Private health insurance
Links to information about private health insurance for consumers, including Lifetime Health Cover, Rebates and frequently asked questions.
There are two types of private health insurance - hospital policies cover you when you go to hospital, while general treatment policies (sometimes known as ancillary or extras) cover you for ancillary treatment (e.g dental, physiotherapy). Most health funds offer combined policies that provide a packaged cover for both hospital and general treatment services, or you can buy separate hospital and general treatment policies to 'mix and match'.
Lifetime Health Cover is a financial loading that can be payable in addition to the premium for your private health insurance hospital cover.
Lifetime Health Cover is a Government initiative that started on 1 July 2000. It was designed to encourage people to take out hospital insurance earlier in life, and to maintain their cover throughout their life.
The Australian Government provides an income tested rebate to help people meet the cost of private health insurance.
The Australian Government Rebate on Private Health Insurance (the rebate) will no longer apply to the Lifetime Health Cover (LHC) component of hospital cover premiums. The changes will realign arrangements under the Private Health Insurance Act 2007 so that all recipients of the rebate receive a comparable benefit relative to their premium, regardless of whether they have a LHC loading or not. Rebate recipients will be treated consistently subject to age and income.
From 1 April 2014, the Government’s contribution to private health insurance will be calculated using base premiums which will be indexed annually. The base premium will be equivalent to the commercial premium (approved by the Minister) on 1 April 2013, indexed annually from 1 April 2014 by the lesser of the Consumer Price Index (CPI) or the commercial premium increase.
Formerly known as Schedule 5 – Benefits payable in respect of surgically implanted prostheses, human tissue items and other medical devices.
Under the Private Health Insurance Act 2007
, private health insurers are required to pay benefits for a range of prostheses that are provided as part of an episode of hospital treatment or hospital substitute treatment for which a patient has cover and for which a Medicare benefit is payable for the associated professional service.
Informed financial consent (IFC) is the provision of cost information to patients, including notification of likely out of pocket expenses (gaps), by all relevant service providers, preferably in writing, prior to admission to hospital or treatment
The Medicare levy surcharge is a tax on people that earn over a certain amount and don’t have private health insurance hospital cover. The Medicare Levy Surcharge is in addition to the normal 1.5 per cent Medicare Levy.
Overseas visitors & overseas students
If you are visiting Australia and hold a temporary visa you should consider taking out Overseas Visitors Health Cover (OVHC). Without OVHC, if you need to visit a doctor or stay in hospital while you are here you could find yourself responsible for the full cost of treatment.
In some cases you may be required to take health insurance as part of your visa conditions. If you are applying for a Visa Subclass 457, as of 14 September 2009 you are required to have a minimum level of health insurance and to maintain it for the duration of your stay in Australia. Students in Australia who hold a temporary student visa may be required, as a visa condition, to take out Overseas Student Health Cover (OSHC).
Private health insurers are required to apply to the Minister for Health and Ageing for premium increases. The Government assesses private health insurance premium applications to keep increases to the minimum necessary to ensure insurer solvency, support forecast benefit outlays, and meet prudential standards, while also ensuring the affordability and value of private health insurance products.
These circulars are distributed to all Australian registered health insurance funds, Australian licensed private hospitals and day hospital facilities, Australian state and territory health authorities, other Australian health organisations and health service providers. The circulars contain important information related to Australian Commonwealth Government legislation which governs the operation of private health insurance and the licensing of new private hospitals and day hospital facilities in Australia.
Prostheses List Advisory Committee (PLAC) bulletins are issued when there is a need to communicate to stakeholders. This page provides links to each bulletin produced to date.
The Department has prepared the NJRR CRIS in accordance with the Australian Government Cost Recovery Guidelines (the Guidelines). The NJRR CRIS reports on the NJRR cost recovery arrangements from 30 April 2010 through to 2013-14. Consistent with the Guidelines, it:
- demonstrates that the levy reflects the operating costs of the NJRR;
- discusses how the NJRR cost recovery arrangements work;
- provides an overview of current and future revenue that will be collected under the levy;
- discusses the Department’s consultations with stakeholders on the levy; and
- establishes that the levy imposed on sponsors is the most appropriate mechanism for cost recovery in the context of these arrangements.
The review of the Australian Government Rebate on Private Health Insurance (the rebate) for natural therapies (the review), will examine the evidence of clinical efficacy, cost effectiveness, safety and quality of in scope natural therapies.