Premium review

Premium changes come into effect from first payments on or after 1 April 2025.

GMHBA is working hard to provide members with their 2025 premium review notice as soon as possible, ahead of premium changes coming into effect on 1 April 2025.

Once it has been issued, you will be able to access a copy of your premium review notice by logging into your member area and viewing your recent interactions. You can also update your preferred contact method in your member area.

As is the case in most industries, healthcare costs are increasing year-on-year. Health funds must review their premiums and policies to ensure they remain sustainable and can meet the future claim obligations of all members in the fund.

Healthcare costs are driven by a number of factors, including:

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

As a health fund, we have a responsibility to address and react to these rising costs and prepare for the future, to ensure our members continue to get access to the care they require.

GMHBA is a member-based health fund and we continually try to put value back into our products for the benefit of all members.

Learn more about private health insurance premium increases.

In 2025, the average industry increase for health insurance premiums is 3.73%. GMHBA Limited’s average increase of 2.44% is below the industry average for the third year running.

The industry average is calculated using the figures from all health insurers in every state, across all products. That’s why the average increase of some funds, and the individual product-level premiums within a single fund, will be higher, while others will be lower.

Individual product-level premiums are impacted by:

• the amount and type of clinical categories and/or extras services covered, and
• the costs of paying benefits towards these services

The rebate amount you may be eligible to receive on your private health insurance policy is determined by income threshold.

The rebate percentages (rates) will be adjusted effective from 1 April 2025.

Your rebate tier and rebate amount – if you have chosen to receive this as a reduction on your premium – will be communicated in your 2025 premium review notice.

Learn more about rebate levels and income thresholds.

Premiums were last adjusted on 1 April 2024.

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

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 Australian Government Department of Health and Aged Care and the Australian Prudential Regulation Authority (APRA). The application is then sent to the Minister for Health and Aged Care. 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.

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 is also an active contributor in building the health and wellbeing of communities.

The best thing you can do is check you’re on the right level of cover. 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.

There are plenty of reasons to have private health insurance – think of it as an investment in your health. Private health insurance can offer:

• greater choice of provider or specialist
• peace of mind for members and their families
• benefits for services not generally covered by Medicare such as dental, physiotherapy and prescription glasses under extras policies – this can be a great way for members to proactively look after their health.