The Australian Government Rebate (AGR) on private health insurance

The Australian Government Rebate helps make private health insurance more affordable by covering part of the cost of your premium. If you’re eligible, you’ll receive this rebate as a discount on your premium. Whether you qualify depends on factors like your income, age and the type of private health insurance policy you have. From 1 April 2026, the Government is reducing the rebate. This means the amount the Government contributes will decrease and this will impact your premium as a result. Find out more on how the rebate works or how you can update your AGR .

Why does the premium increase I've seen reported in the media look different to my own increase?

Premium changes aren’t the same for everyone because each policy is different. A few things can influence how much a premium goes up, including: The type of cover you hold - different products and levels of cover experience different claim costs over time. How your specific policy has performed - if the cost of claims for your particular product has risen more than others, that can affect your premium differently. Government changes - adjustments to things like the Australian Government Rebate or Lifetime Health Cover loading can also impact individuals differently. We never increase premiums lightly. Our goal is always to keep health cover sustainable so we can continue paying claims when our members need us most.

What change is being made to pharmaceutical benefits claiming from 1 May 2026 and why?

From 1 May 2026, claims for Australian Register of Therapeutic Goods (ARTG) approved weight management medication (including GLP‑1 medicines) will continue to be covered, but we are introducing a new sub-limit of $150 per person, per year to some nib Extras products. Learn more about these changes .

Why is my product name being updated?

nib members on Safeguard - Basic Plus, Basic Plus, Essentials Plus Pregnancy - Basic Plus and Bodyguard - Basic Plus products will be impacted by adjustments to their product tier classification, to align coverage levels with regulatory compliance. To ensure consistency with government-defined tier standards, we will be updating the name of these products from 1 May 2026. This is a name correction only and has not impacted your new premium. Your hospital benefits and entitlements are correct and will remain the same. Find out more about private health insurance tiers .

What is a Private Health Information Statement (PHIS)?

The Private Health Information Statement (PHIS) included with your communications is a document that we are required to supply by the Australian Government. It is intended to give you information about your cover, including things like premiums and cover inclusions. It shows generic information about the cover that you have chosen. Please note, the price on the PHIS is before any rebate, loading or discount is applied. For the specific details regarding your premiums and policy information, please refer to your Policy Statement, also included in your communications. For more information about the PHIS, visit Privatehealth.gov.au . Find out more about why you should review your Private Health Insurance .

Premium Price Changes

Your health cover premium is changing on 1 April 2026

Every year, private health insurers across Australia review their premiums and can submit changes for approval to the Federal Minister for Health, Aged Care and Disability. To make sure we can continue to meet your health needs, we’ve carefully considered how to balance the increasing costs of healthcare and rising claim volumes, whilst continuing to provide ongoing value to our members.

Find out more about the reasons for this change.

Why are premiums increasing?

We understand that premium increases can be challenging. Please know that we’re committed to keeping increases as low as possible, while carefully managing the rising cost of healthcare in Australia and continuing to look for ways to deliver even greater value for our members.

Rising hospital care costs

We pay private hospitals for the care our members receive, including accommodation, theatre time, nursing care and other services. The costs that private hospitals charge health insurers have continued to rise due to higher staffing, infrastructure and operating expenses. As a result, the amount we pay for the same treatments is higher than in previous years.

Healthcare costs continue to grow nationwide

Across the healthcare system, the cost of providing care is increasing. Doctors, specialists, diagnostic services and medical suppliers are facing higher wages, technology and supply costs. These increases are happening across Australia’s entire healthcare sector, which means insurers are paying more for medical services overall.

Increased claims from our members

As access to healthcare returns to normal after disruptions over the previous years (such as COVID-19 lockdowns, postponed surgeries and reduced hospital visits) more of our members are getting the care they need. This includes hospital admissions, procedures and ongoing treatments. While it’s positive that members are using their cover, the higher number of claims increases the total benefits we pay each year.

How can I reduce my premium?

We know that rising costs can make budgeting tougher, but there are a few simple ways to adjust your premium while still getting value from your cover.

Not every option will be available for everyone, but we’re here to help you explore what works best for your situation.

Head to your member account to:

Lock in your premium

If you pay your premium up to 13 months in advance, you can keep your current payment rate – unless there’s a change to your policy. Pay before 1 April 2026 to lock in your current price before rates increase.

Log in to make a one-off payment

Review your policy

It's a good idea to regularly review your policy to make sure you're not paying for things you don’t need. You can also consider increasing your hospital excess to lower your premium.

Log in to manage your policy

Maximise your discounts

If you’re under 30, you may be eligible for an age-based discount of up to 10% on your Hospital cover premium, which can be retained until age 41.¹ Setting up direct debit payments could also save on your premium.

Log in to manage payments

You can also contact us or read our guide to check if you’re eligible for financial suspension.

Frequently asked questions

Here are all the ways we help you save

Make the most from your cover

Your cover comes with a range of tools, discounts and benefits designed to help you get the most value from your nib membership.

Visit our partnered providers

Our First Choice network brings together dental, optical, physiotherapy, mental health and hearing services that offer No gap options and agreed rates, helping to lower your out of pocket costs.²

Reduce your hospital costs

With a large network of MediGap-registered specialists, you could benefit from reduced or eliminated 'gap' costs for in-patient treatments nationwide including anesthesia, general practice, obstetrics and gynaecology, paediatrics and child health, surgery, ophthalmology and psychiatry.³

Manage your health from the comfort of home

Access telehealth consultations from hub.health and if recommended, medical certificates or treatments delivered to your door.⁴

Access free health and wellbeing tools

Explore a range of health and wellbeing resources to help you lead your healthiest life. Access personalised health insights with our free online skin or health check in the nib App.

Use our Health Management Programs

We offer eligible members access to a range of programs at no additional costs to suit your needs – whether it's to help get you in shape, keep you out of hospital, improve your physical and mental wellbeing or to aid a quicker recovery after you've been in hospital.

Why private health insurance is worth keeping

You could pay less at tax time

Having hospital cover can help you avoid the Medicare Levy Surcharge (MLS) if you earn above a certain threshold. Plus, private health insurance lets you access the Australian Government Rebate (AGR), making your cover more affordable.

Skip long public hospital wait lists

Our Hospital cover gives you more control over your care, letting you choose your doctor, your hospital and the timing of your treatment, so you get the care you need, when it suits you.

Save on everyday health

Our Extras cover helps you stay on top of your day-to-day health and wellbeing with cost savings on services such as dental check-ups, physio sessions and optical care.

Be prepared for the unexpected

The last thing you’ll want to worry about during an emergency is paying for the cost of an ambulance. Depending on the state where you live, our covers give you access to unlimited emergency ambulance cover, so you’re protected when you need it most.

How we made a difference in the 2025 Financial Year (FY25)

We’ve been focused on supporting our members and helping you get the most out of your health cover. Here’s a snapshot of how we’ve helped you access healthcare in FY25.

Key statistics from Financial Year 25

Through nib’s First Choice network, members saved $44 million in out of pocket costs on dental*, $33 million in out of pocket costs on optical* and $1.5 million in out of pocket costs on physio**
The highest individual claim nib paid in FY25 was $259,929^
nib paid on average $3,774 per hospital admission^
22,382 members enrolled in a Health Management Program and were supported to improve their wellbeing, minimise future health risks or recover quicker after a hospital admission. Find a program.
Over 89,000 members undertook a health assessment or used a screening program to better understand their health.

We’re here to help

We’re committed to being here for you, offering guidance and support at every step of your journey towards better health and wellbeing.

Contact us

Disclaimers

¹Eligible members must be aged 18-29 and not a dependant under the policy. Discount calculated at 2% for each year an eligible member is aged under 30, to a maximum of 10% for 18 to 25 year olds. Read more.

²No gap options are available through partner providers on our nib First Choice network and include a range of services such preventative dental, initial consultations and gap free optical and hearing packages. For full terms and conditions, visit our website https://www.nib.com.au/first-choice-network

³Coverage may differ depending on your level of cover and policy exclusions, waiting periods, hospital excess and limits and whether you go to an nib Agreement Hospital, a non-agreement private hospital or a public hospital. Out of pocket expenses may apply.

⁴ The provision of treatments is not guaranteed. It will be based on the information you provide during your consultation and whether the GP deems it to be appropriate for the care of your condition(s).

⁵ nib Travel Insurance Distribution Pty Limited, ABN 40 129 262 175, AR 336467 is an authorised representative of nib Travel Services (Australia) Pty Ltd (nib), ABN 81 115 932 173, AFSL 308461 and act as nib's agent and not as your agent. This is general advice only. Before you buy, you should consider your needs, the Product Disclosure Statement (PDS), Financial Services Guide (FSG) and Target Market Determination (TMD) available from us. This insurance is underwritten by Pacific International Insurance Pty Ltd, ABN 83 169 311 193.

⁶ Eligible nib members are entitled to a 10% discount on nib Life Insurance premiums, which remains in place for the duration of the cover. nib members are current nib Health members (excluding international members), current Free members or an nib Travel policyholder with an unexpired policy. Eligibility is subject to age, residency and NobleOak's underwriting requirements from time to time. This offer applies only to new customers who take out a quote and purchase nib Life Insurance policies. The terms of this offer may change at any time. This offer may be revoked at any time.

*Dental and Physio figures are based on the average out of pocket costs per service at non-network providers compared to the average out of pocket costs per service at network providers and the number of network services we have paid in the full financial year 1 July 2024 - 30 June 2025.

**Optical figure is based on the average out of pocket costs at non-network providers compared to the average out of pocket costs at network providers and the number of customers who have used a network provider in the full financial year 1 July 2024 - 30 June 2025.

^Figures are general claims statistics taken for the full financial year July 1 2024 – June 30 2025 for nib Health Insurance, including nib Corporate Private Health Insurance, Real Health Insurance, Australian Seniors Health Insurance, GU Health Insurance, Qantas Health Insurance, AAMI Health Insurance, APIA Health Insurance, Suncorp Health Insurance, Priceline Health Insurance, ING Health Insurance.