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...
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...
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...
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...
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...
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...
Bupa members who had Hospital Cover claims rejected between 1 May 2018 and 31 August 2023 may be entitled to compensation. The health insurer has announced it incorrectly rejected “mixed coverage” claims – claims for 2 or more treatments at a time – and certain other types of claims during this period. Bupa has apologised...
Members of Teachers Health and TUH are about to become part of the sixth largest health insurer in Australia. The two not-for-profit insurers have announced they will merge next week on 1 July, forming a combined insurer that will cover 500,000 people, Teachers Health said. TUH said the merger will bring some small benefits to...
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Australian government private health insurance incentives The Australian government offers 2 incentives to encourage Australians to take out private health insurance: Private Health Insurance Rebate The Private Health Insurance Rebate is a rebate from the Australian government to help you pay for private health insurance. The rebate applies to Hospital Cover, Extras Cover and Ambulance...
In Australia, you do not have to take out private health insurance. If you have a Medicare Card, you can receive treatment as a public patient in a public hospital. If you do not take out private health insurance, you will not receive help from an insurer to pay for: Alternatively, you can pay to...
If you have private health insurance, you may in certain situations receive treatment more quickly than someone without private health insurance. Receiving treatment at a private hospital can be very expensive. Most people who elect to go to a private hospital for surgery have Hospital Cover. This insurance helps them pay for the cost of...
Why don’t private health insurers cover the cost of appointments with my GP or specialist? In Australia, Medicare covers some or all of the cost of appointments with your General Practitioner (GP) or specialist. GPs and specialists have the legal right to run their practices as private businesses. This means they can charge whatever fees...
How to decide whether you need private health insurance When deciding whether you need private health insurance, consider the advantages and disadvantages to make the best decision for your situation. If you buy Hospital Cover, the main benefit is that it helps you pay for the cost of being treated as a private patient in...
Private health insurance works on the basis that you take out a policy and pay an insurer a monthly premium. In return, the insurer provides you with health cover. Depending on the policy you take out, private health insurance helps you pay for: If you want both Hospital Cover and Extras Cover, you can take...
In Australia, private health insurance is community rated not risk rated. Community rated means a private health insurer must offer its policies at the same price irrespective of an individual’s risk factors, such as:
About private health insurance In Australia, private health insurance is health insurance offered by registered private insurers. You can buy a private health insurance policy (Hospital Cover) to help cover the cost of being treated in hospital as a private patient rather than a public patient covered by Medicare. You can also take out a...