Private health insurance reforms

Private Health Insurance in Australia is being reformed. Starting in April 2019, everything’s going to get simpler, clearer, and easier to understand. (Finally.)

Here’s everything you need to know.

Gold, Silver, Bronze & Basic

No more messing around with complicated names, features, and descriptions. All hospital cover will be categorised into one of four brackets, so you can quickly tell what sort of cover you’ve got, and make it easier to compare with others.

Clinical Definitions

You’ve probably noticed that there’s some serious jargon in private health insurance. There are literally thousands of technical terms floating around and it's not completely obvious what they all mean. The terminology has been rewritten into ‘standard clinical definitions’ which will be much more customer-friendly. Now you can actually understand what you’re covered for, and it’ll be much easier to compare and understand different health insurance policies.

Some Natural Therapies will lose coverage

The government have conducted a thorough review of natural therapies and have decided Health Funds in Australia are no longer able to pay a benefit towards certain services.

Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi, and yoga are all being shown the door.

Age-based discounts

Health insurers now have the option to offer a discount on hospital cover to customers aged between 18 and 29. The discount will be based on the customer’s age. However the longer you wait the less of a discount you get.

Increased Excess

Health insurers can now offer a $750 excess for a Single cover and $1,500 for a Couple, Family or Single Parent cover. This will allow people to choose cover with a higher excess in return for lower premiums, while also meeting the requirements for Medicare Levy Surcharge exemptions.

Prostheses Reform

14% of all annual private health insurance hospital benefits is spent on prostheses. They’re simply too expensive, so the government is making these more affordable, which will help us keep premium increases as low as possible.


What is a PHIS?

Your PHIS (Private Health Insurance Statement) provides a general overview of your cover with, and contains a summary all of the key product features.

We’re required to send you a copy of this once per year—exciting, we know— but don't stress: you can also request a copy at any time and we'll send it to you.

Your PHIS also replaces the tax statement we used to send out to you. All the relevant information and data is now automatically sent to the Australian Taxation Office (ATO).

There are a few types of Private Health Information Statements:

Hospital - describes the clinical categories covered by the policy, and identifies restrictions, waiting periods and any additional payments (excesses, co-payments and gaps).

General Treatment - describes general treatment cover, including which services are covered, waiting periods, benefit limits and example benefits for each type of service.

Combined - describes the features and limitations of a combined hospital and general treatment cover, with details as above.

Please keep in mind that a PHIS only gives a summary of each product. If you’re keen to read the fine print and detail contained in your specific policy guide, you can check it out when logged in here.


Keen to know more? Drop us a line.