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...
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Yes. The most recent Medical Benefits Schedule (MBS) Review ran from 2015–2020.The MBS Review Taskforce looked at more than 5,700 MBS items to see whether they needed to be amended, updated or removed.The objectives of the review were to:The review collected feedback from thousands of stakeholders, which helped shape its final recommendations to the Australian...
The Medical Benefits Schedule (MBS) does not include a wide range of medical and health services:
Services from doctors included on the MBSMBS Benefits are payable for these types of services from doctors:Services from allied health professionals included on the MBSMBS Benefits are payable for some services from allied health workers, including:How services from allied health services for patients with a chronic disease are funded under the MBSYou can claim Medicare...
The Medicare Benefits Schedule (MBS) Fee is the amount the Australian government sets as appropriate to pay a health professional for a particular service. The fee is listed in the Medicare Benefits Schedule (MBS).The MBS also lists the rates for calculating the benefit payable by the government: Type of service Amount General practitioner (GP) services...
The Medicare Benefits Scheme and the Medicare Benefits Schedule (MBS) are terms that sound similar but refer to completely different parts of the Australian Health System.The Medicare Benefits Scheme is the official name for Medicare, which is Australia’s universal health scheme.In contrast, the Medicare Benefits Schedule (MBS) is the list of all medical services subsidised...
The Medicare Benefits Schedule (MBS) is a vital part of Medicare, Australia’s universal healthcare system.It lists all the medical services that the Australian government subsidises and pays a Medicare Benefit for. The MBS lists each service with:Generally, the MBS includes these types of services:The Australian Government Department of Health manages the MBS and Services Australia administers...
In this Guide, we outline how the Medicare Benefits Schedule (MBS) operates, as well as answer your most common questions.The Medicare Benefits Schedule (MBS) lists all the medical services where the Australian government subsidises and pays a Medicare Benefit.This Guide explains how the Medicare Benefits Schedule (MBS) works, as well as what services are included...