Compare health insurance in Australia
Compare hospital, extras and combined private health insurance policies from Australian funds on what they cover, the excess, waiting periods and extras limits, then start a free quote. Like for like means tier first: every hospital policy is Basic, Bronze, Silver or Gold, and every policy has a government-format Private Health Information Statement you can check line by line.
By Better Rate Mate Editorial Team · Last reviewed
Free, with no obligation. We don't compare every provider or every policy.How we're paid
Start with the cover you need
Or start with who it's for
4 tiers
Basic, Bronze, Silver, Gold
38
Clinical categories
12 months
Longest hospital wait
1 April
When premiums change
How to compare health insurance like for like
Health funds name their products differently, bundle them differently and advertise different features, which makes headline prices close to meaningless. The government standardised the parts that matter in 2019 and 2020. Use them in this order.
- 1Decide what you need coveredList the hospital treatments that matter to you in the next few years (joint surgery, pregnancy, cataracts, heart) and the extras you actually use. That list, not the fund's brand, decides the tier and the extras package.
- 2Shortlist by tier, then by clinical categoryPick the lowest tier that guarantees your categories: Basic, Bronze, Silver or Gold. Then check each 'Plus' policy's category list, because Plus products add categories above the tier minimum and differ between funds.
- 3Read the Private Health Information StatementEvery policy has a PHIS in a standard government format showing covered, restricted and excluded categories, waiting periods, excess and co-payments, and extras limits with example benefits. Compare PHIS to PHIS, not ad to ad.
- 4Compare the out-of-pocket settingsTwo policies at the same tier can differ in excess (per person or per policy), co-payments, restrictions on psychiatric and rehabilitation care, and gap-cover arrangements with doctors. These decide what a hospital stay actually costs you.
- 5Then compare priceOnce the cover is genuinely equivalent, price is a fair tie-breaker. Premiums are community rated, so the same policy costs the same for everyone in your state, apart from Lifetime Health Cover loading and the under-30 discount.
The PHIS comes in three versions: hospital, general treatment (extras) and combined. Insurers must send you one at least once a year and whenever your policy changes, and privatehealth.gov.au publishes the standard PHIS for every policy on the market. It is the closest thing to a neutral spec sheet the industry has.
Find cover for your situation
The rules change depending on who you are covering and what you need covered. Each of these guides goes into the detail, with the tables and sources behind it.
I'm looking for
- Singles CoverSingles health insurance: how to compare and choose cover for one person
- Couples CoverCouples health insurance: compare cover for two adults
- Family CoverFamily health insurance: compare private health cover for families
- Pregnancy CoverPregnancy health insurance: tiers and waiting periods
- Seniors CoverSeniors health insurance: cover for over 60s, 65s and 70s
- Under 30s CoverHealth insurance for under 30s and young adults
By cover type
- Hospital CoverHospital cover: compare Basic, Bronze, Silver and Gold
- Extras CoverExtras cover: compare limits, waiting periods and extras-only policies
- Hospital & ExtrasCombined hospital and extras cover compared
- Dental CoverDental health insurance: how dental cover works
- Ambulance CoverAmbulance cover by state: who is covered and who pays
Health insurance guides
Hospital, extras and ambulance: the types of health cover
Private health insurance comes in three types: hospital, general treatment (extras) and ambulance. Most funds also sell combined hospital and extras policies, and you can mix and match across funds.
Hospital cover
Covers: Treatment as a private patient in hospital: accommodation, theatre, and at least 25% of the MBS fee for in-hospital doctors (Medicare pays 75%). Sold as Basic, Bronze, Silver or Gold.
Suits: Choice of doctor and timing, avoiding the Medicare Levy Surcharge, and locking in no Lifetime Health Cover loading.
Extras (general treatment)
Covers: Out-of-hospital services Medicare does not cover: dental, optical, physio, chiro, podiatry, psychology, hearing aids, up to annual limits.
Suits: People whose yearly dental, optical and allied-health claims exceed the extras premium.
Combined hospital + extras
Covers: A hospital tier and an extras package in one policy. You can also hold them separately, even with two different funds.
Suits: Families and regular extras users who want one policy and one renewal.
Ambulance
Covers: Emergency ambulance transport and treatment. Medicare does not pay for ambulance services.
Suits: Residents of states where you can be billed. Queenslanders and most Tasmanian residents are already covered by their state.
Extras packages aren't standardised, so compare extras cover on the dollar benefit for the services you use rather than the headline limit. If you want both in one policy, see how hospital and extras cover works when the two are combined.
What none of them pays for: GP visits, specialist consultations in their rooms, and scans and tests outside hospital are Medicare's territory. And hospital cover does not remove every cost. Doctors can charge above the Medicare Benefits Schedule fee, and the difference, the "gap", is yours unless your fund has a gap-cover arrangement with that doctor.
The four hospital tiers: Basic, Bronze, Silver and Gold
Hospital treatment is grouped into 38 clinical categories, and since 1 April 2020 every hospital policy has been classified by the minimum set of categories it covers. If a policy covers a category it must cover everything in it. A policy that meets a tier and adds more categories can be sold as Basic Plus, Bronze Plus or Silver Plus, which is why two policies with the same tier name can cover different things.
Below Gold, rehabilitation, psychiatric and palliative care can be restricted, which means you are covered as a private patient in a public hospital but pay most of the accommodation cost in a private one.
| Tier | Must cover | Does not have to cover | Often chosen for |
|---|---|---|---|
| Basic | Rehabilitation, hospital psychiatric services and palliative care (3 categories, may be restricted) | The other 35 categories | Meeting the Medicare Levy Surcharge and Lifetime Health Cover rules at the lowest premium |
| Bronze | Basic's 3, plus 18 more: brain and nervous system, eye (not cataracts), ear nose and throat, tonsils and grommets, bone joint and muscle, joint reconstructions, kidney and bladder, male reproductive, digestive, hernia and appendix, endoscopy, gynaecology, miscarriage and termination, cancer chemotherapy and radiotherapy, pain management, skin, breast surgery, diabetes management | Heart, lung, back and spine, dental surgery and the Gold-only categories | Younger and active people wanting cover for common procedures and sports injuries |
| Silver | Bronze's 21, plus 8 more: heart and vascular, lung and chest, blood, back neck and spine, medically necessary plastic surgery, dental surgery, podiatric surgery, hearing device implants | Cataracts, joint replacements, dialysis, pregnancy and birth, IVF, weight loss surgery, insulin pumps, pain devices, sleep studies | Broader cover without paying for pregnancy and joint replacement |
| Gold | All 38 clinical categories, with rehab, psychiatric and palliative care unrestricted | Nothing in the category list | Pregnancy, IVF, joint replacements and cataracts, and people who want everything covered |
See every category tier by tier on our hospital cover comparison, and which tier covers birth on our pregnancy health insurance guide.
Health insurance brands
- Bupa
- GMHBA
- HBF
- HCF
- Latrobe Health
- nib
- See-U by HBF
We do not compare every provider or every product in the market, and not every product is available in every area. Availability can change.
What is the best health insurance in Australia?
The best health insurance is the policy that covers the clinical categories you are likely to need, at an excess you could pay tomorrow, with extras benefits that match what you really claim. That will be a different policy for a 26-year-old who plays rugby, a couple planning a baby and a retiree thinking about a knee replacement. Rankings of "best funds" usually reflect a scoring method, not your situation.
Things that do separate funds, once the cover is equivalent: which private hospitals they have agreements with near you, how many doctors use their gap-cover scheme, the size of their extras provider network, how they apply the excess on couples and family policies, how long adult children can stay as dependants, and whether they offer the under-30 discount. Our health fund reviewsset out how the major funds handle each of these.
Every fund selling hospital cover in Australia is a registered private health insurer and must follow the same tier rules, waiting-period limits and community rating. Fund size says little about value; check the policy, not the brand.
| What to compare | What it tells you | Industry result, 2024–25 | Where to check |
|---|---|---|---|
| Hospital agreements | Which private hospitals near you have a contract with the fund, which usually means lower or no out-of-pocket hospital costs there | The most any insurer had at 1 October 2026: 95 private hospitals in NSW, 73 in Victoria | Agreements for the five largest funds |
| No-gap rate | How often members had no out-of-pocket medical bill for in-hospital services | 87.1% of services had no gap | The five largest side by side |
| Complaints against market share | Whether a fund draws more or fewer Ombudsman complaints than its size predicts | 1.00 means complaints in proportion to size | Complaints by fund |
| Benefits paid as % of premiums | How much of the premium pool went back to members as claims | 84.5% | Every insurer's figures |
The largest health funds (largest, not best)
If you're asking who the biggest insurers are: in 2024–25 the five largest were Medibank (incl. ahm), Bupa, HCF (incl. RT Health), nib (incl. GU Health) and HBF (incl. see-u), with 82.5% of the market between them. Size alone tells you nothing about value or service.
| Insurer | Market share | Hospital policies (30 June 2025) | Structure | Its figures also cover |
|---|---|---|---|---|
| Medibank (incl. ahm) | 26.5% | 1,532,670 | Shareholder-owned company, for-profit | ahm |
| Bupa | 25.5% | 1,498,193 | For-profit, owned by BUPA Group International | Its own brand only |
| HCF (incl. RT Health) | 12.8% | 842,024 | Member-owned mutual, not-for-profit | RT Health |
| nib (incl. GU Health) | 9.8% | 627,626 | Shareholder-owned company, for-profit | GU Health, and policies sold as AAMI, Apia, ING, Qantas, Real, Seniors and Suncorp health insurance |
| HBF (incl. see-u) | 7.9% | 466,291 | Member-owned mutual, not-for-profit | see-u by HBF |
Compare health funds on every official measure, across all 33 insurers and brands listed on PrivateHealth.gov.au, or read our reviews ofMedibank,Bupa,HCF,nib andHBF.
How to get cheap health insurance without being underinsured
The cheapest policy is the one you do not have to claim on in a hurry and find wanting. These are the levers that lower the premium, roughly in order of impact, with the trade-off each one carries.
Pick the right tier, not the top tier
Gold covers all 38 categories. If you do not need pregnancy, joint replacement or cataract cover, Silver or a Bronze Plus policy that adds what you do need can cost considerably less.
Raise your hospital excess
A higher excess lowers the premium and costs you only if you are admitted. Keep it at or below $750 (singles) or $1,500 (couples and families) if the policy is also for the surcharge.
Use the under-30 discount
Funds may discount hospital premiums by 2% for each year you are under 30 when you join, up to 10% for ages 18 to 25, kept until 41. Ask which policies offer it.
Join before your Lifetime Health Cover base day
Holding hospital cover by the 1 July after your 31st birthday avoids a loading of 2% a year that can reach 70%.
Right-size your extras
Drop extras you do not claim, or choose a smaller package with better benefits on the services you use. Unused limits are usually lost each year.
Claim the rebate you are entitled to
Take it as a premium reduction or at tax time, and check it rises when the oldest person on the policy turns 65 and again at 70.
Pay ahead of 1 April
Funds apply annual premium changes from 1 April once approved by the Health Minister (the 2026 average was 4.41%). Paying in advance before then, where the fund allows, delays the increase.
Ask about other discounts
Funds may discount for paying by direct debit or payroll, for paying three or more months ahead, or through workplace and association groups.
Switch without losing your waits
Moving to another fund at the same or a lower level keeps the waits you have served. Compare at renewal rather than staying out of habit.
One lever to be careful with: restricted and excluded categories. A policy that looks cheap because it restricts psychiatric care or excludes back surgery is only cheap until you need that treatment. Upgrading later restarts the wait on the new categories, and for a pre-existing condition that can be 12 months.
Health insurance waiting periods
The law caps how long a fund can make you wait before claiming hospital benefits. Waits apply when you first join and to new or higher benefits when you upgrade, but not when you switch funds to the same or a lower level of cover. A pre-existing condition is anything you had signs or symptoms of in the six months before joining, whether or not it was diagnosed.
| Treatment | Maximum wait | Notes |
|---|---|---|
| Pre-existing conditions (other than the three below) | 12 months | Signs or symptoms in the 6 months before you joined or upgraded, judged by the insurer's appointed medical practitioner |
| Pregnancy and birth (obstetrics) | 12 months | The mother must have served the full wait before admission |
| Psychiatric care, rehabilitation, palliative care | 2 months | Applies even if the condition is pre-existing |
| All other hospital treatment | 2 months | Includes most new illnesses |
| Accidents after your cover starts | Usually none | privatehealth.gov.au says there is usually no wait for accident treatment; check your policy |
| Extras (general treatment) | Set by each insurer | Typically 2 to 6 months for general dental, optical and physio; 12 months or more for major items such as orthodontics and hearing aids |
More detail, including the once-in-a-lifetime mental health exemption, is in ourhealth insurance waiting periods guide.
Medicare Levy Surcharge, LHC loading and the rebate
Three government rules shape the price of health cover in Australia more than any fund's marketing. For many people above the surcharge threshold, a low-tier hospital policy costs less than the surcharge they would otherwise pay, which is why "cheapest hospital cover to avoid the Medicare Levy Surcharge" is such a common search.
| Rule | What it does | Key figures | Only hospital cover counts? |
|---|---|---|---|
| Medicare Levy Surcharge | Adds 1% to 1.5% of your income at tax time if you earn above the threshold without appropriate hospital cover | 2026–27 thresholds: $105,000 singles, $210,000 couples and families (+$1,500 per child after the first). Hospital excess must be no more than $750 singles or $1,500 couples and families | Yes |
| Lifetime Health Cover loading | Adds 2% to your hospital premium for each year you are over 30 when you first take hospital cover, counted from the 1 July after your 31st birthday | Capped at 70%; removed after 10 years of continuous hospital cover; 1,094 permitted days without cover over your lifetime | Yes (extras, OVHC and OSHC do not count) |
| Private health insurance rebate | Reduces your premium by a percentage based on income and the age of the oldest person on the policy | Four income tiers; higher percentages from age 65 and 70 (a bill before the Senate would remove these from 1 April 2027); percentages adjusted each 1 April | No: applies to hospital, extras and ambulance policies |
Switching health funds
You can move to another fund at any time. For cover at the same or a lower level, your new fund must recognise the waits you have already served; you serve waits only on new or higher benefits. Switching does not affect your Lifetime Health Cover status as long as you keep hospital cover.
- Keep the gap between policies short. There is no fixed legal window; some funds allow up to two months and others only a week before continuity is lost.
- Ask your old fund for a clearance (transfer) certificate. It must provide one within 14 days, and it carries your waiting-period and LHC history.
- Used extras limits may count against the new fund's limits, and loyalty benefits and accrued bonuses usually do not transfer.
- If you have paid ahead, your old fund should refund premiums paid in advance, less any small administration charge.
Health insurance FAQs
What is the best way to compare health insurance?
Private health insurance, sometimes called private medical insurance, comes as hospital, extras or ambulance cover. Decide which hospital clinical categories and extras you need, shortlist policies by tier, then compare each policy's Private Health Information Statement: covered and restricted categories, waiting periods, excess, and extras limits. Compare price only once the cover is equivalent. The government's privatehealth.gov.au lets you search every insurer's PHIS.
Who is the best private health insurer in Australia?
There is no single best insurer for everyone, and no official rating. The best policy is the one that covers the categories you need at an excess you can afford, from a fund whose hospital agreements and extras network suit where you live. Our health fund comparison sets out every insurer's official complaints, benefits and gap figures.
Which is the No. 1 health insurer in Australia?
By size, Medibank (including ahm) was the largest in 2024–25 with 26.5% of the market, just ahead of Bupa on 25.5%. HCF (including RT Health) was third on 12.8%, then nib and HBF. Largest isn't the same as best: see the five largest health funds side by side on every official measure.
What are the top 3 health insurance companies in Australia?
By market share in 2024–25, the three largest health insurers were Medibank (including ahm) with 26.5%, Bupa with 25.5% and HCF (including RT Health) with 12.8%; nib (including GU Health, 9.8%) and HBF (7.9%) complete the top five, on the Private Health Insurance Ombudsman's figures published on privatehealth.gov.au. Largest isn't the same as best: our big-fund match-ups set them side by side.
Is it better to have an excess (deductible) or not?
In Australian health insurance the deductible is called the excess. A higher excess lowers the premium, but you pay it when you're admitted to hospital, so it suits people who rarely go to hospital and could cover it. If you hold the policy to avoid the Medicare Levy Surcharge, the excess can't be more than $750 a year on a one-person policy or $1,500 on any other (ATO). Check whether it applies per person or per policy, and whether it's waived for children.
Which health insurer denies the most claims?
No official figure for denied claims is published. The closest official measures are each insurer's share of complaints to the Private Health Insurance Ombudsman, and of the complaints the Ombudsman investigates, set against its market share. We list both for every fund on our health fund comparison.
What is the cheapest health insurance in Australia?
The cheapest hospital policies are Basic and Bronze with a high excess, and the cheapest overall cover is hospital-only with no extras. Cheapest is not always best value: a Basic policy covers very little beyond restricted rehab, psychiatric and palliative care. We do not quote prices because funds change them every 1 April.
Is private health insurance worth it?
It is worth pricing if your income is above the Medicare Levy Surcharge threshold ($105,000 singles, $210,000 families in 2026–27), if you are approaching the 1 July after your 31st birthday, or if you value choosing your doctor and the timing of elective surgery. Emergency and public hospital care is available through Medicare either way.
What is the difference between hospital and extras cover?
Hospital cover pays towards treatment when you are admitted as a private patient and is standardised into four tiers. Extras cover pays towards services outside hospital, such as dental, optical and physio, and each fund designs its own packages and limits. Only hospital cover counts for the surcharge and Lifetime Health Cover.
Can a health fund refuse to cover me or charge me more because of my health?
No. Private health insurance is community rated: a registered insurer must sell you any policy at the same price as anyone else in your state, whatever your health or claims history. You may have to serve a waiting period of up to 12 months before claiming for a pre-existing condition.
When do health insurance premiums go up?
Usually on 1 April each year, after the Health Minister approves each fund's application. The government-approved average increase for 2026 was 4.41%, but individual policies can rise by more or less.
Do I have to serve waiting periods again if I switch funds?
No, for cover at the same or a lower level, as long as you move without a long break. You serve waits only on new or higher benefits. Ask your old fund for a clearance certificate, which it must provide within 14 days.
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