Administer private health insurance laws
We administer the:
- Private Health Insurance Act 2007
- Private Health Insurance (Complaints Levy) Act 1995
- Private Health Insurance (National Joint Replacement Register Levy) Act 2009
- Private Health Insurance (Prostheses Application and Listing Fees) Act 2007
- Private Health Insurance (Risk Equalisation Levy) Act 2003.
These laws set out the rules for private health insurance and insurers.
- publish guidance to help industry and the general public understand the laws
- administer the Private Health Insurance Rebate together with Services Australia and the Australian Taxation Office
- improve the laws to encourage health care providers and health insurers to provide better value for money.
Learn more about private health insurance laws in Australia.
Assess applications for premium increases
Once each year, health insurers can apply to the Minister for Health to increase premiums. This happens at the same time each year. We call this the annual premium round.
We assess all applications with the Australian Prudential Regulation Authority (APRA) before the Minister considers them.
Approved premium changes take effect each 1 April.
Assess applications from private hospitals
We also assess applications from private hospitals for:
- declaration as a private hospital – this allows private hospitals to receive health benefit payments from health insurers
- second-tier default benefits eligibility – private health insurers must pay higher benefits for services in eligible private hospitals, even if the health insurer doesn’t have an agreement with that hospital.
Engage with stakeholders
We consult with industry and other stakeholders to make private health insurance laws as clear and effective as possible.
We keep insurers, hospitals, health service providers and state and territory health agencies up to date with private health insurance circulars.
We also chair or participate in a number of committees and working groups that contribute to administering private health insurance.
Make it easier to understand and compare insurance
We are reforming private health insurance to improve transparency and make it easier for you to choose what’s right for you.
Find out more about private health insurance reforms.
Improve access to prostheses and medical technology
The Australian Government signed the Strategic Agreement with the Medical Technology Association of Australia, aiming to:
- keep the sector stable and sustainable
- reduce the time it takes to bring new medical technology to market
- ensure access to safe, effective and cost-effective medical devices
- make sure processes are efficient and transparent
- recognise superior clinical performance.
Considering the impact of COVID-19, the Minister for Health, the Hon Greg Hunt MP, has agreed to pause all Prostheses List reviews and all reform work under the Strategic Agreement with Medical Technology Association of Australia, starting from 1 April 2020.