‘No plans’ to allow private health cover of GP care

Calls for the Federal Government to scrap a ban on private health insurers subsidising GP visits have been shut down by the Health and Aged Care Minister.
 
The calls came in response to Monday’s release of the 2025 Cleanbill survey, which found patients are facing increased out-of-pocket costs and lower bulk-billing rates when visiting their GP.
 
Currently, under Australian law, private health insurance cannot offer cover for out-of-hospital medical services, including GP visits, because they can be covered by Medicare.
 
This comes at a time when the number of Australians signing up for private health insurance cover continues to rise.
 
As of 30 September 2024, 54.7% of the population had some form of general treatment cover, up 2.3% in just one year.
 
Matthew Koce, Chief Executive of Members Health, the body representing not-for-profit health funds, said there must be an immediate end to the ban to help cover GP costs, saying it is ‘long passed its used by date’.
 
‘GPs underpin the health system. They are fundamental to good population health. Putting off a trip to the GP due to expensive out-of-pocket costs can have very serious consequences,’ he said.
 
‘It makes no sense that health insurance funds can help cover the cost of dental, optical and physio appointments but not something as important as a trip to the GP.
 
‘It will help make a trip to the GP more accessible for more Australians, deliver better health outcomes and combat rising cost-of-living pressures.’
 
However, Federal Health and Aged Care Minister Mark Butler said, ‘we have no plans currently’ to end the ban on insurers covering GP visits.

‘There’s been a very long-standing position in Australia not to create the possibility of a two-tier system in basic general practice and access to basic primary care,’ he said.
 
‘That’s been a very important part of the Medicare principles that have delivered such a high-quality healthcare system that’s ranked among the best in the world.
 
‘That would be a very, very significant change to the way in which Medicare operates.’
 
Last year, private health insurer Bupa began offering more than two million of its customers access to free telehealth consults per year through its digital health platform, Blua, labelling it a ‘cost-of-living health measure’.
 
However, this could only be done because while Medicare benefits are available for video and phone telehealth services provided by GPs, telehealth items can only be used for patients they have an existing relationship with, or who have visited the practice for a face-to-face service in the last year.
 
‘I also understand that some of our big private health insurers are doing some really innovative work to improve the access that their members have to, not just primary healthcare, but also prevention as well,’ Minister Butler said.
 
‘I encourage them to continue doing that.’
 
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