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...
Increased out-of-pocket costs for specialists are leading many Australians to delay or cancel specialist care, a recent study has found. A survey of 4,000 people by Private Healthcare Australia – peak body for the health insurance industry – found that 55% of people received a higher specialist bill than expected in the past 3 years, and almost one in 3 people had delayed or cancelled specialist care due to costs. The survey – which included 2,300 people...
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...
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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...