The number of Australians paying the Medicare Levy Surcharge at tax time continues to rise. New data from the Australian Tax Office shows the number of people who paid the Surcharge jumped from 768,537 in 2022-23, to 885,087 in 2023-24 – a 15% increase. The Medicare Levy Surcharge (MLS) applies to people who earn above the ATO income threshold and do not have Hospital Cover covering all members of their household. The thresholds...
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...
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What is covered under Pain Management?Hospital Cover for Pain Management includes hospital treatment for pain management that does not require the insertion or surgical management of a device. Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Pain Management clinical category are under...
What is covered under Pain Management with Device?Hospital Cover for Pain Management with Device includes hospital treatment to implant, replace or surgically manage a device needed to manage pain.Examples include implanting:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Pain Management with Device...
What is covered under Palliative Care?Hospital Cover for Palliative Care includes hospital treatment to provide quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain. This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Treatments covered under the Palliative Care category are meetings with your doctor...
What is covered under Plastic and Reconstructive Surgery (medically necessary)?Hospital Cover for Plastic and Reconstructive Surgery (medically necessary) includes hospital treatment to investigate and treat any physical deformity, whether acquired as a result of illness, accident or from birth.Examples include:It does not include Cosmetic Surgery.This clinical category includes these treatments listed in the Medicare Benefits...
What is covered under Podiatric Surgery?Hospital Cover for Podiatric Surgery includes hospital treatment for foot and ankle surgery when performed by an accredited podiatric surgeon.Examples include:Treatments for this clinical category are not covered in the Medicare Benefits Schedule (MBS).This means your health insurer does not have to pay fees for your podiatric surgeon or anaesthetist....
What is covered under Pregnancy and Birth?Hospital Cover for Pregnancy and Birth includes hospital treatment to investigate and treat conditions associated with pregnancy and childbirth.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Pregnancy and Birth clinical category are under different clinical...
What is covered under Rehabilitation?Hospital Cover for Rehabilitation includes hospital treatment to help people recover from surgery, illness or injury.Examples include:Treatments for this clinical category are not covered in the Medicare Benefits Schedule (MBS).Which Hospital Cover tiers include Rehabilitation? Tier Clinical category covered? Can insurers offer restricted cover? Basic Yes Yes Bronze Yes Yes Silver...
What is covered under Skin Conditions?Hospital Cover for Skin Conditions includes hospital treatment to:Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Skin Conditions clinical category are under other clinical categories. For example: Which Hospital Cover tiers include Skin Conditions? Tier Clinical category...