The Australian Medical Association (AMA), an advocacy group for doctors, says private health insurance no longer provides value for money, and wants the government to overhaul the industry. The association’s annual Private Health Insurance Report Card, released today, found premium prices had doubled over the past 16 years, outstripping health inflation.“Australians are paying more for their...
Increased claim costs are putting health insurers under pressure, new data shows. The latest figures from industry regulator, the Australian Prudential Regulation Authority (APRA), show $5.2 million was paid for hospital treatment claims in the September 2025 quarter – an 8.0% increase compared with the same quarter last year and much higher than the growth in...
Specialist fees for private hospital care in Australia have increased dramatically – in some cases, by as much as 9 times, new data shows. Figures from Private Healthcare Australia, the peak body for the health insurance industry, found that average out-of-pocket fees charged for treating private patients have surged by staggering amounts between 2018-19 and 2023-24. Average...
The Minister of Health has warned health insurers to focus on providing value to customers when they apply to increase their premiums over the next few weeks. Private health insurers are allowed to raise premiums once a year only, subject to government approval. Insurer applications for 2026 premium increases are due in November, with approved prices...
Some ACT residents are being hit with shock bills for public hospital treatment, new figures show. Following news this week that health insurance premiums for ACT residents may rise by at least $180 next year, an analysis of billing records has revealed the high Gaps being paid for Canberra hospital treatment. Data from Private Healthcare Australia...
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...
New data from the Australian Tax Office shows that the number of people being charged the Medicare Levy Surcharge (MLS) has almost quadrupled over 6 years. Data found 768,537 Aussies paid the MLS in the 2022-23 financial year, up from 196,807 in 2017. An article in The Australian says the increase is due to rising wages. The...
Australians treated with natural therapies may soon be able to claim rebates on Extras Cover. Following a review completed last year, the government has reinstated 7 of the 16 natural therapies that were removed from private health insurance cover in 2019. The health insurance industry is now developing framework to cover: Private Healthcare Australia, the peak body for...
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There are several ways to make your premium for health insurance cheaper: The higher your excess (which is the amount you pay for a claim), the lower your premiums. However to avoid paying the Medicare Levy Surcharge, your excess cannot be higher than $750 for a policy covering one adult, nor more than $1,500 for a...
What is covered under Insulin Pumps?Hospital Cover for Insulin Pumps includes hospital treatment to provide or replace diabetic insulin pumps used to treat diabetes.There are no devices or treatments listed in the Medicare Benefits Schedule (MBS).However, Medicare still covers visits to your doctor, other treatments to help with diabetes and several treatments for chronic kidney...
What is covered under Joint Reconstructions?Hospital Cover for Joint Reconstructions includes hospital treatment for surgery for joint reconstructions.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Joint Reconstructions clinical category are under other clinical categories. For example, treatments for:Which Hospital Cover tiers...
What is covered under Joint Replacements?Hospital Cover for Joint Replacements includes hospital treatment for joint replacement surgery, including revisions, resurfacing, partial replacements and removal of prostheses. Examples include replacement of:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Joint Replacements clinical category are under...
What is covered under Kidney and Bladder?Hospital Cover for Kidney and Bladder includes hospital treatment to investigate and treat the kidney, adrenal gland and bladder. Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Kidney and Bladder clinical category are under different clinical...
What is covered under Lung and Chest?Hospital Cover for Lung and Chest includes hospital treatment to investigate and treat the lungs, lung-related conditions, the chest and the mediastinum.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Lung and Chest clinical category are...
What is covered under Male Reproductive System?Hospital Cover for Male Reproductive System includes hospital treatment to investigate the male reproductive system, including the prostate.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Male Reproductive System clinical category are under different clinical categories....
What is covered under Miscarriage or Termination of Pregnancy?Hospital Cover for Miscarriage or Termination of Pregnancy includes hospital treatment to investigate and treat miscarriage of a pregnancy or to terminate a pregnancy.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Miscarriage or Termination of Pregnancy? Tier...