’t, you’re not alone. The government has changed the rules about health insurance cover for natural therapies twice in the past decade, which means there’s a lot of confusion around what can be claimed on Extras Cover. That can make it...