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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Yes. The Lifetime Health Cover Loading (LHCL) does apply to a dependant over the age of 31, which may result in an increase to your health insurance premium. The LHCL is a penalty imposed on people taking out Hospital Cover for the first time after the age of 31. If a dependant with a disability over...
You will be exempt from paying the Lifetime Health Cover Loading on your Hospital Cover if you:
If you are an Australian citizen or permanent resident who has been living overseas on your Base Day and return to Australia permanently, the Lifetime Health Cover Loading rules are different. There are two factors that will affect your Loading:Once you have calculated your Base Day, you can calculate your Lifetime Health Cover Loading by using...
If you are an Australian who lives overseas and returns to Australia temporarily, your Lifetime Health Cover Loading will depend on your particular situation. There are 3 factors that could affect your Loading:
If you are a new migrant to Australia, the Lifetime Health Cover Loading and Base Day rules are different.If you are a new migrant, your Base Day will be the later of:For example:
The Lifetime Health Cover Loading rules apply to people with a disability.As a dependent person with a disability who takes out Hospital Cover for the first time after your Base Day, you will have to pay a 2% loading for every year you are aged over 30.
Yes. You will have to pay the Lifetime Health Cover Loading if there was a gap in your Hospital Cover.However, if you had Hospital Cover on your Base Day and then cancelled or suspended your Hospital Cover, and the gap in your Hospital Cover is less than 1,094 days (3 years minus 1 day) during...
If you live in Australia permanently, your Base Day will be the later of 1 July 2000 or 1 July following your 31st birthday.For example:If you are a new migrant to Australia or an Australian who has been living overseas, the rules about how to calculate your Base Day are different.A quick and easy way...