Annual premium round
Insurers can apply to increase the premiums of their private health insurance policies once each year.
We call this the annual premium round.
View the average annual price changes for each insurer and the industry from 1997 onwards.
When to apply
Applications are due 3pm AEST, Wednesday, 12 November 2025.
Approved premium price changes take effect on 1 April each year.
View the 2026 Premium Round circular for more information about the projected timeline.
Our last round (the 2025 premium round) closed on 13 November 2024.
How to apply
Apply using the approved premium increase application form. We provide this form when a new round opens.
To find out about the information we ask for, view the application form for the 2026 round.
Assessment
We assess all applications to ensure requested increases are justified. We consider:
- the application’s merits
- an actuary’s opinion
- the Australian Prudential Regulation Authority (APRA) advice on potential adverse prudential outcome for each insurer
- APRA data.
When we have examined an application it is passed to the Minister to consider.
In the interest of providing insurers with greater clarity and transparency of the matters the Minister intends to pay particular regard to in his consideration of applications, he has issued a Statement of Expectations for the 2026 Premium Round.
By law, the Minister must approve an application unless satisfied that a change that would increase premiums is not in the public interest. 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.
Outcome
The indicative timing for the announcement of the premium round outcome by the Minister is December to 31 January for implementation the following 1 April. However, the timing is subject to the Minister’s consideration of applications.
Notify policy holders
Insurers must give policy holders notice of approved premium price changes. This notice should be provided with sufficient time for policy holders to review their current cover and consider a different product, if they choose to.
The industry-developed Private Health Insurance Code of Conduct provides more detail about how to communicate with policy holders.
Legislation
See Section 66–10 Minister’s approval of premiums in the Private Health Insurance Act 2007.
Average premium price change
The average premium price change for each insurer is calculated according to the following formula.
(Where FCI is the forecast contribution income for the insurer for the 12-month period following the implementation of the changes, excluding forecast changes in membership, and including age-based discounts, rate protection and dependants reforms impacts.)
A revenue-based measure, such as the percentage change in forecast contribution income, is considered to be the most appropriate way of reflecting the price change in premiums that will be received by an insurer. This method is less biased by extremely low changes for particular products and/or distortions arising from wide fluctuations in the number of policies covered by a particular product, compared to other methods such as simply averaging out the premium changes for individual products.
The industry weighted average premium change calculation formula is outlined in the Private Health Insurance (Incentives) Rules 2012 (No.2). It specifies the industry average premium increase being the average change in premiums for each product subgroup offered by every private health insurer and weighted according to the number of people covered under complying health insurance policies in each product subgroup and includes the impact of rate protection and age-based discounts.
More information on rate protection, age-based discounts and dependants reforms:
- if you can pay your health insurance premiums in advance, some insurers will offer a rate protection. With rate protection, if premium rates are increased within the period you have already paid for your insurance, you will not have to pay increased rates until that period ends. If you do not have rate protection, the insurer will ask you to pay the balance owing on the new rates or reduce the length of time your advance payment covers
- from 1 April 2019, insurers can offer persons aged 18-29 years discounts of up to 10 per cent of their private health insurance hospital premiums. More information can be found at www.privatehealth.gov.au by searching ‘age-based discounts’
- the dependants reform measure increased the maximum allowable age of dependants for private health insurance from 24 to 31 years and removed the age limit for dependants with a disability. More information can be found on this website by searching ‘private health insurance reforms’.