Administer private health insurance laws
We administer the following laws:
- 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
- Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007
These laws set out the rules for private health insurance and private health insurers.
- publish guidance to help industry and the general public understand the laws
- administer the private health insurance rebate together with the Department of Human Services and the Australian Taxation Office
- improve the laws to encourage health care providers and health insurers to provide better value for money
Assess applications for premium increases
Health insurers must apply to the Minister for Health to increase premiums.
Along with the private industry regulator, we assess the applications before the Minister considers them. This happens at the same time each year with premium changes taking 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.
Our private health insurance circulars provide updates and information to health insurers, hospitals, health service providers and state and territory health agencies.
Reforms to private health insurance
It can be hard to choose the right private health insurance for you. Find out how private health insurance reforms are making it easier to compare different levels of cover.