APRA publishes statistics on the private health insurance industry (PHI) on a quarterly basis. The statistics provides industry aggregate summaries of key financial and membership statistics. Specific sets of statistics are also provided in the areas of membership, coverage, benefits paid, medical gap, prostheses, and medical services.
Media release: APRA releases quarterly private health insurance statistics for June 2023.
The highlights provide an overall view of industry performance and insights into observed trends.
The private health insurance quarterly statistics contains industry aggregate summaries of financial performance, as well as key metrics and observed trends in the areas of membership and coverage, benefits paid, service utilisation, and out-of-pocket payments.
Membership and benefits statistics
The membership and benefits statistics contains data on policies, benefits paid for services by age group and gender, number of services, and gap benefits, on a state and territory basis.
Membership and coverage statistics
The membership and coverage statistics contains data on the number of insured persons for hospital and general treatment, and the proportion of the population these persons represent, on a state and territory basis.
The medical gap statistics contains data on in-hospital medical services, on a state and territory basis.
The prostheses statistics contains data on prosthetic benefits paid, grouped by the major prosthetic categories, on a state and territory basis.
Medical services statistics
The medical services statistics contains data on benefits paid and gap payments, grouped by the major speciality blocks, on a state and territory basis
Statistical trends in membership and benefits
The statistical trends reports detail historical trends in the number of insured persons and benefits paid for hospital and general treatment.
Next release date
22 November 2023 (September 2023 edition) – Statistical publications on membership, coverage, benefits paid, medical gap, prostheses and medical services only.
Information regarding a break in the September edition of the Quarterly Private Health Insurance Statistics can be found here.