Private Healthcare Australia

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

15/04/2026

Almost 100 complaints have been made about health practitioners involved in patients accessing their superannuation early to fund dental and medical treatments including cosmetic surgery.

Regulators are concerned some practitioners and third-party businesses are encouraging patients to access their super early for procedures that do not meet the Australian Taxation Office’s criteria for compassionate access.

Raiding your super now for $20,000 to fund medical or dental treatment could leave you $100,000 worse off in retirement.

The ATO says consumers should be concerned if a health practitioner is:

- Encouraging use of superannuation rather than a payment plan
- Only using telehealth appointments rather than in-person examinations
-Requiring use of a specific provider to submit your application for use of superannuation
- Saying fees are associated with submitting your application.

Read more here: https://www.abc.net.au/news/2026-04-14/doctor-suspended-superannuation-release-for-lipsuction/106562598

10/04/2026

Influenza is more than a bad cold, and every year it leads to hospitalisations, missed work and school, and preventable deaths. Vaccination rates have fallen sharply since the pandemic. Last year, only one in three Australians received a flu shot, compared with one in two before COVID-19. Even more concerning, just one in four children under five were vaccinated, despite free flu vaccines being available to young kids because they face a higher risk of serious illness and complications from influenza.

This year, to help combat falling rates, Australia has introduced a new nasal spray flu vaccine for children - a welcome option for families whose kids are anxious about needles. Parents now have more choice and fewer barriers to protecting their children.

It's becoming more accessible for adults to get vaccinated, and some health funds including Bupa and Medibank are offering free flu vaccinations for members, and Australians can access flu jabs through local pharmacies, workplace programs or their GP.

Talk to your GP or health provider about getting your flu vaccine this year.

01/04/2026

On behalf of 15 million Australians investing in health insurance, we welcome the new parliamentary inquiry into access and affordability of medical specialists in Australia.

Following consistent advocacy from PHA and health funds on behalf of their members, this inquiry will look into:
• the effectiveness and equity of referral pathways to medical specialists such as psychiatrists and surgeons
• the affordability of specialist medical care, including out-of-pocket costs in the private system
• the distribution of specialist doctors across Australia including shortages and factors affecting this
• the impact of cost delays on people’s health
• innovative and emerging models of care that may improve access for patients.

The inquiry is now accepting submissions until the 16th of October. Further information, including the full terms of reference and specific details on how to lodge a submission, are available at the Committee’s website:

On 31 March 2026, the Minister for Health and Ageing, the Hon Mark Butler MP, referred an inquiry into the access to and affordability of medical specialists in Australia to the House Standing Committee on Health, Aged Care and Disability. The Committee accepted the Minister&rsqu

27/03/2026

It’s disappointing that Australians with health insurance will have to continue subsidising the delivery of intravitreal eye injections in the most expensive setting after the government decided to back away from its decision to reclassify the simple procedure so it is performed in the most appropriate and cost-effective setting.

Even the profession’s peak body, the Royal Australian and New Zealand College of Ophthalmologists, agrees these injections are best delivered outside hospital unless there is a medical reason to do otherwise.

The reform the government has decided to abandon would have helped save people with health insurance up to $75 million a year by avoiding unnecessary hospital admissions for injections to treat conditions such as macular degeneration in consulting rooms. It would also have saved the federal government around $15 million annually through lower spending on the private health insurance rebate.

Those savings represent real pressure that could have been taken off health insurance premiums and public spending. Australia already spends substantial amounts of money on healthcare that delivers little or no clinical value.

Our healthcare system should reward appropriate care, not the most expensive location in which to deliver it. Read more insights from our CEO Dr Rachel David via Health Services Daily https://www.healthservicesdaily.com.au/why-the-government-blinked-on-eye-injections-and-why-we-will-all-pay-the-100m-price/42164

13/03/2026

Are you concerned about the cost to see a specialist doctor?

You’re not alone. Research suggests one in three Australians are delaying or skipping specialist care because they’re concerned about the price.

That’s why a current Senate inquiry into the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 is so important.

The bill would upgrade the Medical Costs Finder website so it can publish real data on specialist fees and likely out-of-pocket costs using Medicare and insurer data.
The current voluntary system hasn’t worked. Only 88 doctors have listed their fees nationwide.

If implemented properly, a stronger Medical Costs Finder website could help:
• patients understand likely costs before booking an appointment
• GPs have better conversations with patients about referral options
• reduce the fear of unexpected bills that stops people seeking care.

The Senate inquiry is now accepting submissions until 24 March.

If you support better transparency in specialist fees, consider making a submission.

And if you’ve ever navigated specialist care, your experience matters.

What was your experience with specialist fees?
Did you get a surprise bill?
Submissions can be made here:
https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/HealthAmendmentChoice

09/03/2026

Nicole's private health insurance funded her life-saving breast cancer treatment. At 45 years-old, her mammogram did not show she had cancer, but an ultrasound confirmed the diagnosis. Nicole's health cover enabled her to opt for the precise treatment she wanted, and receive it quickly.

Private health insurance is providing Australians with access to life-saving treatment when they need it.

Read Nicole's story here (The Age, subscription required): https://www.theage.com.au/money/insurance/five-years-ago-today-i-beat-breast-cancer-this-insurance-saved-me-20260306-p5o836.html

04/03/2026

Congratulations to Patients Australia on the launch of Australia’s National Telehealth Standards - an important, patient-led initiative to strengthen the safety and quality of virtual care.

Developed by the Australian Telehealth Standards Consortium, bringing together health funds and medical groups, the Standards set clear expectations across areas such as clinical governance, patient safety, informed consent, continuity of care, technology and data security.

As telehealth continues to play a growing role in Australia’s health system, consistent national standards will help build trust, support high-quality care and ensure virtual services deliver the best possible outcomes for patients.

18/02/2026

Health Minister Mark Butler has announced private health insurance premiums will increase by an average of 4.41% this year. This rate reflects rising claims for care and the higher cost of delivering health services in Australia, including wages for healthcare workers.

Health funds know the cost of healthcare is hitting consumers hard, so we are focussed on:

- Delivering more ‘no-gap’ fee and ‘known-gap’ fee private health services to give people greater certainty about costs when they need care.
- Expanding health management and prevention programs to help people stay well and reduce the need for more expensive hospital care in future.

Private health insurance continues to provide the highest return of any type of insurance in Australia. For every dollar you spend on health insurance, 85 cents is spent on healthcare.

Read more here: https://privatehealthcareaustralia.org.au/health-insurance-premiums-to-rise-as-healthcare-costs-and-claims-increase/

12/02/2026

We welcome the Albanese Government's legislation to upgrade the Medical Costs Finder website. This is a crucial step toward tackling Australia's growing specialist fee crisis.

The reform will expand information available about specialist doctors’ fees, allowing patients to compare typical costs before booking an appointment and better estimate their likely out-of-pocket expenses.

The announcement comes after the release of our Restoring affordable access to specialist care in Australia report, backed by a nationally representative survey of more than 4,000 Australians. The report revealed the rapid rise in fees to see specialist doctors, outpacing inflation, and the prevalence of illegal "booking and "admin" fees.

Health funds stand ready to contribute more data to the upgraded Medical Costs Finder website to help consumers use private healthcare more confidently.

Read our full statement here: https://privatehealthcareaustralia.org.au/health-funds-back-stronger-transparency-laws-for-specialist-doctor-fees/

05/02/2026

A national survey of more than 4,000 Australians reveals widespread concern about access to specialist doctors, particularly fees and billing. The survey found:

- 1 in 3 Australians have delayed or cancelled specialist care due to cost in the last three years
- 38% received a bill they were not expecting, with 55% receiving a larger bill than anticipated
- 29% were charged potentially illegal administration or booking fees not visible through Medicare
- 19% were asked to pay non-refundable deposits before their appointment

A new report out today, “Restoring affordable access to specialist care in Australia”, shows specialist fees for in-hospital care have jumped 22% since 2022.

This trend is reshaping how Australians use our mixed public-private heath system, and it reducing demand for private hospitals. We want a series of reforms to help reduce visible and hidden costs in the private health system.

See our full release here for more information: https://privatehealthcareaustralia.org.au/australians-demanding-action-to-keep-medical-specialist-fees-affordable-research-reveals/

14/01/2026

Did you know you that Medicare won’t always cover your healthcare expenses on an Australian cruise ship? For more than 1.3 million Australians who go on cruises each year, it's worth looking into travel insurance, even if you’re just sailing around Australia.

Consumer advocacy group Choice says Australians may need either international travel insurance or a domestic cruise insurance policy to avoid medical bills. This is because doctors working on cruise ships may not have Medicare provider numbers, meaning you can't claim on your Medicare or private health insurance.

Read more here: https://www.canberratimes.com.au/story/9145613/the-hidden-costs-of-aussie-holidays-without-travel-insurance/?cspt=1768345720|71690affeb8bf6758f6abc27648d711c