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...
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...
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Private health insurance can help to cover some medical and health costs that Medicare does not cover.How much and what private health insurance covers depends on the policy you purchase. Examples of some of the medical services Medicare provides for free or at a reduced cost include:Medicare does not cover:There are 3 types of private health...
Medicare Safety Net explainedThe Medicare Safety Net is the mechanism the Australian government uses to ensure your medical costs are affordable.If you see a doctor or get medical tests regularly, you could end up with high medical costs.When you spend over a certain amount in a calendar year, Medicare gives you back a higher amount...
The Australian Government funds Medicare through the Medicare Levy and the Medicare Levy Surcharge.If you work, you pay the Medicare Levy as part of your income tax.If you are a high-income earner who does not have an appropriate level of private Hospital Cover, you also pay the Medicare Levy Surcharge. Revenue from the Medicare Levy and...
There are 4 ways to claim a Medicare Benefit:Medicare will not accept claims for services that are more than 2 years old.How to claim your Medicare Benefit at your provider’s officeThe quickest and easiest way to claim your Medicare Benefit is when you pay for the service at your doctor or healthcare provider’s office.To claim...
A Medicare Rebate is the amount the Australian Government pays for medical services listed on the Medicare Benefits Schedule.The term is no longer used by Medicare.Instead, Medicare now uses the term Medicare Benefit.Sometimes the term Medicare Rebate is used to refer to the Private Health Insurance Rebate.
A Medicare Benefit is the amount the Australian Government pays when you make a claim for a medical service.This is usually 85-100% of the schedule fee, which is the amount the Government sets for each medical service under the Medicare Benefits Schedule (MBS).Previously, a Medicare Benefit was called a Medicare Rebate.
To apply for a Medicare Card, there are 3 steps:
When you enrol in Medicare, you are given a Medicare Card.It is a plastic card similar in size to a credit card. It is proof you are enrolled in Medicare.Your Medicare Card records your Medicare Number, name, IRN (individual reference number) and the date your card will expire.It looks like this:It allows you to access...