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How to Reduce the Pain of Private Health Insurance Premium Increases

The 2026 industry-average increase was 4.41%, but your policy may differ. Check your insurer’s notice, compare cover and likely costs, and review rebate and tax implications before changing.
From TheFinanceBase Team3 min to read
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If your Australian private health insurance premium has gone up, start with the exact notice from your insurer—not the industry average. The approved average increase for 2026 was 4.41% from 1 April, but your policy’s change may be higher or lower. Compare the cover and likely out-of-pocket costs, check your rebate eligibility, and weigh any premium saving against the risks of changing your excess or cover.

First, find out what changed on your policy

Read your insurer’s notice and record the new premium, the dollar and percentage increase, the effective date, and any changes to benefits or policy terms. Insurers must notify members of their specific change; the approved industry average is a benchmark, not an individual quote. The Department of Health explains the difference between average and individual premium changes, and PrivateHealth.gov.au outlines common questions about premium changes.

For 2026, the Australian Government approved a weighted industry-average premium increase of 4.41%, effective 1 April. The Department reported that medical and hospital service costs rose 5% in the preceding financial year. It also reported $26.7 billion in insurer benefits for the 12 months to 30 September 2025: $20 billion for hospital treatment and $6.7 billion for general treatment. These industry figures help explain the context, but do not determine what your own policy should cost. See the Department’s 2026 premium announcement.

Compare cover and total costs, not just premiums

Use PrivateHealth.gov.au’s independent policy comparison database as a starting point. Then confirm the policy details and a current quote directly with the insurer. A cheaper headline price can reflect less cover or more cost-sharing.

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  • Hospital cover: Check which treatment categories are covered, excluded or restricted, and whether any excess or co-payment applies.
  • Extras: Compare annual limits with the services you expect to use and the benefits you are likely to receive.
  • Out-of-pocket costs: Ask about likely provider charges and gap exposure, not only the insurer’s premium.
  • Switching details: Confirm waiting periods, transfer arrangements and whether provider arrangements will change.
  • Annual cost: Compare the premium after any applicable rebate, alongside expected treatment costs and benefits you actually use.

The Commonwealth Ombudsman says your current insurer or another insurer may be able to offer a cheaper policy that still meets your needs. Ask your fund to explain precisely what you would give up—or pay more toward—under each alternative. Read the Ombudsman’s guidance on health insurance premium increases.

Price a higher excess or co-payment before choosing one

A higher hospital excess or co-payment may reduce the premium, but it shifts more of the cost to you if you are admitted. Ask the insurer for the exact premium saving and the maximum payment that could apply under the policy. Compare the annual saving with that potential cost, and choose the higher excess only if you could afford it when treatment is needed. Policy terms and insurer quotes determine the actual amounts.

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Check whether your rebate is right

Eligible policyholders can generally have the Australian Government rebate applied to premiums by their insurer or claim it through the ATO. Eligibility and the amount depend on factors including income and age. If your household income or circumstances change, check that the estimate used for your rebate remains appropriate. Services Australia explains eligibility and how to claim.

For the 2026–27 period from 1 July 2026 to 31 March 2027, PrivateHealth.gov.au lists these base rebate percentages for people under 65:

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Income tier Single threshold Family threshold Base rebate under 65
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Tier 1 $105,001–$123,000 $210,001–$246,000 16.079%
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Tier 3 Above $164,000 Above $328,000 0%

These are published thresholds and base rates for that period, not a personal rebate calculation. Older age groups have higher rebate percentages; family thresholds rise by $1,500 for each child after the first. Check the current official page for the applicable age-based rate and your circumstances: Australian Government PrivateHealth.gov.au rebate information.

Check tax and Lifetime Health Cover consequences before dropping hospital cover

Do not cancel or downgrade hospital cover solely to cut the premium without checking how it could affect you. Some higher-income people without eligible hospital cover may have to pay the Medicare Levy Surcharge. Taking out hospital cover after the relevant age deadline can also mean a Lifetime Health Cover loading. Whether either applies depends on your circumstances. The Department of Health’s overview explains the rebate, Medicare Levy Surcharge and Lifetime Health Cover.

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Confirm any change in writing

Before changing insurer or policy, get written confirmation of the new premium, cover, excess or co-payment, and effective date. Ask both insurers about continuity and waiting-period arrangements, and keep the policy documents and confirmation so you can check that the change took effect as agreed.

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Product prices and availability are accurate as of the date/time indicated and are subject to change. Any price and availability information displayed on Amazon at the time of purchase will apply.

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