Annual premium round
This circular provides information about the 2026 private health insurance (PHI) premium round. Arrangements for the application process requesting PHI premium rate changes have been determined in consultation with private health insurers and the Australian Prudential Regulation Authority (APRA).
The Department of Health, Disability, and Ageing (the department) coordinates the annual premium round. The department will consult with APRA throughout this process. APRA’s role in relation to the premium round is to advise the department whether premium increase requests from private health insurers would result in an adverse prudential outcome for individual insurers.
Timetable
Private health insurers requesting changes to premiums are to submit their application form no later than 3pm AEST on Wednesday 12 November 2025.
The timetable for the 2026 Premium Round is as follows:
| Friday, 19 September 2025 | PHI Circular released to inform industry of timeline, release of application forms and Ministerial Statement of Expectations. |
| Wednesday, 12 November 2025 | Applications due by 3pm. The Department of Health and Aged Care and APRA’s assessment of applications commences. |
December 2025 to 31 January 2026 (Indicative only – subject to Minister’s consideration of applications) | Insurers notified of outcome outside business hours. |
| Tuesday, 1 April 2026 | Premium changes take effect. |
Submission of applications
Applications should be submitted via the Health Data Portal, a cloud-based Department of Health and Aged Care owned file transfer system.
Private health insurance premium application form
Applications are to be submitted in the forms provided and consistent with the detailed guidance at Attachment 1A and 1B.
Statement of Expectations
In the interest of providing insurers with greater clarity and transparency of the matters the Minister for Health and Ageing intends to pay particular regard to in his consideration of applications, he has issued a Statement of Expectations (Attachment 2A) for the 2026 Premium Round.
Note: Each application is assessed on its individual merits and the Minister has broad discretion to consider any relevant matters in determining whether a proposed change is contrary to the public interest.