Why do Premiums change?

Being a not-for-profit health fund means we believe healthcare should be accessible for everyone. We’re always looking for ways to keep premiums as low as possible for our members, and only adjust costs when we really need to.

All health funds review members’ premiums each year. They’re reviewed annually to help cover the cost of providing health and medical care to Australians. There are lots of factors that influence why premiums change or impact the cost of healthcare, including:

Inflated cost of medical devices

Australians have access to one of the best health systems in the world, however new and improved medical technology and treatment options often come with higher costs.

Private Health Insurers are required to pay benefits for products listed on the Australian Government's Prescribed List of Medical Device and Human Tissue Products ('prescribed list') provided to a patient as part of hospital substitute treatment.

Of real concern is the inflated price of many items on the prescribed list, with Australians paying between 30 and 100% more for medical devices and human tissue products than other countries, including the UK and New Zealand.

There are more than 11,000 products on the prescribed list which includes set prices for artificial joints and pacemakers, but also includes items like staples and surgical sponges that should not be considered medical devices and human tissue products.

The exorbitant costs of all these items, which paid for by insurers, is having a direct impact on premiums.

While the Government has committed to reforms that will drive down prices, pressure from multi-national medical device companies has stalled promised reforms being implemented.

We’re actively lobbying for these important reforms to be delivered to shift value away from medical device manufacturers to consumers, so we can continue to offer you affordable health insurance.

Ageing population and the rise in chronic conditions

Australia’s ageing population and the associated rise in incidence of chronic conditions like cancer and heart disease means more and more people are using the health system. While treatment for these often-complex medical conditions can be life-saving, they are costly and can require frequent hospital admissions.

Your premiums, including any necessary increases, ensure that we can continue to pay claims for these vital treatments now, and offer peace of mind that you can access treatment quickly and with your choice of doctor, if you need it in the future.

Premium increases vary from product to product

Our premiums are adjusted relative to the costs associated with providing each individual policy. This means the amount your premium increases depend on your policy and may be above or below our average premium increase.


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Here when you need us

Health and wellbeing look different for everyone, so our local Member Care team is here to support you. If you have any questions, call us on 1300 113 113 or visit our website to chat with us online.

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