What's happening in Australia’s private health insurance market?

Report highlights uptick in memberships and benefits paid

What's happening in Australia’s private health insurance market?

Life & Health

By Roxanne Libatique

The Australian Prudential Regulation Authority (APRA) has revealed key statistics for the private health insurance sector as of December 2023.

The publication, which provides insights into membership, coverage, and financial disbursements, among other metrics, aims to offer a comprehensive overview of the sector’s performance in the concluding quarter of the year.

Private health insurance - key figures

As of December 31, 2023, hospital treatment coverage was reported at 44.9% of the Australian population, translating to 12,092,921 individuals. This represents a marginal uptick from the figures reported in September 2023, with an additional 54,908 individuals obtaining coverage.

The data showed a diversification in policy uptake, with family policies increasing by 7,077 and single policies by 12,277 within the quarter. Notably, the demographic seeing the most significant growth was those aged between 40 and 44, with a net increase of 7,298 individuals. Children aged 0-4 years also saw a notable rise in coverage, increasing by 24,407.

Lifetime health

The report touched on the lifetime health cover aspect, highlighting that 88.5% of adults with hospital cover are within the certified entry age of 30, thus avoiding penalty loading.

However, as of the end of the December quarter, 1,002,666 individuals exceeded this entry age, marking a 62,320 increase in those subject to lifetime health cover loading compared to the previous year. Conversely, the segment of individuals entering at the certified age of 30 grew by 106,289 over the same period, with 121,255 people successfully removing their loading after a decade.

General treatment

General treatment cover also saw an increase, with 14,724,543 individuals, or 54.6% of the population, now holding some form of this insurance, up by 53,078 from the previous quarter. The increase was predominantly attributed to single policies, which grew by 13,982.

Over the year, the total insured under general treatment rose by 304,225. The report further highlighted a 42,896 increase in individuals with general treatment (ancillary) coverage, with the 0 to 4 age group experiencing the largest net growth.

Benefits paid

Financially, the December quarter saw health insurers pay out $4,471 million in hospital treatment benefits, marking a 0.75% increase from the preceding quarter. The expenditure was broken down into $3,197 million for hospital services, $667 million for medical services, and $607 million for prostheses items.

The age group 75-79 received the highest amount of hospital benefits, with a detailed breakdown showing variations in average benefits paid per person across different services.

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