APRA publishes 2025 Private Health Insurance Coverage Survey
APRA released the Private Health Insurance Annual Coverage Survey for 2025 detailing hospital treatment cover by demographics.
The annual survey provides demographic breakdowns of insured populations at December 2025. Insurers should reflect updated coverage trends in risk equalisation, pricing assumptions and capital planning under LAGIC.
Coverage trends directly influence PHI underwriting, capital adequacy and product sustainability assessments.
Action Required
Update PHI portfolio analytics, pricing and capital models with the 2025 coverage data and reassess demographic concentration risk.
Key sector dataset for Australian private health insurers' risk and actuarial functions.
Actuarial to reconcile portfolio demographics with APRA 2025 survey; risk to review concentration and adverse selection indicators; update ORSA inputs where material.
“APRA has released its Private Health Insurance Annual Coverage Survey for 2025, providing a snapshot of people with hospital treatment cover by age, gender and state at December each year.”
Published: 2026-07-31