Compare Australian health funds and health insurance companies

The five largest health funds

The five largest health funds in 2024-25 were Medibank (incl. ahm), Bupa, HCF (incl. RT Health), nib (incl. GU Health) and HBF (incl. see-u), which together held 82.5% of the market. Size says nothing about price or quality, and every fund must follow the same tier rules, waiting-period limits and community rating.

Here are the same five on every measure the Ombudsman publishes, with the industry result. Read across each row: a fund that is ahead on one measure can be behind on the next, and none of these figures is a price.

General advice only. This information doesn't take into account your objectives, financial situation or needs. Consider whether the product is right for you and read the Product Disclosure Statement (PDS) and Target Market Determination (TMD) before you decide. We don't compare every product in the market, and we may earn a commission if you take up a product through our links.

Bupa vs HCF, Bupa vs Medibank and the other big-fund match-ups

"Is Bupa or HCF better?" and "Bupa or Medibank?" are among the most common health insurance questions. Neither fund is better on every measure, so here is each pairing of the five largest on the official 2024-25 figures, with a one-line summary of who had the stronger figure on what. As for which is cheaper: neither is cheaper across the board. Premiums depend on the policy, tier, excess and state and change each 1 April, so compare like-for-like policies on privatehealth.gov.au.

• Bupa vs HBF
• Bupa vs HCF
• Bupa vs Medibank
• Bupa vs nib
• HBF vs HCF
• HBF vs Medibank
• HBF vs nib
• HCF vs Medibank
• HCF vs nib
• Medibank vs nib

Is there a best health fund? What the official data can show

No official body ranks health funds, and we don't either. What the official data can do is show how funds compare on the things that affect members, so you can rule funds in or out before comparing their policies. These are the measures, and where each one is on this page:

• Complaints against market share: whether a fund draws more or fewer Ombudsman complaints than its size predicts (complaints table).
• Investigated complaints: the share of complaints the Ombudsman couldn't resolve by referring back to the fund.
• No-gap rate: how often members had no out-of-pocket medical bill for in-hospital services (industry 87.1%).
• Hospital agreements in your state, which usually mean lower or no hospital out-of-pocket costs. In Tasmania, see private health insurance in Tasmania for every fund's agreements.
• Benefits paid as a share of premiums (industry 84.5%), and member retention (industry 85.0%).

A fund that's ahead on one measure is often behind on another, and none of them is a price. The best policy for you is the one that covers the clinical categories you need, at an excess you can afford, from a fund that passes these checks, at the lowest premium after the rebate.

Every registered health insurer

Sorted by market share. Where two names share a registered insurer (Medibank and ahm, nib and GU Health, HCF and RT Health, HBF and see-u), they share one set of figures. Fund names link to our full review where we've written one.

Fund reviews

Each review covers who owns the fund, who can join, the hospital tiers it sells now (from the Government's product data at 1 September 2026), its ambulance and age-based discount arrangements, and its full performance table against the industry.

Complaints against market share

The raw number of complaints mostly tells you how big a fund is. What matters is whether a fund draws more or fewer complaints than its size would predict. Dividing each insurer's share of Ombudsman complaints by its market share gives a like-for-like figure: 1.00 is exactly proportional.

In 2024-25 Defence Health stood out: 10.3% of all complaints on a 1.9% market share. HBF, GMHBA and Teachers Health drew noticeably fewer complaints than their size. A single year can be distorted by one event, such as a systems change or a policy dispute, so read the Ombudsman's State of the Health Funds report for what the complaints were about.

Open funds and restricted funds

An open fund sells to anyone. A restricted fund can only accept people from a defined group, usually an employer, profession or union, together with their families. Restricted funds tend to have loyal memberships: Teachers Health, CBHS and Defence Health all kept more than 90% of their hospital members in 2024-25, against an industry result of 85.0%. Eligibility is often wider than the name suggests, so check before assuming you can't join.

Some open funds are regional mutuals with deep roots in one state but members everywhere: St Lukes Health in Launceston, Latrobe Health Services in Victoria's Latrobe Valley and HBF in Perth.

For-profit and not-for-profit funds

For-profit insurers, including the two largest, Medibank and Bupa, can pay profits to shareholders or a parent company. Not-for-profit funds, most of them member-owned mutuals, keep any surplus in the fund. That doesn't make a not-for-profit fund cheaper or better by default: premiums, benefits and service vary within both groups. What the structure changes is where surpluses go.

On the Ombudsman's benefits measure, the highest share of premiums paid back as benefits among insurers with at least 0.5% of the market in 2024-25 was Police Health (94.0%), followed by AIA Health (90.4%) and Teachers Health (90.3%), against an industry result of 84.5%.

Brands and the insurers behind them

Many health insurance names you see advertised are brands of a larger insurer. Your policy, fund rules and complaints process belong to the insurer, not the brand.

What this data can't tell you

None of these figures is a price. Two funds with identical complaint and benefits records can charge very differently for the same hospital tier, and a fund with an average record can still have the best policy for you. Use this page to shortlist and to rule out funds you're uneasy about, then compare policies on what they cover, the excess, waiting periods and price. Our guides to hospital cover tiers, the government rebate, the Medicare Levy Surcharge and Lifetime Health Cover loading explain the rules that apply whichever fund you choose.

Now compare policies

Fund data helps you shortlist. The decision is about the policy: which hospital clinical categories it covers, the excess, the waiting periods, the extras limits and the price. Take your shortlist to:

• our guide to compare health insurance policies like for like, tier first and then the Private Health Information Statement;
• cover for your situation: singles health insurance, health insurance for couples or family health insurance;
• the rules that apply whichever fund you pick: the Medicare Levy Surcharge calculator and the Lifetime Health Cover loading calculator.

Frequently asked questions

General advice only. It doesn't consider your circumstances. Read the PDS and TMD before you decide.