Resources
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Prostheses List
This list sets out the prostheses that private health insurers must pay benefits for (if the patient is covered) and the benefit amount. The latest version is effective from 1 March 2021. Prostheses include surgically implanted prostheses, human tissue items and other medical devices.
Private health insurance assignment of MBS Items for hospital treatment
This spreadsheet lists the Medicare Benefits Schedule (MBS) items assigned to a clinical category or treatments list for private health insurance hospital policies. It provides a description, schedule fee, and benefit amount for each MBS item.
Average annual increases in private health insurance premiums
View the average annual increases in premiums from 1997 to 2021 for each insurer and the industry. Premium increases take effect from 1 April each year. Premium increases for some policies may be higher or lower than the industry or insurer’s average.
Review of the General Miscellaneous Category of the Prostheses List report
This document reports on the outcomes of the Review of the General Miscellaneous Category of the Prostheses List.
Options for a revised framework for setting and reviewing benefits for the Prostheses List report
This report describes the proceedings of the Revised Benefit Setting and Review Framework Industry Working Group (BSRIWG) over 8 meetings held between April 2018 and February 2020.
All declared hospitals (current as at 14 December 2020)
Current listing of Commonwealth declared hospitals.
Statistics – Private health insurance reform data April to June 2020
This report provides statistics and data on private health insurance reforms for the reporting period 1 April to 30 June 2020.
Part of a collection: Private health insurance reform data quarterly reportsPrivate health insurance reform data quarterly reports
These reports provide statistics and data on private health insurance reforms by quarter.
Statistics – Private health insurance reform data July to September 2020
This report provides statistics and data on private health insurance reforms for the reporting period 1 July to 30 September 2020.
Part of a collection: Private health insurance reform data quarterly reportsCost Recovery Implementation Statement for Second-Tier Default Benefits
This statement describes how the Department of Health recovers the costs of administering private health insurance second-tier default benefits.
Cost Recovery Implementation Statement for Second-Tier Default Benefits
This statement describes how the Department of Health recovers the costs of administering private health insurance second-tier default benefits.
Cost Recovery Implementation Statement for the National Joint Replacement Registry
This statement describes how the Department of Health recovers the costs of administering the National Joint Replacement Registry.
Tranche 1 submitted evidence
Tranche 1 evidence submitted by the public as part of the calls for evidence in the Natural Therapies Review 2019–20.
NTREAP Meeting Outcomes 21 October 2020
Natural Therapies Review Expert Advisory Panel (NTREAP) meeting outcomes for 21 October 2020 meeting
Prostheses List Management System (PLMS)
Sponsors and suppliers can use the PLMS to create, edit and monitor applications for prostheses listings.
Lifetime Health Cover Calculators
Use these calculators to help you work out the lifetime health cover (LHC) loading payable on your private hospital cover.
Compare health insurance policies
To compare policies, all you need is the type of cover you want, who the policy will cover, and where you live. PrivateHealth.gov.au contains details of every health insurance policy available in Australia.
Overseas Student Health Cover (OSHC) resources
A collection of resources about overseas student health cover (OSHC) for the general public and private health insurers.
Natural Therapies Review Expert Advisory Panel — Terms of Reference
The Terms of Reference for the Natural Therapies Review Expert Advisory Panel (NTREAP).
PHI 67/20 attachments – 2021 private health insurance premium application form and templates
These attachments to PHI circular 67/20 are the 2021 private health insurance premium application form and templates.
Private health insurance reforms campaign poster
This poster outlines the Government’s reforms to private health insurance.
Part of a collection: Private health insurance reforms – campaign materialsMedical Costs Finder
The Medical Costs Finder helps you understand the cost of common medical procedures provided by specialists in Australia.
Private hospital second-tier category list
Private health insurers use this list to calculate the second-tier default benefits payable to individual hospitals. This list is updated every year by 1 August.
Hibernation of Agreement with the Medical Technology Association of Australia (MTAA)
Find out about the hibernation of all Prostheses List reform work covered under the Agreement with the MTAA. The work will pause for up to 12 months.
Second-Tier Default Benefits Eligibility Application Form
This form is for private hospitals to apply for second-tier default benefits eligibility.