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...
Bupa members who had Hospital Cover claims rejected between 1 May 2018 and 31 August 2023 may be entitled to compensation. The health insurer has announced it incorrectly rejected “mixed coverage” claims – claims for 2 or more treatments at a time – and certain other types of claims during this period. Bupa has apologised...
Members of Teachers Health and TUH are about to become part of the sixth largest health insurer in Australia. The two not-for-profit insurers have announced they will merge next week on 1 July, forming a combined insurer that will cover 500,000 people, Teachers Health said. TUH said the merger will bring some small benefits to...
Australians uncertain about whether or not to get health insurance could find the decision a little easier next week, as of 1 July. Those who don’t have Hospital Cover and earn over a certain income threshold get charged the Medicare Levy Surcharge at tax time – a levy of between 1% and 1.5%. For some...
Australians are claiming on private health insurance more than ever, new data shows. The latest figures from APRA (Australian Prudential Regulation Authority), which regulates the health insurance industry, show that insurers paid $18.9 billion in Hospital Cover claims for the 12 months ending 31 March 2025 – an increase of 6.9%. For Extras Cover claims,...
Healthscope private hospitals remain open for surgeries and treatments, despite the organisation going into receivership this week. Some Australians with Hospital Cover were concerned that private hospital treatment could be harder to access in the wake of the Healthscope collapse, but the organisation said its hospitals will remain open for treatments. Healthscope – which operates...
The government has announced it will investigate health insurers for using a loophole to raise their prices. In December last year, Minister of Health Mark Butler warned health insurers to stop ‘phoenixing’ policies after a Commonwealth Ombudsman report brought the practice to light. By law, health insurers can only raise prices once a year, but...
Most Australians will pay more for health insurance next week due to a reduction in a rebate designed to make health cover cheaper. Cuts to the Private Health Insurance Rebate take effect on April 1 at the same time as most policies are increasing in price by an average of 3.7% – which adds up...
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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...
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...
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...
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...
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...
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...
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...
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 clinical category are under other clinical categories. For example: Which Hospital Cover tiers include Skin...