Private health insurance

Links to information about private health insurance for consumers, including Lifetime Health Cover, Australian Government Rebate on private health insurance and frequently asked questions.

Page last updated: 07 December 2017

Note: If you have an enquiry regarding the conditions of your health insurance policy for hospital or ancillary (extras) cover, please contact your health insurer in the first instance.

What is Private Health Insurance?

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'.

Private Health Insurance Rebate

The Australian Government provides an income tested rebate, (the Australian Government Rebate on private health insurance) to help people meet the cost of private health insurance.

Lifetime Health Cover

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 over their lifetime.

Government's contribution to the Private Health Insurance Rebate - presentation to industry 19 December 2013

A presentation was made to the private health insurance industry on 19 December 2013 explaining proposed changes to the calculation of the Government's contribution to the Private Health Insurance Rebate.

Private Health Insurance – Prostheses

Private Health Insurance – Prostheses 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

Informed Financial Consent IIFC) 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.

Medicare Levy Surcharge

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 Medicare Levy.

Overseas Visitors Health Cover

If you are visiting Australia and hold a temporary visa you should consider purchasing Overseas Visitors Health Cover (OVHC) . OVHC provides assurance that you are covered for medically necessary treatment and hospital care while visiting Australia. Without OVHC you may face significant out-of-pocket costs.

In some cases you may be required to purchase private health insurance as part of your visa conditions. This means that you are required to have a minimum level of health insurance and maintain it for the duration of your stay in Australia.

On 18 April 2017 the Australian Government announced the abolition of the subclass 457 Temporary Work (Skilled) visa (457 visa) to be replaced with a new temporary skill shortage visa from March 2018. This change will not affect current 457 visa holders.

Overseas Students Health Cover

Students in Australia who hold a temporary student visa may be required to purchase Overseas Student Health Cover (OSHC) to meet the conditions of their student visa. For more information please visit the Department of Immigration and Border Protection website.

Private Health Insurance Premiums

Private health insurers are required to apply to the Minister for Health for premium increases.

Private Health Insurance Circulars

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 and Devices Committee (PDC) and Prostheses List Advisory Committee (PLAC) Bulletins

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.

National Joint Replacement Registry (NJRR) Cost Recovery Impact Statement (CRIS)

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 for Natural Therapies

The review of the Australian Government Rebate on Private Health Insurance for natural therapies will examine the evidence of clinical efficacy, cost effectiveness, safety and quality of in-scope natural therapies.