Rising Specialist Fees: Implications for Private Health Insurance Policyholders

Understanding the Impact of Increased Specialist Charges on Healthcare Costs

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Private Healthcare Australia has released a report highlighting a 22% increase in specialist fees for in-hospital care over the past three years, resulting in higher out-of-pocket expenses for patients.

The median hospital out-of-pocket cost is now $270.

The report also found that more than half of the surveyed patients received medical bills larger than expected, with some delaying or canceling necessary care due to costs. Rachel David, CEO of Private Healthcare Australia, emphasized the need for greater consumer protections and more assistance for GPs to help patients find specialists with competitive fees.

In response, the Australian Medical Association (AMA) has called for urgent reforms in the private health insurance sector to address these rising costs and ensure patients receive value for their premiums.

Published:Friday, 3rd Apr 2026
Author: Paige Estritori

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