Private Healthcare Australia

Private Healthcare Australia We are the peak representative body for Australia’s private health insurance industry.

We represent 22 Australian health funds with a combined membership of 15 million Australians or 99% of the sector.

Did you know that for the same surgery, some Australians are paying thousands of dollars more than others?Too often, peo...
01/06/2026

Did you know that for the same surgery, some Australians are paying thousands of dollars more than others?

Too often, people assume specialist fees are fixed or don't discover the cost until they've already committed to an appointment.

The good news? You can shop around. Here are some tips:

- Ask your GP to recommend a surgeon who charges modestly or bulk bills
- Remember you can take your referral to any specialist, not just the one named on the letter
- Ask about fees before booking an appointment
- Request a written estimate of costs upfront
- Check whether the surgeon participates in a no-gap or known-gap arrangement.

In Australia, surgeons are highly trained and qualified. There is no evidence that paying higher fees leads to better outcomes.

Being informed could save you thousands.
https://www.theage.com.au/healthcare/tamara-was-grappling-with-a-cancer-diagnosis-then-came-the-35-000-in-medical-bills-20260521-p5zzh7.html

There is growing concern about the Government’s plan to slash its health insurance rebate for people aged 65 and over. I...
28/05/2026

There is growing concern about the Government’s plan to slash its health insurance rebate for people aged 65 and over. If this proceeds, it will contribute to estimated premium increases of hundreds of dollars for many older people next year. A couple in their 70s could end up paying $1600 more for gold cover.

If you are concerned, talk to your local MP about how it will affect you and your family. Swipe to read what your politicians and health commentators are saying.

Today’s article in The Senior provides helpful guidance about how the Government's proposed rebate change will impact yo...
20/05/2026

Today’s article in The Senior provides helpful guidance about how the Government's proposed rebate change will impact your access to healthcare.

There is no need to make rushed changes to your health insurance policy. The rebate proposal is still being debated and private hospitals, doctors, insurers, consumer groups and state governments are all warning the Commonwealth that reducing support for older Australians risks worsening the public system for everyone.

There is no need to cancel or downgrade your insurance based on this debate alone. Even if the proposal proceeds, it will not affect your premiums until 1 April 2027, giving you plenty of time to consider your options carefully.

If you are concerned about the Government’s proposal, speak up. Contact your local federal MP and explain how higher premiums will affect your ability to keep private cover and access timely care.

Access the full article here: https://www.thesenior.com.au/story/9249439/dont-panic-over-health-rebate-cuts-expert-tips-for-retirees-to-save-money/

18/05/2026

Denise Peters is one of hundreds of thousands of pensioners who will be forced to pay more for their health cover under proposed changes to the health insurance rebate.

PHA is calling for the Albanese Government to spare pensioners like Denise from this change because it will hurt them the most.

It is not fair to make people earning under $55,000 a year pay hundreds of dollars more for the health cover.

Read more from the ABC: https://www.abc.net.au/news/2026-05-18/aged-care-government-private-health-rebates/106684476

Under a Federal Government budget proposal, some seniors are facing annual premium increases of more than 21% next year,...
04/05/2026

Under a Federal Government budget proposal, some seniors are facing annual premium increases of more than 21% next year, compared with about 4% for people aged under 65.

The proposed changes to the private health insurance rebate risks placing hospital cover beyond the reach of many retirees living on fixed incomes, including more than 400,000 pensioners, with major consequences for the balance of demand across our health system.

While Health Minister Mark Butler has said the proposed changes are about intergenerational equity, the changes disproportionately affect Australians who are most likely to need hospital care but least able to absorb rising costs.

We urge the Government to reconsider their proposal to exclude low-income Australians aged over 65 earning less than $55,000. These people cannot take another financial hit to maintain their access to health insurance and private healthcare.

Read the full article here: https://privatehealthcareaustralia.org.au/seniors-face-health-insurance-bill-shock-of-up-to-1600-a-year-under-government-rebate-changes/

Do you know how to avoid paying for the Medicare Levy Surcharge? The surcharge can be as much as 1.5% of your income, an...
24/04/2026

Do you know how to avoid paying for the Medicare Levy Surcharge? The surcharge can be as much as 1.5% of your income, and many Australians can avoid paying with access to basic hospital cover without the need to pay for benefits too.

Any single person with no dependants and an income over $101,000, and any person with a spouse and/or dependants and an income over $202,000 will need to have private hospital cover (including those dependants) to avoid paying the surcharge.

Here are some helpful tips to avoid unnecessarily paying:

• Include all dependants on private hospital cover - just one person missed means the full surcharge applies

• Include all forms of income, for example fringe benefits, superannuation contributions, investments and rental properties etc

Avoiding the Medicare Levy Surcharge can save you thousands of dollars each year, making private health cover a smart financial decision rather than a cost. Read the full article here: https://www.theage.com.au/money/tax/how-a-missing-name-on-your-health-policy-could-cost-you-thousands-20260414-p5znq0.html

Health insurers are calling on the Government to exempt Australians aged over 65 on low incomes - including those on the...
24/04/2026

Health insurers are calling on the Government to exempt Australians aged over 65 on low incomes - including those on the Age Pension - from changes to the Private Health Insurance Rebate, warning the move could force vulnerable people to drop their cover.

Requiring pensioners and low-income older Australians to find hundreds of dollars more each year to maintain their private health insurance will lead some to downgrade their cover, or abandon it altogether.

Our CEO Dr Rachel David said "Many of these people have annual incomes under $30,000 and many of them are in rural and regional Australia. While we recognise the Government’s equity rationale for aligning rebate rates for those over and under 65, the reality is this broad-brush approach will make private health insurance unaffordable for thousands of vulnerable Australians."

Read our full release here: https://privatehealthcareaustralia.org.au/health-insurers-urge-government-to-continue-rebate-discounts-for-australians-over-65s-on-low-incomes-including-aged-pension/

In 2020, the former Coalition Government introduced the Gold, Silver, Bronze and Basic tiering system to try to make it ...
23/04/2026

In 2020, the former Coalition Government introduced the Gold, Silver, Bronze and Basic tiering system to try to make it easier for consumers to understand and compare health insurance products, but it has had significant unintended consequences that warrant review. As a consequence, close to 118,000 policyholders choose to leave Gold health insurance last year - a 6.1% decrease.

The tiering structure must be revisited to ensure Australians can make important decisions about the health insurance they need.

Read the full piece from our CEO Rachel David, via Herald Sun here: https://www.heraldsun.com.au/health/guides/health-funds/thousands-flee-toptier-health-insurance-as-gold-cover-faces-collapse/news-story/a563905893c2abbfabb6812e2257365c?btr=49b95f197d91adc861441aeaa27ad95b

The Government’s decision to cut the Private Health Insurance Rebate will disappoint thousands of older Australians. Pre...
22/04/2026

The Government’s decision to cut the Private Health Insurance Rebate will disappoint thousands of older Australians. Preliminary estimates suggest more than 1.4 million older Australians will be affected by the policy announcement made by Health Minister Mark Butler during his National Press Club address today. Premiums for older Australians could rise by up to $640 per year as a result.

Our CEO, Dr Rachel David said "Health funds recognise this group receives significant benefits that could be better targeted elsewhere. PHA has previously recommended reducing the rebate for this cohort and redistributing it to lower-income Australians who rely on private health insurance".

Read out full release here: https://privatehealthcareaustralia.org.au/cuts-to-private-health-insurance-rebate-disappointing-for-older-australians-health-insurers-say/

Yesterday, the final report of the committee findings and recommendations for the Health Legislation Amendment Bill was ...
15/04/2026

Yesterday, the final report of the committee findings and recommendations for the Health Legislation Amendment Bill was published.

We welcome the report reinforcing the need to upgrade the Medical Costs Finder website. The committee confirmed deep concerns "that an increasing number of Australians are not taking up referrals from their general practitioner to see a specialist due to the cost."

"It is unfair to expect patients to commit to a medical treatment without knowing what the true cost of that treatment may be, and without being able to compare those costs against the fees charged by other providers."

Updating the Medical Costs Finder website is essential in enabling Australians to transparently compare fees, anticipate out of pocket costs, and make informed healthcare decisions without unexpected financial shocks.

Read the full report here: https://www.aph.gov.au/Parliamentary_Business/Tabled_Documents/16001

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