2020 Premium Rise FAQs

Why should I keep hospital cover?

There are plenty of reasons that we believe private hospital cover is important. Things like:

  • knowing you can have access to private hospitals with state-of-the-art facilities 
  • being able to choose your doctor
  • not having to spend months (even years) on a public hospital waiting list by going into a private hospital
  • if you earn over the threshold for Medicare Levy Surcharge (currently $90,000 for singles and $180,000 for families), you may save tax by not having to pay the Medicare Levy Surcharge. 
  • avoiding a Lifetime Health Cover loading (by having hospital cover before you turn 31)

You might be surprised by just how much it costs to enter hospital as a private patient. Here are just some of the claims we paid in 2019 and early 2020:

  • $16,700 for a teenager’s jaw surgery
  • $71,300 for a man’s heart surgery
  • $71,600 for a woman’s spinal surgery
  • $39,600 for a woman’s Cochlear implant
  • $93,200 for a woman’s leg surgery

When you think about health insurance, it is important to think about more than just the cost. Health insurance is about giving you more choice for your healthcare, less time waiting for the services you need and (most importantly) the peace of mind to know that you’ll be looked after when you need it most.

Why are my membership payments rising?

In short, we need to be able to pay members’ claims. To do that we need to keep up with medical costs that are growing every year, as well as having more people claiming for these services.

We made a conscious decision this year not to increase extras benefits, for instance, because any increase in benefits would push premiums up. We have been listening to members, who generally want us to do everything possible to keep premiums as low as possible. An increase to certain extras benefits does not always benefit everyone (if you aren’t claiming those specific benefits); keeping premiums down benefits all members. We will continue to review our benefits on an annual basis to ensure we are offering the best possible value at affordable prices. 

This is our lowest average premium rise in the last eight years at 3.08%. The other good news is that this is we are not-for-profit, which means we only charge what it costs to pay claims and run our fund. In fact, last financial year we paid $12.9 million for member benefits out of $15.9 million in premiums (or 81% of our revenue), but rising health care costs and usage necessitate an increase in premiums.

We try to keep our costs down in other ways too, such as:

  • running as efficiently as possible so we have low administration costs
  • working with the Australian Health Service Alliance (AHSA) to have more bargaining power with hospitals and doctors
  • working with industry bodies to push the Government for changes that make healthcare more affordable for everyone

Premium increase vs Government Rebate decrease

If you get a Government Rebate, the increase to the amount you pay for health cover is made up of two things – an increase to our premiums and a change in the rebate percentage the Government pays towards your cover (which we have no control over). If you want the exact percentage of your rate increase, it is important to take the Government Rebate into account. 

Why is the increase above the inflation rate?

Put simply, healthcare and medical costs are rising faster than CPI (inflation). We know money is tight for a lot of people and we can promise you that we’re always looking for ways to keep costs as low as possible while still giving you great value and service.

How do you decide how much you increase membership payments by?

We only ever increase membership payments by what it costs to pay claims and keep our fund running. All health fund increases are reviewed and approved by the Government. 

What if I have paid in advance?

If you have paid in advance you will not have to start paying the new amount until your next payment is due. For example, if you are paid up to 4 May 2020, you will start paying the new amount from 5 May 2020.

For more information, please call us.