| CBHS Health Fund | |
|---|---|
| Registered insurer | CBHS Health Fund Limited |
| Who can join | Restricted: current and past employees of Commonwealth Bank Group, franchisees, contractors, and their families. |
| Business structure | Member-owned mutual, not-for-profit |
| Hospital policies (30 June 2025) | 96,799 (1.6% of all hospital policies), covering 215,890 people |
| Hospital tiers on sale (1 September 2026) | Gold, Silver Plus, Bronze Plus, Basic Plus |
| Excess options on open hospital policies | $500, $750 |
| Age-based discount (18-29) | Offered on its open hospital policies |
| Ambulance | Emergency ambulance included on its open hospital policies |
| Question | What the official data shows |
|---|---|
| Out-of-pocket costs in hospital | 84.2% of in-hospital medical services had no gap for the member (industry 87.1%), and 89.2% of hospital charges were covered (industry 89.0%), 2024-25 |
| Waiting periods and pre-existing conditions | The legal maximums apply: 12 months for a pre-existing condition (signs or symptoms in the 6 months before you joined or upgraded) and for pregnancy and birth, 2 months for other hospital treatment. Every hospital policy open to new members in the Government's data at 1 October 2026, at every fund, used the 12-month pre-existing wait |
| Switching from another fund | Waits you've already served on the same or a lower level of cover carry across to CBHS Health Fund, and from it. Ask your old fund for a clearance certificate and keep the break between policies short |
| The Medicare Levy Surcharge | Excess options on its open hospital policies go up to $750, so all are within the $750 singles limit, and every policy was flagged as meeting the surcharge rules in the Government's data at 1 October 2026 |
| Adult children (dependants) | Up to age 30, studying or not, in the fund's own record (Government data, 1 October 2026). Adult dependants often need an extended family option |
| Claims experience | 1.8% of Ombudsman complaints about insurers on a 1.4% market share (ratio 1.29), and 2.7% of the complaints the Ombudsman investigated, 2024-25 |
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.
Who can join CBHS
Its PrivateHealth.gov.au record says the current or former employees of the Commonwealth Bank Group are eligible: the Commonwealth Bank of Australia and its current and former subsidiaries, Gateway Bank, employees of contractors who supply goods or services to the group, and employees of franchisees of group subsidiaries. The eligible person's partner (including a former partner), dependants, siblings, parents and grandchildren can also join. The fund says eligibility continues after you leave the group.
PrivateHealth.gov.au lists CBHS as a mutual organisation operating on a not-for-profit basis. A related insurer, CBHS Corporate Health, sells corporate cover and is reported separately by APRA.
Benefits and retention
CBHS paid 86.8% of premium income as benefits in 2024-25 (industry 84.5%) with management expenses of 10.2% (industry 10.9%). Retention was 91.1%, well above the industry's 85.0%. 89.2% of hospital charges were covered (industry 89.0%). The weaker number: 84.2% of in-hospital medical services had no gap, below the industry's 87.1%. Extras paid 45.3% of charges on average (industry 50.7%).
Complaints
CBHS accounted for 1.8% of Ombudsman complaints against a 1.4% market share, and 2.7% of investigated complaints. Both are above its size.
What CBHS sells
Its open hospital policies at 1 September 2026 cover Gold, Silver Plus, Bronze Plus and Basic Plus, with $500 and $750 excess options. All were listed with the age-based discount and all include emergency ambulance. Its fund record says NSW and ACT residents with hospital cover can also claim some non-emergency ambulance services.
CBHS Health Fund against the industry: 2024-25 data
Every year the Private Health Insurance Ombudsman compares all insurers on the same measures, and PrivateHealth.gov.au republishes the results on each insurer's profile. The table below is CBHS Health Fund's, with the industry result beside each figure. Its complaints-to-market-share ratio was 1.29: a figure of 1.00 means complaints exactly in proportion to size.
| Measure | CBHS Health Fund | Industry | Reading |
|---|---|---|---|
| Share of all Ombudsman complaints | 1.8% | Market share 1.4% | More complaints than its size |
| Share of investigated complaints | 2.7% | Market share 1.4% | |
| Member retention (hospital cover) | 91.1% | 85.0% | Better than industry |
| Benefits paid as % of premiums | 86.8% | 84.5% | Better than industry |
| Management expenses % of premium income | 10.2% | 10.9% | Better than industry |
| Hospital charges covered | 89.2% | 89.0% | In line with industry |
| Medical services with no gap | 84.2% | 87.1% | Weaker than industry |
| Medical services with no gap or a known gap | 97.3% | 97.1% | In line with industry |
| Extras (general treatment) charges covered | 45.3% | 50.7% | Weaker than industry |
How to read it: complaint share is the fairest single comparison of service across funds of different sizes, because it's measured against market share. Benefits as a % of premiums shows how much of the premium pool went back to members as claims; a mutual that returns more is not necessarily cheaper, and a fund can move this figure by changing prices. The gap measures show how often members avoided an out-of-pocket medical bill after a hospital stay, which is what most people mean by "good cover".
Hospital agreements
| ACT | NSW | VIC | QLD | SA | WA | TAS | NT | |
|---|---|---|---|---|---|---|---|---|
| Private hospitals | 5 | 89 | 65 | 51 | 17 | 22 | 7 | 1 |
| Most held by any insurer | 7 | 95 | 73 | 63 | 17 | 23 | 7 | 1 |
| Day hospitals | 8 | 81 | 57 | 48 | 24 | 21 | 7 | 2 |
| Most held by any insurer | 11 | 109 | 73 | 58 | 35 | 28 | 12 | 2 |
What to check before you join CBHS Health Fund
- Complaints were above its market share in 2024-25.
- No-gap rate (84.2%) was below the industry.
- Check eligibility through a family member if you don't work for the group yourself.
- Over 31 and joining for the first time? Work out your Lifetime Health Cover loading first, and if you earn over the threshold, check the Medicare Levy Surcharge you'd avoid.
Common questions about CBHS Health Fund
Who can join CBHS?
Current and former employees of the Commonwealth Bank Group (including subsidiaries and Gateway Bank), employees of its contractors and franchisees, and their partners, dependants, siblings, parents and grandchildren.
Is CBHS not-for-profit?
Yes. PrivateHealth.gov.au lists CBHS Health Fund as a mutual organisation operating on a not-for-profit basis.
Does CBHS offer the age-based discount?
Yes. All its hospital policies open to new members were listed with the age-based discount in the Government's product data at 1 September 2026.
Other fund reviews
See every registered health insurer compared on complaints and benefits, or read how the private health insurance rebate and hospital cover tiers work.
General advice only. It doesn't consider your circumstances. Read the PDS and TMD before you decide.
This review is general information based on published government and regulator data. We don't rate or rank funds, and it doesn't consider your circumstances. Check a policy's Private Health Information Statement before you buy.