Income Protection NZ :: News
SHARE

Share this news item!

Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms

Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms

Recent findings from the Australian Medical Association (AMA) reveal a concerning trend in the private health insurance sector: Australians are facing higher premiums while experiencing diminishing returns on their policies.
The AMA's latest Private Health Insurance Report Card, released on 5 December 2025, highlights the urgent need for reforms to address these issues.

The report indicates that premiums have consistently outpaced inflation and wage growth, placing additional financial strain on policyholders. Despite these increases, the value derived from private health insurance has been eroding, with many policies now containing numerous exclusions that limit coverage.

Dr Danielle McMullen, President of the AMA, expressed concern over the narrowing scope of coverage, stating that Australians are paying more for their private health insurance and receiving less value in return. She emphasised the need for insurers to make their products more transparent and to ensure that policyholders are adequately covered for essential healthcare services.

One of the key findings of the report is the significant variation in benefits paid by insurers for identical procedures. For instance, the AMA found an almost 30% difference in the benefits paid between two insurers for an uncomplicated childbirth. Such discrepancies highlight the complexity and lack of standardisation within the industry, making it challenging for consumers to make informed decisions.

In response to these issues, the AMA has called for insurers to allocate at least 90% of their earnings directly into patient healthcare. This recommendation aims to ensure that a greater proportion of premiums are returned to consumers in the form of health services, rather than contributing to insurer profits.

For healthcare professionals, particularly those in the allied health sector, these developments underscore the importance of understanding the evolving landscape of private health insurance. As premiums rise and coverage becomes more restrictive, practitioners may encounter patients facing increased financial barriers to accessing care. Staying informed about these trends and advocating for patient interests will be crucial in maintaining the quality and accessibility of healthcare services in Australia.

Published:Saturday, 14th Feb 2026
Source: Paige Estritori

Share this news item:

Insurance News

AMA Advocates for Regulatory Reforms to Curb Health Insurers' Market Power AMA Advocates for Regulatory Reforms to Curb Health Insurers' Market Power
14 Feb 2026: Paige Estritori

The Australian Medical Association (AMA) has recently highlighted concerns regarding the substantial market power wielded by private health insurers and its potential adverse effects on patient care and healthcare costs. In a position statement released on 4 February 2026, the AMA emphasised the need for regulatory reforms to prevent insurers from exploiting their dominant positions in the healthcare sector. - read more
Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms
14 Feb 2026: Paige Estritori

Recent findings from the Australian Medical Association (AMA) reveal a concerning trend in the private health insurance sector: Australians are facing higher premiums while experiencing diminishing returns on their policies. The AMA's latest Private Health Insurance Report Card, released on 5 December 2025, highlights the urgent need for reforms to address these issues. - read more
Private Health Insurers Under Fire for Premium Increases Despite Government Warnings Private Health Insurers Under Fire for Premium Increases Despite Government Warnings
14 Feb 2026: Paige Estritori

Private health insurers in Australia are facing mounting criticism for implementing significant premium increases, despite explicit warnings from the Health Minister. This development has sparked concerns about the affordability of healthcare and the practices employed by insurers to maximise profits. - read more
AIA Australia's Commitment to Mental Health: City2Surf Partnership AIA Australia's Commitment to Mental Health: City2Surf Partnership
14 Feb 2026: Paige Estritori

In August 2025, AIA Australia, a leading life, health, and wellbeing insurer, took a significant step in addressing the nation's mental health crisis by partnering with the City2Surf event in Sydney. This collaboration aimed to raise both funds and awareness for mental health, a pressing issue that has seen a notable increase in related insurance claims over recent years. - read more
AUSactive and Private Healthcare Australia: Pioneering Health Insurance Reforms AUSactive and Private Healthcare Australia: Pioneering Health Insurance Reforms
14 Feb 2026: Paige Estritori

In July 2025, AUSactive, Australia's peak body for the exercise and active health sector, announced a strategic partnership with Private Healthcare Australia (PHA) aimed at reforming private health insurance to include evidence-based preventive health services. This collaboration follows recent legislative changes that permit private health insurers to offer rebates for select natural therapies, marking a significant shift in the integration of preventive health into the insurance framework. - read more
AIA Australia's New Member Insurance Portal: Revolutionising Claims Processing AIA Australia's New Member Insurance Portal: Revolutionising Claims Processing
14 Feb 2026: Paige Estritori

In July 2024, AIA Australia, a prominent life, health, and wellbeing insurer, unveiled its cutting-edge Member Insurance Portal, designed to streamline the insurance experience for group insurance customers. This digital innovation focuses on optimising the claims process, providing members with the ability to track their claims throughout the entire lifecycle, thereby ensuring transparency and simplicity during potentially challenging times. - read more


Life Insurance Articles

Financial Safety Nets: Why Income Protection Should Be a Priority Financial Safety Nets: Why Income Protection Should Be a Priority
Unexpected sickness can disrupt your life in many ways, especially when it comes to your financial stability. The loss of income during illness can create a financial burden, making it tough to manage daily expenses and bills. - read more
How to Choose the Right Income Protection Insurance as a Freelancer How to Choose the Right Income Protection Insurance as a Freelancer
Income protection insurance is a type of coverage designed to replace a portion of your income if you're unable to work due to illness or injury. It's an incredibly vital form of insurance for freelancers, who may not have the same safety nets as traditional employees, such as paid sick leave or disability benefits. - read more
Understanding Income Protection Insurance: A Comprehensive Guide for Australians Understanding Income Protection Insurance: A Comprehensive Guide for Australians
Income protection insurance is an essential component of financial security for Australians, designed to provide a safety net by replacing a portion of your income if you're unable to work due to illness or injury. Despite its critical role in safeguarding livelihoods, it's often overlooked in personal financial planning. - read more
Dispelling the Myths: Why Income Protection is More Accessible Than You Think Dispelling the Myths: Why Income Protection is More Accessible Than You Think
Income protection insurance serves as a financial safety net, designed to support individuals in the event that they are unable to work due to illness or injury. The significance of this type of insurance lies in its ability to provide a continuation of income during tough times, ensuring that one's financial responsibilities are taken care of. - read more
Combining Financial Security and Affordability: Income Protection for Australians Explained Combining Financial Security and Affordability: Income Protection for Australians Explained
Financial security is a cornerstone of peace of mind, particularly when life is known for its unpredictability. This introductory section sheds light on the vital nature of income protection insurance and its role in safeguarding Australians' financial well-being. Ensuring continual financial inflow during times of illness or injury not only offers stability but also protects one's standard of living. - read more
How Illness Can Impact Your Financial Stability: The Role of Income Protection How Illness Can Impact Your Financial Stability: The Role of Income Protection
Life is unpredictable, and unforeseen health issues can strike at any time, profoundly impacting your financial well-being. An unexpected illness can bring not only physical pain but also financial strain as medical bills pile up and the capacity to generate income diminishes. - read more

Start Here !
income insurance protection

Start Here

Monthly Income Benefit:
Postcode:

All quotes are provided free and without obligation. We respect your privacy.

Knowledgebase
Liability Insurance:
A type of insurance that provides protection against claims resulting from injuries and damage to people and/or property.