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...
CEO and Founder
Chief Operating Officer
Chief Technical Officer
Writer and Researcher
UX/UI Designer
Brand and Graphic Designer
Led by Chris Payne
What is covered under Sleep Studies?Hospital Cover for Sleep Studies includes hospital treatment to investigate sleep patterns, problems with sleeping and other anomalies. Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Sleep Studies? Tier Clinical category covered? Can insurers offer restricted cover? Basic Optional Yes Bronze...
What is covered under Tonsils, Adenoids and Grommets?Hospital Cover for Tonsils, Adenoids and Grommets includes hospital treatment to:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Some treatments you might expect to be in the Tonsils, Adenoids and Grommets clinical category are under different clinical categories. For example, treatments for throat and...
What is covered under Weight Loss Surgery?Hospital Cover for Weight Loss Surgery includes hospital treatment for surgery to:Weight loss surgery is usually performed on people who are morbidly obese. This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). Which Hospital Cover tiers include Weight Loss Surgery? Tier Clinical category covered? Can insurers offer...
What is covered under Implantation of Hearing Devices?Hospital Cover for Implantation of Hearing Devices includes hospital treatment to correct hearing loss, including implants of a prosthetic hearing 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 Implantation of Hearing Devices clinical category...
What is covered under Dialysis for Chronic Kidney Failure?Hospital Cover for Dialysis for Chronic Kidney Failure includes hospital treatment for chronic kidney failure.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Scheme (MBS).Which Hospital Cover tiers include Dialysis for Chronic Kidney Failure? Tier Clinical category covered? Can insurers offer restricted cover? Basic...
What is covered under Back, Neck and Spine?Hospital Cover for Back, Neck and Spine is for hospital treatment to investigate and treat the:Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Back, Neck and Spine clinical category are under other clinical categories....
What is covered under Blood?Hospital Cover for Blood is for hospital treatment to investigate and treat blood and blood-related conditions. Examples include:Some treatments you might expect to be in the Blood clinical category, such as treatment for cancers of the blood, are under the Chemotherapy, Radiotherapy and Immunotherapy for cancer clinical category.This clinical category includes at...
What is covered under Bone, Joint and Muscle?Hospital Cover for Bone, Joint and Muscle is for hospital treatment to investigate and treat diseases, disorders and injuries of the musculoskeletal system.Examples include:This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).Some treatments you might expect to be in the Back, Neck and Spine...