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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Health insurer promotions include discounts, services, waivers, gifts or other offers that may be used by health insurers to appeal to new customers or incentivise existing customers. There are 2 types of insurer promotions which may reduce the price you finally pay for your policy. These include: For new customers: up to the equivalent of 12% of...
Health insurance from a well-known brand is not necessarily better than a lesser-known brand, since all health insurers are subject to the same government regulations. However larger insurance brands do have access to larger networks of healthcare providers and hospitals which may be beneficial for members. All health insurers in Australia are regulated by the Australian...
Most health insurers allow you to pay your premiums 12 months in advance, and a few allow payment up to 18 months ahead. Contact your insurer to ask how far in advance it allows payments.
The way you pay for health insurance could mean your insurer offers you reduced premiums of up to 12% per year on an ongoing basis. This may apply if you meet certain payment conditions, such as:
Generally, the term white labelling refers to the situation where products and services are made by one company but are sold by another company. This involves asking a company to make a product for you and then rebranding those products as your own and marketing them to your target audience.For example, a hairdresser enters an agreement...
As at 30 June 2024, 5 insurers controlled more than 80% of the Australian market. Insurer Market share Medibank (including ahm) 26.7% Bupa Health Insurance 25.4% HCF 12.6% nib 9.7% HBF 8.1% TOTAL 82.5% Source: Private Health Insurance Ombudsman: State of the Health Funds Report 2024
As at February 2025, there were 30 registered private health insurers in Australia. These insurers are licensed by the Australian government to sell private health insurance. They are regulated by the Australian Prudential Regulation Authority (APRA).An insurer must be registered to sell private health insurance in Australia.Some of these are open funds.Others are restricted funds. No....
In this Guide, we list all the private health insurers operating in Australia and explain how they are regulated.In Australia there are several different types of health insurers:This Guide is designed to help you find everything you need to know about private health insurers so you can make an informed decision about which one you...