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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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....
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...
In Australia, there are 2 main types of private health insurance – Hospital Cover and Extras Cover. Hospital Cover Hospital 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...
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....
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...
How the Hospital Cover tiers work The 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....
The following steps can help you decide which Hospital Cover tier is best: