What are the Prostheses List Benefit Reductions?

Prostheses List benefit reductions

Reductions in minimum benefits for prostheses paid by all private health insurers in Australia commenced on 1 February 2018 saving Members $1.1 billion over four years

What does this mean?

Minimum benefits payable for almost all medical devices listed on the Prostheses List were reduced on 1 February 2018 (reductions vary by category).The 2018 round of benefit reductions has saved private health insurers $188 million on prostheses expenditure in the 2018 premium year and further reductions to some device benefits will also occur on 1 February 2019 and 1 February 2020

Expenditure on prostheses accounts for 14% of private health insurance hospital benefits paid annually. Evidence suggests that Prostheses List benefits are generally inflated when compared to the equivalent prices paid for devices in the public sector. By reducing prostheses expenditure this places downward pressure on premium increases.

Who will benefit?

Members will benefit from lower private health insurance premium changes, whilst private health insurers will also benefit from reduced expenditure on prostheses, passing these savings onto our Members.

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