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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About private health insuranceIn 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 private health insurance...
Does private health insurance cover visits to a non-GP specialist? No. Private health insurance does not cover visits to see a non-GP specialist in their consulting rooms.Instead, visits to a non-GP specialist in their consulting rooms are covered by Medicare.If you are enrolled with Medicare, it will pay some or all of the cost:However, if you...
Does private health insurance cover visits to a GP? No. Private health insurance does not cover visits to see a General Practitioner (GP).Instead, visits to the GP are covered by Medicare.If you are enrolled with Medicare, it will pay some or all of the cost:
Residential Aged Care and private health insuranceWhat is Residential Aged Care?In Australia, Residential Aged Care is care for older people who can no longer live independently at home.It includes accommodation and 24-hour personal and nursing care, including:The idea behind Residential Aged Care is to ensure older people receive the support they need to maintain their...
Natural therapies and private health insuranceWhat is a natural therapy?A natural therapy is a complementary or alternative therapy used to diagnose, treat and prevent illness, including:In other words, natural therapies are treatments that fall outside conventional or mainstream medicine. Are natural therapies covered by private health insurance?At present, private insurers can cover only some natural therapies....
Home Care Packages and private health insuranceWhat are Home Care Packages?If you are older and have complex needs, you can get a Home Care Package to help you live independently in your own home.Many older people choose a Home Care Package because it helps them stay at home rather than go into Residential Aged Care.If...
Cosmetic surgery and private health insuranceWhat is cosmetic surgery?Cosmetic surgery is surgery that is designed to improve a person’s appearance by reshaping a bodily feature.In other words, cosmetic surgery is not performed for a medical reason.What is the difference between cosmetic surgery and plastic surgery?Plastic surgery is a broad field of medicine that includes reconstructive...
In this Guide, we provide an overview of private health insurance in Australia, as well as answer your most common questions.This Guide explains: