PHI 58/19 Nursing home type patient contribution rates and minimum benefits – 20 September 2019

Private health insurance announcement.

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

The Private Health Insurance Legislation Amendment (No. 3) Rules 2019 (the Amendment Rules) were registered with the Federal Register of Legislation and commenced on 20 September 2019.

The Rules amend the Private Health Insurance (Complying Product) Rules 2015 (the Complying Product Rules) and the Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Requirement Rules).

Complying Product Amendment Rules

Section 8A – Benefit requirement – nursing home type patient

Nursing home type patient contribution rates have been updated to reflect the indexation applied to the Adult Pension Basic Rate and Maximum Daily Rate of Rental Assistance.

The amendments update the patient contribution rate for privately insured nursing home type patients in public hospitals in New South Wales, Queensland, South Australia, Tasmania, Western Australia, Victoria and Northern Territory, as well as in private hospitals nationally to $61.80 on 20 September 2019.

Public state/territory hospitals
Patient contribution rate

New South Wales
from $61.30 to $61.80

Queensland
from $61.30 to $61.80

South Australia
from $61.30 to $61.80

Tasmania
from $61.30 to $61.80

Western Australia
from $61.30 to $61.80

Victoria
from $61.30 to $61.80

Northern Territory
from $61.30 to $61.80

Private hospitals
Patient contribution rate

Nationally
from $61.30 to $61.80

The existing rate for the Australian Capital Territory remains in force and is as follows:

State/territory
Patient contribution rate

Australian Capital Territory
$61.30

Benefit Requirements Amendment Rules

Schedule 4 – Nursing home type patient accommodation – hospitals in all states/territories

Nursing home type patient minimum benefits have been updated to take account of the indexation applied to the Adult Pension Basic Rate and Maximum Daily Rate of Rental Assistance.

The amendments increase the minimum benefits payable for privately insured nursing home type patients at public hospitals in New South Wales, Queensland and Tasmania on 20 September 2019. The changes are as follows:

State/territory
Minimum benefit per night

New South Wales
From $129.30 to $131.00

Queensland
From $129.50 to $132.50

Tasmania
From $147.10 to $148.30

The existing rates for other states and territories remain in force as follows:

State/territory
Minimum benefit per night

Australian Capital Territory
$128.15

Northern Territory
$125.00

South Australia
$122.00

Victoria
$137.00

Western Australia
$138.10

The minimum benefit payable by insurers for nursing home type patient accommodation in private hospitals in all states and territories has reduced from $49.80 to $49.30.

See details of the individual amendments and the Explanatory Statement accompanying the Amendment Rules.