Annual Private Health Insurance Premium Increase – your questions answered


As a fund that solely exists for our members, we promise that we’re committed to providing you with health insurance that is both quality and affordable.

We want you to know that any changes we make are always made with you in mind and we’re extremely conscious of the impact premiums increases have on you, but want to assure you that any adjustments we make are the minimum amount necessary to meet the escalating costs of healthcare services.

Rate Rise, Premium Adjustment, Price Increase –  no matter what you call it, when it comes to the private health insurance pricing changes on 1 April each year, there’s so much information around, and with that a lot of questions – so we’ve put together some of the most commonly asked ones, to help you have all the right information.

Why are premiums reviewed every year?

Like any business offering a product or service, we as a health fund need to review our products from time to time to make sure they are still providing our members with the best possible value for their money; as well as review our pricing to ensure we are able to keep up with the rising cost of healthcare services and are always able to pay your claims when you need us.

Why are you increasing my premiums on 1 July?

As much as we’d love to not increase our prices, the escalating costs of healthcare services means we need to. You can be assured that we’ll only ever increase prices by the minimum amount necessary.

As a fund run for you, our members, and not for profit, we don’t like putting prices up and are extremely conscious of how any increase impacts you.

Earlier this year we reviewed our approved premium adjustments and decided to postpone the 1 April 2023 premium adjustment for three months until 1 July 2023.

Is there anything I need to do right now?

No, there’s nothing you need to do. Your adjusted premiums will be automatically applied from your next payment on or following 1 July 2023.

Paid your Premiums in advance? Any premiums paid in advance of 1 July 2023 are locked in, the rate increase doesn’t apply to them.
The rate increase will be applied to your next payment on or following 1 July 2023.

I’ve heard other funds aren’t increasing their premiums – why are Phoenix Health?

While any price adjustments have to be approved by the government, it’s up to each fund to make their own decisions and whilst continuing to postpone any premium increase sounds amazing, the truth is that premiums will have to be increased at some point – it’s being postponed, not cancelled.

What we’re more concerned about is the impact increasing our premiums twice in a short amount of time, would have on our members. If a fund is postponing their increase until 1 October 2023 for example, they may then have to have another increase 6 months later on 1 April 2024, which in the long run will put more pressure on you.

I've even heard some funds are refunding members for not being able to use their cover because of COVID

As a health insurer, we are regulated by and work closely with APRA to ensure as a business we are always able to meet our obligations – to always have the resources available to be able to pay your claims and to be able to sustain us as a business over the long term.

We’re aware of other funds who have provided a refund to members and were pleased to also do this for eligible members in 2022. To date Phoenix Health have committed over $2.204 million in member support since the onset of the pandemic.

As part of our commitment to you at the beginning of the pandemic to not profit from COVID-19, we returned cash-back payments to eligible members in lieu of benefits otherwise claimed in May 2022. Whilst things have largely returned to normal, we understand this isn’t the case for everyone and continue to monitor the situation and stand by our promise to not profit from COVID-19 into the future.

Why is my increase higher than Phoenix Health’s average increase?

Each Phoenix Health product in each state is priced individually, and takes into account the costs of health care services within each state. For that reason, some of our rates have gone up less than our average, and some more – depending on the particular product and the state in which you live.

What have Phoenix Health done to support members through the pandemic?

We understand that the challenges of the last two years and have experienced them with you. Through lockdowns and restrictions, there may have been times in which we haven’t been able to access face-to-face services, however we want to remind you that…

  • you still always have access to urgent treatment in a private hospital for the services included on your cover;
  • where you need to be hospitalised, any treatment related to COVID-19 will be covered under your Hospital cover, regardless of your level of cover;
  • we expanded our range of Health Management Programs to include Pre-Hab support to members whose surgery was delayed as a result of restrictions…
  • …as well as giving vulnerable members and members who’ve experienced extensive lockdowns access to speak with clinical staff and trained nurses (YHN) who can then provide further support tailored to their specific needs;
  • services on our Health Management Programs including our pregnancy support program have been extended to include online classes;
  • Extras benefits are available for telehealth services for Physio, Psychology, Dietetics and Speech Therapy.

Despite the pandemic, in FY22 we still paid out 90 cents in every dollar back to members in benefits, while the industry average sits at 86.2 cents.

Phoenix Health paid $44.101 million in member claims, including $26.352 million in treatments provided to members while they were admitted to hospital.

If you’d like more details on Phoenix Health’s response to the global pandemic and the claims we paid out, check out our Year in Review – 2022