Each year, all private health funds review the cost of providing health cover. Premium changes are usually needed to make sure we can continue paying for members’ hospital and extras claims — both now and in the future.

The main reasons health cover premiums increase include:

• Rising healthcare costs – hospitals, medical devices, and specialist services all cost more each year.
• More claims being made – members are using more health services, especially post-pandemic.
• Advances in medical technology – new treatments improve outcomes but can be expensive.
• Higher wages and supplier costs – health professionals and service providers are also facing inflation.

HCi carefully analyses these pressures. Then, we only apply a change that’s needed to maintain sustainable cover for all members.

Who approves premium changes?

All private health fund premium changes must be approved by the Federal Minister for Health.  This includes an annual review and premium change process for all private health insurers, which generally take effect from 1 April.

Before approval, the Department of Health and the prudential regulator (APRA) assess each fund’s proposal to make sure increases are necessary and reasonable.

This means no health fund — including HCi — can raise premiums without government approval.

Does HCi profit directly from premium increases?

No, absolutely not – HCi is a profit-for-members health fund. We don’t have shareholders and we don’t pay dividends. Every dollar we receive is used to:

• pay members’ claims
• improve member services and systems
• build modest capital reserves so we can stay strong and continue supporting members into the future

If we ever generate a surplus, it goes straight back into the fund for the benefit of members — not investors.

Why is my premium change different from the reported “average”?

You might see news reports quoting an average industry-wide premium increase, but the premium changes to your own policy may be higher or lower.  That’s because several factors affect individual premiums, including:

• the type of cover you hold (Hospital, Extras, or combined)
• your state or territory of residence
• the people covered on your policy
• Government rebates and loadings that apply to you

Your premium notice outlines your specific change and when it starts. If you’d like to talk through your options, our team is here to help.

How does HCi keep premiums as low as possible?

We work hard to control costs without compromising member benefits by:

• negotiating fair prices with hospitals and healthcare providers
• operating efficiently* to keep administration costs low
• offering digital tools that reduce overhead expenses and streamline claims and payment processes
• regularly reviewing benefits to ensure value for money

Our goal is always to deliver the best possible cover at the lowest sustainable price.

What can I do to manage my premium?

Everyone’s needs are different, and it’s worth reviewing your cover regularly. So, you may want to:

• Review your cover level – make sure it still matches your health needs.
• Increase your excess – a higher excess can mean lower ongoing premiums.
• Combine Hospital and Extras – often more cost-effective than standalone policies.
• Claim your Australian Government Rebate – this can reduce what you pay.

You can make these changes or check your current options anytime via OMS, or speak with our friendly team for personalised advice.

How do HCi’s average premium changes compare to other health funds?

Each year, the Federal Government publishes the average premium change for all health funds.  A breakdown of the premium changes by each private health insurer in Australia can be viewed on the Government’s Health site.

HCi consistently performs well compared with larger national funds. We maintain competitive premiums and offer excellent member value because we focus on what matters most — helping members access affordable, reliable health cover when they need it.

Why should I stay with HCi?

We’ve been here for the long haul – since 1938 in fact. So we have the knowledge and experience to provide our members with choice in and access to high quality healthcare when they need it most.  HCi provides members with personalised service and access to a range of cover products and options, as well as additional health programs to make the most of your membership.

* If we have your email address, we can send you news and information more quickly. It also costs us less so we can keep our premiums as low as possible. You can give us your email address by calling us, using our policy changes form or logging into OMS.