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...
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 wages. The...
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 peak body for...
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An Agreement Hospital is a private hospital which has a contract with a health insurer to treat the insurer’s members for an agreed fee. This means members will pay either no Hospital Gap or a ‘known Hospital Gap’ (a set fee) for inpatient treatment at that hospital. A Hospital Gap refers to the out-of-pocket costs you...
According to the Australian Private Hospitals Association, there are 633 private hospitals, including day hospital facilities, in Australia.You can find a list on the healthdirect website.
Private hospitals are often perceived as expensive because, unlike public hospitals, they do not receive all their funding from the government. As a patient, you are charged for the treatments and services you receive. This is because private hospitals are run either as not-for-profit organisations or for-profit businesses. If you enter a private hospital, you may...
If you are a private hospital patient and the treatment you are receiving is listed on the Medicare Benefits Schedule (MBS), Medicare will cover 75% of the MBS fee for your doctors’ services.You have to pay the rest of the hospital and medical fees, which could include:If you have Hospital Cover for that treatment, you...
Some larger private hospitals have emergency departments.When deciding whether to go to a public or private emergency department, consider:
In Australia, private hospitals are owned and operated by private organisations. These include for-profit companies and not-for-profit organisations.The companies with the largest share of the private hospital market include:
In Australia, a private hospital is a hospital owned and operated by a private organisation but licensed and regulated by the state and territory governments.If you decide to be treated in a private hospital, you will have more choice about the treatment you receive and your accommodation because:You also have to pay for your treatment...
In this Guide, we provide an overview of how private hospitals operate in Australia.Private hospitals play an important role in the Australian Health System, especially for surgery that is classified as ‘elective’.If you need this type of surgery, it is sometimes hard to know whether you should use the public or private system.This Guide explains: