The Government is now operating in accordance with the Caretaker Conventions pending the outcome of the 2022 federal election.

Private health insurance reforms

We have made changes to private health insurance to make it simpler and easier for you to choose the cover that best suits you and your family.

Why the reforms are needed

More than half the Australian population – about 13.6 million people – have private health insurance, but many people don’t fully understand what they are getting for their money and what they are covered for.

Australians have told us they find private health insurance complex and hard to understand what different policies cover and what they do not.

We want to make private health insurance simpler and easier for you to choose the cover that best suits you and your family.

What the reforms include

First wave of reforms

The first wave of reforms included the following:

Second wave of reforms 

The second wave of reforms included the following:

Find more information on the second wave of reforms in the 2021–22 Budget fact sheets.

Increasing the age of dependants

The Australian Government is committed to improving the affordability, value, and attractiveness of private health insurance, particularly for younger Australians. Increasing the age of dependants able to stay on a family policy, from 24 years of age to up to 31 years of age, will make it easier for young people, and also people with a disability, to maintain private health insurance.

How the increase to the age of dependants will work

The Private Health Insurance Legislation Amendment (Age of Dependants) Bill 2021 will change the maximum allowable age for people to be covered under a family private health insurance policy as a dependant and enable people with a disability, regardless of their age, to be covered under a family private health insurance policy as a dependant.

While some aspects of the definition of dependants are in legislation, such as age ranges and partner status, insurers can define the nature of the dependency in their insurer rules.

The definition of a person with a disability will be a person who is a participant in the National Disability Insurance Scheme (NDIS). However, is important to note that insurers will have flexibility to offer cover to people with a disability that are not participating in the NDIS.

When this reform will begin

Insurers are in the process of considering the legislative amendments and developing new products for this reform measure, which may take some time to implement.  Insurers interested in implementing the changes have indicated they expect to be ready to offer extended dependant products in the second half of 2021.

Learn more about the increase to the age of dependents.

Third wave of reforms

  • Extension to the Medicare Levy Surcharge (MLS) and Private Health Insurance (PHI) Rebate for a further 2 years
  • Review and enhance the Government’s PHI Rebate Model
  • Investigate private hospital default benefit arrangements
  • Improvements to the certification process for admitting patients to hospital.

Find more information on the third wave of reforms.

Consumer resources

Private health insurance reforms – consumer resources

These resources contain information for the general public on reforms to private health insurance. Resources include fact sheets, an infographic and a video about the product tiers.

Private health insurance reforms campaign

A consumer information campaign, first launched on Sunday 17 February 2019, is helping Australians better understand the Australian Government’s reforms to make private health insurance simpler.
 
Campaign materials are available below. Many of these are also available in 5 other languages.

Private health insurance reform data quarterly reports

Private health insurance reform data quarterly trends reports

This report provides statistic and data trends on private health insurance reforms by quarter.

Australian Government Coat of Arms

Authorised by the Australian Government, Canberra.

Last updated: 
11 April 2022

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