Hospital Cover claims jump 11.6% amid public hospital strain 

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 for hospital treatments, an 11.58% increase compared to the March 2025 quarter.  

Hospital episodes (or admissions) claimed on health insurance were up, with an 8.3% increase from the previous quarter. 

Extras Cover claims, however, decreased by 4.6% over this period, with $1.69 billion paid by insurers. 

Gap payments continued to increase, showing Australians with health insurance are paying more out of pocket for hospital treatments. The average Gap is now $478.42, up 9.4% from June 2024.  

Read the APRA quarterly statistics here. 

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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