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AMA Calls for Urgent Reforms in Private Health Insurance Sector

Addressing the Declining Value and Rising Costs for Consumers

AMA Calls for Urgent Reforms in Private Health Insurance Sector?w=400

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

The Australian Medical Association (AMA) has released its annual Private Health Insurance Report Card, revealing that Australians are paying more for private health insurance while receiving less value.
The report indicates that premiums have risen sharply, outpacing inflation and wage growth, with nearly 70% of policies now containing exclusions that limit coverage.

AMA President Danielle McMullen highlighted that consumers are facing higher costs for narrower coverage, leading to questions about the value of private health insurance. The report also found that insurers returned about 84% of premiums to patients in 2024-25, despite large profit margins, suggesting that a significant portion of premiums is not being utilized for patient care.

In response, the AMA is advocating for mandatory requirements for insurers to return at least 90% of premiums to consumers in the form of treatment benefits. Additionally, the association calls for the establishment of an independent authority to oversee the health insurance sector and ensure that consumers receive fair value for their premiums.

For fitness professionals, these findings emphasize the importance of carefully evaluating private health insurance options to ensure adequate coverage for both personal health needs and professional liability. Staying informed about industry reforms and advocating for policies that enhance the value of health insurance can contribute to better outcomes for both practitioners and clients.

Published:Thursday, 26th Mar 2026
Author: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

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Coinsurance:
A percentage of the cost of a covered healthcare service that you pay after you have paid your deductible.