Health insurance premiums will increase by an average of 4.41% on 1 April, but some Australians are already experiencing bill shock after finding their policies will increase by as much as 10.74%. In the past few weeks policyholders have been notified by health insurers about their premium rises on 1 April 2026 and in some cases, the increases are significantly higher than 4.41%. Analysis by health insurance comparison...
Out-of-pocket fees for Australians with health insurance have risen, new data shows. Statistics from health insurance industry regulator APRA reveal average Gaps for hospital treatment rose by 7.7% in 2025, from an average of $437.61 to $471.29. Gaps for Extras Cover claims were up 5.6% from an average $59.53 to $62.87. Despite the increased Gaps and the cost-of-living crisis, Australians are holding onto their health insurance policies. There was no change to...
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...
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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 Department of Health, Disability and Ageing’s list of declared hospitals, there are 636 private hospitals, including day hospital facilities, in Australia as of February 2026.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: