The Private Health Insurance Legislation Amendment Rules (No. 3) 2026 (the Amendment Rules) amend the:
- Private Health Insurance (Complying Product) Rules 2015 (the Complying Product Rules).
- Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Rules).
The Amendment Rules will be registered on the Federal Register of Legislation.
We administer private health insurance under the Private Health Insurance Act 2007 and associated rules.
The Amendment Rules, commencing 20 March 2026 amend the:
- Complying Product Rules to increase the daily patient contribution payable by a nursing-home type patient (NHTP) in private hospitals nationally and public hospitals in all states and territories except for the Australian Capital Territory (ACT) and Western Australia (WA).
- Benefit Rules to update the benefits payable by private health insurers per night for NHTPs in private hospitals nationally and public hospitals in New South Wales (NSW), Tasmania (Tas) and Victoria (Vic). Benefits payable in the ACT, Northern Territory (NT), Queensland (Qld), South Australia (SA) and WA, remain unchanged.
Nursing Home Type Patient accommodation adjustments
NHTP contributions and minimum insurer benefits are indexed by the Commonwealth twice annually, on 20 March and 20 September. Jurisdictions are consulted on changes to rates in public hospitals. Total fees and charges for privately insured NHTPs in public hospitals are determined by the state or territory in which the patient is receiving hospital treatment. Some jurisdictions apply changes from July or September, annually.
Patient contribution
The daily patient contribution rate payable by a NHTP in hospital is set out in the Complying Product Rules Part 2 – 8A(3) Benefit requirement – nursing-home type patients.
The table below shows the daily patient contribution payable by a NHTP in hospital from 20 March 2026, as described in the Amendment Rules.
| Public hospitals | Patient contribution for each day a NHTP |
| Australian Capital Territory | $78.95 NO CHANGE |
| New South Wales | $82.50 |
| Northern Territory | $82.50 |
| Queensland | $82.50 |
| South Australia | $82.50 |
| Tasmania | $82.50 |
| Victoria | $82.50 |
| Western Australia | $80.95 NO CHANGE |
| Private hospitals | Patient contribution for each day a NHTP |
| All states and territories | $82.50 |
Benefit payable by private health insurers for NHTP
The benefit payable per night by private health insurers for NHTP in hospitals is set out in the Benefits Rules Schedule 4 – Nursing-home type patient accommodation: hospitals in all states/territories, Rule 6.
Rates will be updated from 20 March 2026 for private patients in private hospitals nationally, and for private patients in public hospitals in NSW, Tas and Vic.
The table below shows the minimum benefit payable by insurers for NHTP from 20 March 2026 as described in the Amendment Rules.
| Public hospitals | Minimum benefit per night |
|---|---|
| Australian Capital Territory | $152.25 no change |
| New South Wales | $197.35 |
| Northern Territory | $162.75 no change |
| Queensland | $150.75 no change |
| South Australia | $150.00 no change |
| Tasmania | $197.95 |
| Victoria | $175.39 |
| Western Australia | $155.15 no change |
| Private hospitals | Minimum benefit per night |
| All states and territories | $28.60 |
More information
Further details on amendments are included in the Explanatory Statement accompanying each set of Amendment Rules available on the Federal Register of Legislation website by searching ‘Private Health Insurance Legislation Amendment Rules (No. 3) 2026.’
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