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 visited a dentist to improve your smile recently, you might not have been smiling when you went to pay. Dental care in Australia is generally not covered by Medicare, which means it can hurt your hip pocket. Having Extras Cover is one way to eliminate dental bill shock, but often health insurance doesn’t...
If you’re using Hospital Cover to pay for surgery or a hospital procedure as a private patient, you probably assume your insurer will pick up the bill. But unfortunately health insurance doesn’t always cover 100% of the private hospital costs – sometimes there will be out-of-pocket costs, also known as Gaps. So what is a Gap?...
If you’re looking for cheaper health cover, corporate health insurance policies are definitely worth considering. Depending on the policy and what’s on offer, taking out a corporate health insurance policy could save you money and get you benefits that might not be available to the general public. Here’s everything you need to know about corporate policies...
If you’re among the 1.7 million Australians caring for someone with dementia, or you’ve been diagnosed with the condition yourself, you might be wondering whether private health insurance can help. While there isn’t a cure for dementia, there are many treatments that can help manage the condition. In this blog we’ll explain more about using health...
If you have both Hospital Cover and Extras Cover with one insurer, you might assume that those 2 policies are treated as one policy. It turns out you can have Hospital and Extras cover as ‘separate’ policies – also called ‘split’ or ‘second’ or ‘standalone’ policies, depending on the terminology your insurer uses. This can...
If you’ve visited a pharmacy lately you’ll know that medicines can be expensive, even when they’re subsidised by the government. The good news is that if you’re prescribed medication that isn’t subsidised by the government, you might be able claim back some of those costs on private health insurance, depending on your cover. Here’s what...
Private health insurance exists to help you access healthcare treatments or services that might otherwise be very expensive or out of reach. Even if you’re healthy now, you don’t know what’s ahead, and it can be reassuring to know that if you face a long waiting list in the public health system, you could be...
If you have a health condition and you’re worried it might disqualify you for health insurance, we have good news. In Australia, health insurers legally can’t deny you cover for a pre-existing condition nor for a family history of illness. But they can impose a waiting period, which means you won’t be able to claim...