Premium review
Private health insurance premium changes came into effect on 1 April 2025.
Learn more about why premiums are reviewed annually by health funds below.
Each year health insurers review the cost of healthcare and use this information to adjust premiums. These changes usually take place in April and can only occur once per year.
Why are premiums reviewed annually?
Put simply, the cost of healthcare delivery continues to increase in Australia. Costs are driven by:
Increased cost of health service delivery
An ageing population and people living longer
Increases in chronic conditions
New medical technologies and treatments
Frequently Asked Questions
Premium changes came into effect from first payments on or after 1 April 2025.
You can access a copy of your premium review notice by logging into your member area and viewing your recent communications.
Health insurance premiums are reviewed because healthcare costs increase year-on-year. Health funds review their cover each year to ensure they remain sustainable and can meet future claim obligations of all members in the fund.
Healthcare costs are driven by a number of factors, including:
- higher costs associated with new medical technologies and treatments
- an ageing population requiring higher levels of care
- rates of chronic health conditions increasing
Health funds are required to justify a premium increase by submitting an application to the Federal Government for approval. All applications to increase premiums are first assessed by the Department of Health and the Australian Prudential Regulation Authority (APRA). The application is then sent to the Minister for Health and Aged Care to consider if the increase is necessary. If a proposed premium increase is found to not be in the public interest, it won’t be approved.
Learn more about private health insurance premium increases.
- the amount and type of clinical categories and/or extras services covered, and
- the costs of paying benefits towards these services.
In 2025, the average industry increase for health insurance premiums is 3.73%. We’re proud to have one of the lowest average price increases in the industry.
The rebate amount you may be eligible to receive on your private health insurance policy from the Australian Government is determined by income threshold.
The rebate percentages (rates) were adjusted effective from 1 April 2025.
Your rebate tier and rebate amount – if you have chosen to receive this as a reduction on your premium – were communicated in your 2025 premium review notice.
Find out more about rebate levels and income thresholds.
All members in the same state/territory pay the same premium for the same policy. Private health insurers cannot discriminate against members based on health status, claims history or age. This is a government requirement called Community Rating. This system is intended to keep health insurance fair and accessible for all Australians. This is in contrast with other insurance industries that use risk rating, such as life insurance or car insurance.
Learn more: Private Health Insurance Community Rating System
There are plenty of reasons to have private health insurance – think of it as an investment in your health. Private health insurance can offer:
- greater choice of provider or specialist
- peace of mind for members and their families
- benefits for services not generally covered by Medicare such as dental, physiotherapy and prescription glasses under extras policies – this can be a great way for members to proactively look after their health.
The best thing you can do is check you’re on the right level of cover. Ask us for a cover review – we’ll go over your cover with you to help you choose a cover suitable for your circumstances. We have a range of policies to suit a variety of budgets and needs.
