Private Health Insurance Legislation Amendment Rules (No. 6) 2025
I, Brian Kelleher, delegate of the Minister for Health and Ageing, make the following Rules.
Dated 24 June 2025
Brian Kelleher
Assistant Secretary
Private Hospitals Branch
Health Systems Strategy Division
Strategy and First Nations Group
Department of Health, Disability and Ageing
2 Commencement
3 Authority
4 Schedules
Schedule 1—Amendments—Minimum accommodation benefits
Private Health Insurance (Benefit Requirements) Rules 2011
Schedule 2—Amendments—Nursing-home type patient contribution 6
Private Health Insurance (Complying Product) Rules 2015 6
Schedule 3—Amendments—Second-tier application fee 7
Private Health Insurance (Health Insurance Business) Rules 2018 7
This instrument is the Private Health Insurance Legislation Amendment Rules (No. 6) 2025.
Commencement information | ||
Column 1 | Column 2 | Column 3 |
Provisions | Commencement | Date/Details |
1. The whole of this instrument | 1 July 2025 | 1 July 2025 |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
This instrument is made under subsection 333-20(1) of the Private Health Insurance Act 2007.
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
1 Clause 2 of Schedule 1 (Table 1)
Repeal the table (including the heading), substitute:
Table 1‑Overnight accommodation for private patients at private hospitals in all States/Territories | |
Column 1 | Column 2 |
Class of patient | Minimum benefit payable per night |
Advanced surgical patient |
|
‑ first 14 days | $540 |
‑ over 14 days | $376 |
Surgical patient or obstetric patient |
|
‑ first 14 days | $501 |
‑ over 14 days | $376 |
Psychiatric patient |
|
‑ first 42 days | $501 |
‑ 43 – 65 days | $435 |
‑ over 65 days | $376 |
Rehabilitation patient |
|
‑ first 49 days | $501 |
‑ 50 ‑ 65 days | $435 |
‑ over 65 days | $376 |
Other patients |
|
‑ first 14 days | $435 |
‑ over 14 days | $376 |
2 Clause 2 of Schedule 1 (Table 2)
Repeal the table (including the heading), substitute:
Table 2‑Victoria‑overnight shared ward accommodation for private patients at public hospitals | |
Column 1 | Column 2 |
Class of patient | Minimum benefit payable per night |
Advanced surgical patient |
|
‑ first 14 days | $540 |
‑ over 14 days | $376 |
Surgical patient or obstetric patient |
|
‑ first 14 days | $501 |
‑ over 14 days | $376 |
Psychiatric patient |
|
‑ first 42 days | $501 |
‑ 43 – 65 days | $435 |
‑ over 65 days | $376 |
Rehabilitation patient |
|
‑ first 49 days | $501 |
‑ 50 ‑ 65 days | $435 |
‑ over 65 days | $376 |
Other patients |
|
‑ first 14 days | $435 |
‑ over 14 days | $376 |
3 Clause 2 of Schedule 1 (Table 3)
Repeal the table (including the heading), substitute:
Table 3‑Tasmania‑overnight shared ward accommodation for private patients at public hospitals | |
Column 1 | Column 2 |
Class of patient | Minimum benefit payable per night |
Advanced surgical patient |
|
‑ first 14 days | $540 |
‑ over 14 days | $376 |
Surgical patient or obstetric patient |
|
‑ first 14 days | $501 |
‑ over 14 days | $376 |
Psychiatric patient |
|
‑ first 42 days | $501 |
‑ 43 – 65 days | $435 |
‑ over 65 days | $376 |
Rehabilitation patient |
|
‑ first 49 days | $501 |
‑ 50 ‑ 65 days | $435 |
‑ over 65 days | $376 |
Other patients |
|
‑ first 14 days | $435 |
‑ over 14 days | $376 |
4 Clause 2 of Schedule 2 (Table 1)
Repeal the table (including the heading), substitute:
Table 1‑Overnight shared ward accommodation for private patients at public hospitals in the Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia and Western Australia | |
Column 1 | Column 2 |
State/Territory | Minimum benefit payable per night |
Australian Capital Territory | $446 |
New South Wales | $446 |
Northern Territory | $446 |
Queensland | $458 |
South Australia | $446 |
Western Australia | $446 |
5 Clause 2 of Schedule 3 (Table 1)
Repeal the table (including the heading), substitute:
Table 1‑Same day accommodation for private patients at public hospitals in all States/Territories | ||||
Column 1 | Column 2 | Column 3 | Column 4 | Column 5 |
Public hospitals | Band 1 | Band 2 | Band 3 | Band 4 |
New South Wales | $324 | $360 | $398 | $446 |
Australian Capital Territory | $324 | $360 | $398 | $446 |
Northern Territory | $324 | $372 | $428 | $446 |
Queensland | $330 | $374 | $409 | $458 |
South Australia | $324 | $372 | $408 | $446 |
Tasmania | $314 | $375 | $432 | $501 |
Victoria | $318 | $376 | $436 | $501 |
Western Australia | $368 | $368 | $368 | $368 |
6 Clause 2 of Schedule 3 (Table 2)
Repeal the table (including the heading), substitute:
Table 2‑ Same day accommodation for private patients at private hospitals in all States/Territories | ||||
Column 1 | Column 2 | Column 3 | Column 4 | Column 5 |
Private hospitals | Band 1 | Band 2 | Band 3 | Band 4 |
All States and Territories | $281 | $352 | $428 | $501 |
7 Clause 6 of Schedule 4 (Table 1, table item dealing with Australian Capital Territory, column headed “Minimum benefit per night”)
Omit “$147.45”, substitute “$152.25”.
8 Clause 6 of Schedule 4 (Table 1, table item dealing with South Australia, column headed “Minimum benefit per night”)
Omit “$146.00”, substitute “$150.00”.
1 Subrule 8A(3) (paragraph (a) of the definition of patient contribution)
Repeal the paragraph, substitute:
(i) Australian Capital Territory ‑ $78.95;
(ii) New South Wales ‑ $78.95;
(iii) Northern Territory ‑ $78.95;
(iv) Queensland ‑ $78.95;
(v) South Australia ‑ $78.95;
(vi) Tasmania ‑ $78.95;
(vii) Victoria ‑ $78.95; and
(viii) Western Australia ‑ $78.95.
1 Rule 7B
Repeal the subrule (not including the heading), substitute: