PHI 48/19 Annual hospital categorisation review consultation second-tier hospital list – 1 August 2019

Private health insurance announcement.

Date published:
PHI circular
PHI circular type:
PHI announcement
Health sector

The purpose of this circular is to inform stakeholders of the outcome of consultation regarding private hospital second-tier categorisation.

On 1 January 2019, the Department of Health commenced administration of second-tier default benefits eligibility. Under these arrangements, private hospitals apply directly to the department for recognition that they are eligible for second-tier default benefits. This has replaced the industry based Second Tier Advisory Committee (STAC).

The department maintains and publishes the list of all private hospitals grouped by second-tier hospital category and their second-tier eligibility status.

The department consults annually on this list. For this year the formal consultation round with private hospitals has now closed. Thank you to those who provided feedback. This review will be undertaken again in June 2020.

The list is used by insurers to develop their second-tier rates. For more information please view the outcome of the consultation process.

Please note there has been some recent changes to the list and a final list has now been published. Please ensure you use the most up to date list when calculating second-tier default benefits rates.

Future changes to second-tier category and eligibility can be found on the Commonwealth declared hospital list.