Premium review

Premium changes came into effect on 1 October 2023.

Learn more about why premiums are reviewed annually by health funds below.

Each year health insurers review the cost of healthcare and use this information to adjust premiums. These changes usually take place in April, but GMHBA froze premium increases until 1 October 2023 as part of our commitment to return COVID-19 savings to members.

Please read through the FAQ's below to answer any questions you may have.

Premium Review FAQs

Health insurance premiums are reviewed because healthcare costs increase year-on-year. Health funds review their cover each year to ensure they remain sustainable and can meet future claim obligations of all members in the fund.

Healthcare costs are driven by a number of factors outside of private health insurers' control, including:

  • Higher costs associated with new medical technologies and treatments
  • An ageing population requiring higher levels of care
  • Rates of chronic health conditions increasing

GMHBA’s 2023 average premium increase of 2.33% is our lowest in over 20 years.

Health funds are required to justify a premium increase by submitting an application to the Federal Government for approval. All applications to increase premiums are first assessed by The Department of Health and the Australian Prudential Regulation Authority (APRA). The application is then sent to the Minister for Health and Aged Care to consider if the increase is necessary. If a proposed premium increase is found to not be in the public interest, it won’t be approved.

Learn more about private health insurance premium increases.

The rebate amount you receive on your private health insurance policy from the Australian Government is determined by income threshold.

While the rebate percentage levels remain unchanged for 2023, the income thresholds that determine which tier you fall into changed from 1 July 2023. Learn more about rebate levels and income thresholds.

Being a not for profit health fund, every decision we make is to benefit our members and community, not shareholders. The premiums you pay go toward paying out member claims and the cost of running the business. GMHBA remains a not for profit, 100% member-based organisation and an active contributor in building the health and wellbeing of communities.

Premium changes come into effect from your first payment on or after 1 October 2023.  

The industry average is calculated using the figures from all health insurers in every state, across all products. That’s why increases in the premiums of some products will be higher, while others will be lower. 

In 2023, the industry average increase for health insurance premiums is 2.9%. GMHBA is delivering below this with an average increase of 2.33%.

All members in the same state/territory pay the same premium for the same policy. Private health insurers cannot discriminate against members based on health status, claims history or age. This is a government requirement called Community Rating. This system is intended to keep health insurance fair and accessible for all Australians. This is in contrast with other insurance industries that use risk rating, such as life insurance or car insurance.              

Learn more: Private Health Insurance Community Rating System

Check that you’re only paying for what you might need. Ask us for a cover review – we'll go over your cover with you to help you choose a cover suitable for your circumstances. We have a range of policies to suit a variety of budgets and needs. 

You can access a copy of your rate review communication by logging into your member area and viewing your most recent communications. You can also update your preferred contact method in your member area.

The most recent premium freeze occurred from 1 April – 30 September 2023. We've previously frozen premiums for six months in 2020 and 2022 as well.

COVID-19 lockdowns may have made it difficult for members to use their cover at times over the last few years. As a not for profit fund, we made the decision to put premium increases on hold for six months each time. This was a simple way to enable GMHBA to return value to members during a challenging time.

In the last financial year we returned funds to current, former and suspended members through the return of COVID-19 claims savings.

The past few years have demonstrated that quality healthcare is more important than ever. Private health insurance can offer: 

  • Greater choice of provider or specialist
  • Protection and peace of mind for members and their families
  • Cover for services not covered by Medicare such as dental, physiotherapy and glasses under extras policies
  • Access to extras benefits is a great way for people to proactively look after their health, such as making it easier to have annual dental check-ups.