Private Health Insurance Reforms

Private Health Insurance Reforms

Summary of the key Reforms


Important Government changes to Private Health Insurance

The Government recently announced a range of Reforms for the Private Health Insurance industry. These changes do not negatively impact your Latrobe membership, rather they are addressing affordability of Private Health Insurance, access to mental health services and the simplification of Private Health Insurance making it easier to understand.

Some of these changes have already taken place, others will be introduced from April 2019. The good news is it is business as usual,
as only 2% of our members will experience a change due to the announced Reforms.

To make it easier for you, we’ve outlined the key Reforms below to help you understand what the changes may mean to you. However,
if you would like to discuss any of these further, please know that we are here ready to assist you, simply give us a call



What does this mean?

When will this come into effect?


Gold/Silver/Bronze/Basic product tiers

To reduce complexity and simplify the comparison of different levels of health cover, the tiers of Gold, Silver, Bronze and Basic must be used by all Health Insurers.

1 April 2019


Standard clinical categories

Health Insurers will use the same terminology in all documentation and systems, which will mean the language used is consistent and easy to understand for their members.

1 April 2019


Increasing maximum excess level

Health Insurers will be able to offer members a higher excess level as a way for members to manage their premium payments, while remaining eligible for the Medicare Levy Surcharge exemption ($750 for singles and $1,500 for couples/families).

1 April 2019


Discounts for
18 - 29 year olds

Health Insurers will have the option to offer a discount of up to 10% on hospital products for
18 - 29 year olds. Current legislation prevents all health funds from offering age based premium discounts.

1 April 2019


Removal of rebate for some natural therapies

Health Insurers will no longer be permitted to pay a benefit for the following natural therapies:

1 April 2019

  • Alexander technique
  • Aromatherapy
  • Bowen therapy
  • Buteyko
  • Feldenkrais
  • Herbalism
  • Homeopathy
  • Iridology
  • Kinesiology
  • Naturopathy
  • Pilates
  • Reflexology
  • Rolfing
  • Shiatsu
  • Tai chi
  • Yoga


Mental health

Members who currently hold limited mental health cover can upgrade their cover without serving the 2 month waiting period. Members will be able to use this exemption from the upgrade waiting period, once in their lifetime.

1 April 2018


Prostheses List reductions

The price paid for prostheses and medical devices is set by the Government. These prices will continue to be reviewed, reducing the amount paid by Health Insurers and their members. In 2018, this represented an industry saving of $188 million.

1 February 2018


Regional and rural travel and accommodation

Health Insurers will have the option of including travel and accommodation benefits under a hospital product.

1 April 2019

The Private Health Insurance Ombudsman website will be updated, making more product information readily available.

1 April 2019


Private Health Insurance Ombudsman

The Private Health Insurance Ombudsman’s role will be strengthened to further protect members of a health fund.

1 April 2019

 For more information regarding the reforms visit The Department of Health