Report finds PHI vital in combatting pandemic’s ongoing effects & delivering mental health care

Private Healthcare Australia’s Annual High Claims Report released today, demonstrates the strong value of private health insurance for Australians, including many who needed care for COVID-19 and mental illness.

The report reveals health funds paid more than $7.7 billion for 379,991 ‘high claims’ for hospital care exceeding $10,000 in 2022.

PHA CEO Dr Rachel David said the report showed PHI was supporting many Australians to get high quality hospital care across treatment areas, especially mental health care which is difficult to access in the public system.

In 2022 (compared to the pre-pandemic period of 2019):

• High claims for mental health treatment for PHI members under 30 increased by 281 claims to 7,253 claims (4% increase), up $8.79M to $151.41M (6.2% increase).
• High claims for mental health treatment for young PHI members aged 15 to 24 increased by 244 claims to 4,803 claims (5.4% increase), up $5.1M to $98.67M (5.4% increase).
• For these young high claimants under 30, the average length of stay in hospital for their mental health treatment episode of care was around 26 days (almost a month’s stay in hospital).
• 72% of mental health treatment under 30s high claimants are females (2 percentage points increase from 2019).

Claims for COVID-19 treatment during 2022 have also increased significantly and continue to do so.

Since the start of the pandemic, there have been 7,504 COVID-19 confirmed hospitalisations funded by private health insurance (220 in 2020; 825 in 2021; 3,706 in 2022; 2,753 in 2022). The average member age with confirmed COVID-19 hospitalisation funded by private health insurance is 74 years old. The highest benefit paid for COVID-19 confirmed hospitalisation in 2022 was $238,462.

High claims where members were hospitalised and had Long COVID as well, totalled 560 (a 46 fold increase on the previous year). The average age was also 74 for these high claims. The highest benefit paid for hospitalisation in 2022 where a member had Long COVID as well, was $431,635.

The report can be viewed here.