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Australian health funds compared

PrivateHealth.gov.au lists 33 health insurers and insurer brands in Australia. 24 are open to anyone and 9 are restricted to a particular workforce or community; 24 operate on a not-for-profit basis. This page lists every one of them with the official data that separates them: their share of complaints to the Ombudsman against their share of the market, and how much of their premium income they paid back as benefits.

The figures are the 2024–25 results the Private Health Insurance Ombudsman publishes and PrivateHealth.gov.au republishes for each insurer, plus APRA's membership data at 30 June 2025. We don't rate funds or take payment for placement.

By Better Rate Mate Editorial Team · Data checked

33

insurers and brands listed

9

restricted funds

24

not-for-profit

6.13m

hospital policies, 30 June 2025

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.

Australian health insurers, 2024–25 performance data
InsurerMembershipStructureComplaints shareMarket shareBenefits as % of premiums
ahmOpenFor-profit, owned by Medibank23.9%26.5%85.6%
MedibankOpenShareholder-owned company, for-profit23.9%26.5%85.6%
BupaOpenFor-profit, owned by BUPA Group International25.2%25.5%82.4%
HCFOpenMember-owned mutual, not-for-profit12.1%12.8%87.8%
RT HealthOpenMember-owned mutual, not-for-profit12.1%12.8%87.8%
GU HealthOpenFor-profit, owned by nib9.6%9.8%82.0%
nibOpenShareholder-owned company, for-profit9.6%9.8%82.0%
HBFOpenMember-owned mutual, not-for-profit4.4%7.9%82.2%
see-u by HBFOpenNot-for-profit4.4%7.9%82.2%
Teachers HealthRestrictedMember-owned mutual, not-for-profit2.2%2.6%90.3%
Australian UnityOpenFor-profit2.7%2.1%81.6%
GMHBAOpenMember-owned mutual, not-for-profit1.8%2.1%81.9%
Defence HealthRestrictedMember-owned mutual, not-for-profit10.3%1.9%85.1%
CBHS Health FundRestrictedMember-owned mutual, not-for-profit1.8%1.4%86.8%
WestfundOpenMember-owned mutual, not-for-profit0.6%0.9%83.1%
Latrobe Health ServicesOpenMember-owned mutual, not-for-profit0.5%0.7%82.9%
Doctors' Health FundRestrictedFor-profit, owned by the Avant Mutual Group0.4%0.6%84.4%
Health PartnersOpenMember-owned mutual, not-for-profit0.3%0.6%87.2%
HIFOpenMember-owned mutual, not-for-profit0.4%0.6%82.0%
Police HealthRestrictedMember-owned mutual, not-for-profit0.5%0.6%94.0%
St Lukes HealthOpenMember-owned mutual, not-for-profit0.2%0.6%84.8%
TUH Health FundRestrictedMember-owned mutual, not-for-profit0.2%0.6%84.8%
AIA HealthOpenFor-profit1.6%0.5%90.4%
PeoplecareOpenMember-owned mutual, not-for-profit0.5%0.5%84.0%
Navy HealthRestrictedMember-owned mutual, not-for-profit0.4%0.4%83.3%
Mildura Health FundOpenMember-owned mutual, not-for-profit0.1%0.3%79.5%
Phoenix Health FundOpenMember-owned mutual, not-for-profit0.2%0.2%87.0%
ACA HealthRestrictedMember-owned mutual, not-for-profit0.1%0.1%83.0%
HCi (Health Care Insurance)OpenMember-owned mutual, not-for-profit0.1%0.1%85.4%
onemedifundOpenFor-profit0.0%0.1%75.4%
CDH Benefits FundOpenMember-owned mutual, not-for-profit0.0%<0.1%78.2%
Reserve Bank Health SocietyRestrictedMember-owned mutual, not-for-profitNot published<0.1%80.2%
Queensland Country Health FundOpenNot-for-profitNot publishedNot publishedNot published
Industry result for benefits as % of premiums: 84.5%. "<0.1%" means the Ombudsman reports a market share below 0.1%. Queensland Country Health Fund, now part of HBF, has no comparable 2024–25 figures published. Source: PrivateHealth.gov.au insurer profiles, checked 28 September 2026.

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.

Bupa reviewFor-profit, open to all. Complaints in line with its 25.5% market share.Medibank reviewFor-profit, open to all. Largest by hospital policies; lowest expense ratio, below-average no-gap rate.ahm reviewMedibank's online brand. Every tier from Basic to Gold; $500 or $750 excess only.HCF reviewLargest not-for-profit. 87.8% of premiums paid as benefits; high share of investigated complaints.nib reviewFor-profit; also sells as Qantas, AAMI, Apia, ING and Suncorp. High extras payout, low retention.HBF reviewPerth-based mutual. Complaints well under its 7.9% share; strong no-gap rate.Australian Unity reviewFor-profit insurer in a mutual group. Good no-gap rate; complaints above its share.GMHBA reviewGeelong-based mutual that also sells Frank. Low complaints; weaker retention.Frank reviewGMHBA's online brand. Basic to Silver Plus only, $750 excess, age-based discount.Latrobe Health Services reviewGippsland mutual (also Federation Health). Few complaints; lowest retention of the funds we review.St Lukes Health reviewLaunceston mutual (also Astute). Complaints a third of its share; no ambulance in hospital policies.Defence Health reviewRestricted to the Defence community. High retention, but complaints five times its share.Teachers Health reviewRestricted to the education community. 90.3% of premiums paid as benefits, 91.8% retention.CBHS Health Fund reviewRestricted to the CBA Group community. 86.8% of premiums paid as benefits, 91.1% retention.GU Health reviewnib's corporate specialist. Gold-heavy range, reported within nib's figures.

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.

Complaints compared with market share, insurers with 1% or more of the market (2024–25)
InsurerShare of Ombudsman complaintsMarket shareComplaints ÷ market share
HBF (incl. see-u)4.4%7.9%0.56
Teachers Health2.2%2.6%0.85
GMHBA1.8%2.1%0.86
ahm23.9%26.5%0.90
HCF (incl. RT Health)12.1%12.8%0.95
GU Health9.6%9.8%0.98
Bupa25.2%25.5%0.99
Australian Unity2.7%2.1%1.29
CBHS Health Fund1.8%1.4%1.29
Defence Health10.3%1.9%5.42
Below 1.00 means fewer complaints than the insurer's size would predict; above 1.00, more. Source: each insurer's PrivateHealth.gov.au profile (Private Health Insurance Ombudsman data, 2024–25), checked 28 September 2026. Ratio calculated by Better Rate Mate.

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.

Restricted health funds and who can join
FundEligibility (summary)
ACA HealthSeventh-day Adventist Church employees, Local Church Officers and their families.
CBHS Health Fundcurrent and past employees of Commonwealth Bank Group, franchisees, contractors, and their families.
Defence Healthcurrent or former members of the ADF and the Defence community and their families.
Doctors' Health FundMedical and allied health professionals, their families, medical students and AMA employees.
Navy HealthCover for the ADF community - serving, ex-serving ADF, employees of contractors to ADF and families.
Police HealthMembers of Australia’s police community, and their families.
Reserve Bank Health SocietyCurrent & former employees of the Reserve Bank.
Teachers Healtheducation union members and their families
TUH Health Fundcurrent or former union members and their families.
Family members of eligible people can usually join too. Source: PrivateHealth.gov.au, Restricted insurers.

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.

Health insurance brands and the insurer behind them
BrandInsurerInsurer structure
Qantas Insurance, AAMI, Apia, ING, Suncorp, Real, Seniors Health Insurance, GU Healthnib Health Funds LtdFor-profit, shareholder-owned
ahmMedibank Private LimitedFor-profit, shareholder-owned
Frank Health InsuranceGMHBA LimitedNot-for-profit mutual
see-u by HBF, Queensland Country Health FundHBF Health LimitedNot-for-profit mutual
RT HealthHCFNot-for-profit mutual
Nurses & Midwives Health, UniHealth, Union Health, TUHTeachers Health groupNot-for-profit mutual
Federation HealthLatrobe Health ServicesNot-for-profit mutual
Astute Simplicity HealthSt LukesNot-for-profit mutual
MyOwnAIA Health InsuranceFor-profit
Hunter Health InsuranceCDH Benefits FundNot-for-profit mutual
Source: brand listings on PrivateHealth.gov.au insurer profiles and the PrivateHealth.gov.au open data (1 September 2026).

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.

Frequently asked questions

How many health funds are there in Australia?

PrivateHealth.gov.au lists 33 health insurers and insurer brands (as at 28 September 2026). Some are brands of the same registered insurer, such as ahm (Medibank) and RT Health (HCF). 24 are open to anyone and 9 are restricted to a particular industry or group.

Which health funds are not-for-profit?

24 of the 33 listed insurers operate on a not-for-profit basis, most as member-owned mutuals. The largest by hospital policies is HCF, followed by HBF and Teachers Health. Bupa, Medibank, ahm, nib, GU Health, Australian Unity, AIA Health, Doctors' Health Fund and onemedifund operate on a for-profit basis.

What is a restricted health fund?

A restricted fund can only accept members from a particular group, such as an employer, profession or union, and usually their families. There are nine: ACA Health, CBHS, Defence Health, Doctors' Health Fund, Navy Health, Police Health, Reserve Bank Health Society, Teachers Health and TUH.

Which health fund gets the fewest complaints?

Among insurers with at least 1% of the market in 2024–25, HBF had the fewest complaints relative to its size (4.4% of complaints on a 7.9% market share). Several small funds, including St Lukes, Mildura Health Fund and CDH, also drew far fewer complaints than their share, but small numbers make their ratios less reliable.

Do I have to re-serve waiting periods if I change health funds?

Not for cover you already held at the same or a lower level: your new fund must recognise waiting periods you've already served. If you move to a higher level of cover, you can be asked to serve waiting periods for the extra benefits.

Which health fund pays the most back in benefits?

Among insurers with at least 0.5% of the market, Police Health returned the highest share of premiums as benefits in 2024–25 (94.0%), followed by AIA Health (90.4%) and Teachers Health (90.3%). The industry result was 84.5%.