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Australian private health insurance reforms from 1 April 2019

From 1 April private health insurance in Australia is changing. If you're planning a hospital admission after this date, be sure to call your health fund first to confirm your level of cover.

The Australian Government has introduced reforms intended to make private health insurance simpler, while helping people choose the cover that best suits their needs.

Most of these reforms will start to roll out from 1 April 2019. If you already have private health insurance, your insurer will send specific information about how your policy.

Private health insurance reforms include:

  1. Four tiers of hospital cover - Gold, Silver, Bronze or Basic - that define what is and isn't covered, and are based on new minimum standard clinical categories
  2. Mental health support for patients with limited cover to upgrade to access higher benefits for mental health services without serving a waiting period as a once off, first introduced on 1 April 2018
  3. Ability to increase excess levels. Insurers can offer the choice to increase your excess in exchange for a lower premium. Maximum excesses will be increased to $750 (singles) and $1,500 (couples and families)
  4. Discounts for younger people. Insurers can offer people aged 18-29 discounts up to 10 per cent off their private hospital premiums
  5. Travel and accommodation benefits as part of hospital cover for people travelling travel long distances to access specialised hospital treatment, particularly beneficial for people living in rural and regional areas
  6. Better consumer protection through expansion of the Private Health Insurance Ombudsman’s role to improve its capacity to resolve complaints or issues raised by consumers about their private health insurer

Download the Australian Government Department of Health fact sheets:

Visit health.gov.au/private-health-reforms for more information.

Watch the video: About private health insurance reforms for all Australians

Private health insurance made simpler