PHI 66/24 Private Health Insurance Legislation Amendment Rules (No. 5) 2024

This circular provides information about hospital nursing home-type patient contribution and insurer benefits from 20 September 2024.

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

The Private Health Insurance Legislation Amendment Rules (No. 5) 2024 (the Amendment Rules) amend the: 

The Amendment Rules will be registered on the Federal Register of Legislation on 19 September 2024. Notification will also be emailed to the sector on 20 September 2024.

We administer private health insurance under the Private Health Insurance Act 2007 and associated rules.

The Amendment Rules amend the:

  • Complying Product Rules to increase the daily patient contribution payable by a NHTP in private hospitals nationally and public hospitals in all states and territories except for the Australian Capital Territory (ACT).
  • Benefit Rules to update the benefits payable by private health insurers per night for nursing-home type patients (NHTPs) in private hospitals nationally and public hospitals in the New South Wales (NSW), Northern Territory (NT), Tasmania (Tas), Victoria (Vic) and Western Australia (WA). Benefits payable in the ACT, Queensland (Qld) and South Australia (SA) remain unchanged.

Nursing‑Home Type Patient (NHTP) accommodation indexation

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. Some jurisdictions apply the changes from July or September, annually. 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.

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 September 2024, as described in the Amendment Rules that will be incorporated into the Complying Product Rules.

Minimum patient contribution each day as a nursing-home type patient at a hospital
Public hospitalsPatient contribution for each day a NHTP
Australian Capital Territory$75.55  NO CHANGE
New South Wales$78.65  
Northern Territory$78.65  
Queensland$78.65  
South Australia$78.65  
Tasmania$78.60   [60c reflects Tas rounding regulations]
Victoria$78.65  
Western Australia$78.65  
Private hospitalsPatient contribution for each day a NHTP

Private hospitals

all states and territories

$78.65  

Minimum 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, Part 6.

Rates will be updated from 20 September 2024 for private patients in private hospitals nationally, and for private patients in public hospitals in NSW, NT, Tas, Vic and WA. Benefits payable in the ACT, Queensland (Qld) and South Australia (SA) remain unchanged.

The table below shows the minimum benefit payable by insurers for NHTP from 20 September 2024 as described in the Amendment Rules that will be incorporated into the Benefits Rules.

Minimum benefit payable per night by insurers for nursing home type patient accommodation
Public hospitalsMinimum benefit per night
Australian Capital Territory$147.45  NO CHANGE
New South Wales$179.10
Northern Territory$155.59
Queensland$145.80  NO CHANGE
South Australia$146.00  NO CHANGE
Tasmania$188.75
Victoria$160.00
Western Australia$152.85
Private hospitalsMinimum benefit per night
Private hospitals all states and territories$32.45

More information

Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules available on the Federal Register of Legislation website by searching ‘Private Health Insurance Legislation Amendment Rules (No. 5) 2024.’

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