Why are premiums increasing?

The Private Health Insurance Act 2007 requires all health insurers to submit detailed proposed premium increases to the Commonwealth Minister for Health for assessment along with the Australian Prudential Regulation Authority (APRA) for approval before any rate increases can occur.

Premium increases are then assessed to further ensure that all premiums proposed are justified and necessary before taking effect on 1st April 2020.

Premium increases occur due to the rise of costs associated with:

  • Increasing costs associated with hospitals such as wages, doctor’s charges, cost of medical equipment and advancing technology
  • More complex and costly procedures performed in Private hospitals eg.robotics
  • High number of hospital admissions and increased claiming rates
  • High prostheses costs within Australia compared to other countries
  • Australia’s ageing population
  • Increases in chronic conditions

Below indicated average cost of common procedures:

Information includes hospital and medical data for Private Hospital admissions only for Westfund Members during 2018-19 FY
Procedure Average Benefit per member
Psychiatry $20,805
Lens Procedures $6,143
Coronary Bypass $50,583
Hip Replacement $23,369
Caesarean Delivery $10,935
Natural Delivery $7,093
Tonsillectomy $2,727

While Westfund acknowledges that nobody likes to pay more, our premiums must keep pace with the rising costs of healthcare to ensure our viability and to allow us to offer competitive pricing and products.