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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Yes. Generally, health insurers package Extras Cover at 3 different levels:Basic Extras CoverIf you buy basic Extras Cover, you are covered for a limited range of treatments such as:You will receive a percentage of the cost each time you claim, up to an annual limit. Sometimes the annual limits are combined across treatments, for example,...
The main benefit of taking out Extras Cover is that it helps you pay for health care services that Medicare does not cover.The easiest way to work out whether you want to take out Extras Cover is to look through the list of treatments offered and decide whether you are likely to use them.Here are...
If you are considering taking out private health insurance, you should consider Hospital Cover.In this overview, we explain everything you need to know about the Hospital Cover tiers – Basic, Bronze, Silver and Gold.We also provide a summary of each of the 38 clinical categories so you know, depending on which tier you select, exactly...
In Australia, there are 2 main types of private health insurance – Hospital Cover and Extras Cover. Hospital CoverHospital Cover helps you pay for the cost of treatment as a private patient in hospital. It helps you cover the cost of being treated as a private patient in a public hospital, private hospital or day hospital.Depending on...
The Australian government has designated 38 clinical categories for Hospital Cover:The government also decides which treatments must be included under each clinical category. Insurers are not allowed to vary or exclude those treatments from their cover.When you get a quote for Hospital Cover, you cannot choose the clinical categories you want cover for.Instead, since 1...
Whether or not you take out Hospital Cover is a question to consider carefully.You may prefer to rely on the public healthcare system. As an Australian citizen or permanent resident with a Medicare Card, you are entitled to receive free healthcare in a public hospital.If you go into a public hospital as a public patient:However,...
How the Hospital Cover tiers workThe difference between Basic, Bronze, Silver and Gold Hospital Cover lies in the number of clinical categories each product tier offers: Clinical category Basic Bronze Silver Gold Rehabilitation ✓ (R) ✓ (R) ✓ (R) ✓ Hospital Psychiatric Services ✓ (R) ✓ (R) ✓ (R) ✓ Palliative Care ✓ (R) ✓...
Sometimes, insurers include additional clinical categories in a Basic, Bronze and Silver Hospital Cover policy. When they do this, they are allowed to market it as a ‘Plus’ policy. It is worth considering Basic Plus, Bronze Plus and Silver Plus Cover because they may offer clinical categories on an unrestricted basis or additional clinical categories. Moreover,...