There is no ‘one best private health fund’ that will satisfy everyone’s requirements. It’s up to you to compare offerings and premiums from the list of health insurance companies available in Australia.
The private health insurance industry is growing and becoming more competitive. We’ve updated our list of the top 10 private health insurance companies in Australia based on 2019 market share.
| Health Fund | Policy | Weekly premium | Apply | |
|---|---|---|---|---|
| | Bronze Plus Hospital 750 and Lite 70 Extras | $30.75* *Premiums are based on a single adult, under the age of 30, living in NSW. It includes a 25.059% Australian Government Rebate and a 5% AIA Vitality discount. | Want to speak to a specialist? Call 1300 035 2904 Monday to Friday 8am to 6pm AEST | Get Hospital and Extra cover with the benefits of AIA Vitality! |
Source: AMA Private Health Insurance Report Card 2018
Our top 10 list of private health insurance companies is based on market share. Market share shows the competitive position of an insurer by assessing how many Australians enrolled in a particular health fund. When an insurance provider owns more of the market, it usually means they have sold a lot of policies, which might indicate that more people are drawn to their offering, and trust them with their health protection needs.
According to the Australian Prudential Regulation Authority (APRA), the 5 largest health funds in Australia account for over 5 million health insurance policies.
The higher the amount of policies sold, the more likely it generally is that the health insurer is receiving higher profits, which could lead to lower premiums and more benefits for its members. This is especially true if the health insurer is a not-for-profit organisation, because they don’t have any shareholders to whom they pay dividends. Instead, the profits go straight back into the fund to be used for its members.
When comparing major private health funds, you might also want to consider how satisfied their customers are with their service and how many complaints the health fund receives on an annual basis.
| Health Fund | Customer Satisfaction | All Complaints |
|---|---|---|
Visit Page | 66.8% | 46.3% |
Visit Page | 68.3% | 17.6% |
Visit Page | 70.2% | 9.7% |
Visit Page | 68.3% | 6.1% |
Visit Page | 76.6% | 4.4% |
Visit Page | 73.7% | 4.8% |
Visit Page | 83.4% | 1.5% |
Visit Page | 71.3% | 2% |
Visit Page | 82.8% | 0.7% |
Visit Page | 82.1% | 0.6% |
Source: Roy Morgan Satisfaction Survey December 2017
Source: AMA Private Health Insurance Report Card 2018
There are 38 private health insurance companies in Australia for you to choose from. However, not all funds are open to the public; some are restricted to specific groups of people, for example, the Teachers Health fund generally only offers cover to Australians in the education community.
| Funds open to the public | Funds restricted to specific members |
|---|---|
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Source: Private Health Insurance Ombudsman
Private health insurance in Australia helps protect you by helping pay for treatments and services not covered by Medicare. In exchange for paying a premium, health insurance gives you more choice in healthcare and the doctor or specialist that provide it. You can buy Hospital insurance, general treatment (Extras) cover or a package combining both.
In Australia, residents generally have access to free health care, called Medicare. However, to relieve some pressure off the public health system and shorten waiting times, you are encouraged to take out private health insurance, if you don’t, you’ll usually have to pay an LHC loading and MLS fee.
Medicare generally pays up to 75% of your medical treatments under the Medicare Benefits Schedule (MBS). Your health fund then contributes at least 25% of the MBS fee.
There are many private health funds in Australia competing for your business. However, to find the best health insurance provider to suit your requirements, you need to be clear about the insurance products available:
Covers some or all of the costs for treatments received in the hospital. The protection you’ll receive depends on the level of hospital insurance your purchase: Gold, silver, bronze or basic.
Provides a benefit for treatments and services received outside of a hospital, for example, optical, dental and psychology. Depending on your fund, you generally have a choice between comprehensive, mid or basic extras.
Includes both hospital and extras. Many insurers will allow you to tailor cover to suit your requirements.
Take note: You do not have to buy hospital and extras from the same company. Find what works for you, even if that means buying a hospital policy from one insurer and an extras policy from another fund.
Private health insurance not only helps you avoid the Lifetime Health Cover (loading) and Medicare Levy Surcharge (MLS), but it’s also an essential purchase if you have a health condition, are thinking about becoming pregnant, have a family, or are getting to an age where more medical assistance is required. Use the below checklist to help you find the best health insurance for your requirements:
To determine who offers the best health insurance, you should first decide on the type of coverage you require, for example, a basic hospital policy will most often cover accommodation as a private patient in a public or private hospital but exclude high-cost services like pregnancy.
Your chosen health insurance company might use dollar or percentage amounts or both to show how much you can claim for a specific service, for example, $250 per person or 75% of the total costs.
A limit refers to the maximum benefit payable each year for a specific service/treatment. Annual limits differ between funds and policies, so make sure that you review the company’s Standard Information Statement (SIS).
In exchange for lower premiums, hospital policies generally have co-payments, also known as an excess, wherein you agree, up front, what amount you’re willing to pay each day you’re in the hospital. Depending on the insurer you’ll typically have the choice of zero, $250 or $500 excess.
Read what customers are saying about the company, how satisfied they are with their service and how many complaints the company annually receive.
Carefully review which services and conditions your provider will not pay benefits towards. With the new health insurance reforms where hospital policies must adhere to a simplified classification system; Gold, Silver, Bronze and Basic, your health fund might decide to exclude or include certain benefits.
A cheap policy isn’t necessarily a good policy. Make sure first to compare funds that provide the coverage you require and then review their cost. This way you can generally find a good value policy at an affordable price.
It’s vital that you look at the length of time you’ll have to wait before you can claim a benefit, for example when you have a pre-existing condition, you generally have to wait 12 months. Waiting periods can range anywhere from 1 day, two months to a year and are different between insurers.
If a health fund owns more of the market, it means that they have sold more policies, which could mean that more people are trusting that particular health fund.
Be sure to consider this checklist when comparing health funds so you can find the best health policy suited to you and your family’s requirements.
There is no best health insurer for every person. As the saying goes ‘you can’t please all people all of the time’. Each person and family unit is different, with specific health requirements and budget. The best private health insurance provider for you should be one that you can afford and provides the type and level of coverage you want.
No, health insurance companies cannot exclude pre-existing conditions, for example, asthma, cancer, or diabetes, because the Australian Federal Government prohibits it. Private health insurers may not refuse to let you buy health coverage or even to charge you a higher premium because you have a pre-existing condition. They can, however, have strict waiting periods associated with pre-existing conditions.
The premium you’ll have to pay for your health insurance policy depends on various factors, including the state you live in, the type of plan you want (hospital, extras or combined), the co-payments you’re willing to make and the level of coverage you require (comprehensive, medium or basic). Remember, premiums rise every year on the 1st of April.
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Hi
I am a 42 year old single female in western Australia earning less than $50,000 a year and am in good health. I really only use dental and optical services. Is there a need to get hospital coverage too?
Thanks
nessie
Hi Nessie.
If you've never had a Hospital policy before, you will be paying extra due to the Lifetime Health Cover Loading. However, whether you need Hospital insurance depends on your unique requirements, for example, your health, whether you have a family history of diseases, if you might need hip or knee replacement in future etc. Please call 1300 795 560 to speak with a specialist regarding your options.
Which health fund offers the best rate for top hospital cover and additional services?
Hi Nancy.
The health fund that would offer you the best rates for combined Top Hospital and Extras depends on your specific requirements, including:
- The state you live in,
- Whether you're having to pay the Lifetime Health Cover loading,
- The level of ambulance cover you want (emergency or emergency and non-emergency),
- If you prefer private hospitals for most services,
- The specific services you want to be included in your policy.
When filling out the quote form at the top of this page, a health insurance specialist will give you a call to assist you.
Hi there. I have a visa 482. I’m looking for health insurance just in case something happens. I’m always on the road and doing heavy manual work. Which insurance will be better for me? So many Insurance, I don’t know which one to pick.
Hi Boglio. Thank for reaching out.
People that work in highly demanding physical jobs generally have a higher probability of back pain, injuries, and increased blood pressure and heart rate. You might want to consider a policy that covers ambulance services (in case of emergencies) in-hospital benefits, GP visits prescribed medicines, and physiotherapy. It all depends on your specific requirements.
However, as I am not aware of the specifics of your job, your age or current health, it's always best to speak with a health insurance specialist before making an informed decision regarding which health fund, policy type and level of cover might meet your requirements.
We do not yet compare quotes for Visa health insurance policies, but you might find assistance regarding health insurance on a Temporary Skills Shortage visa (482) from Allianz Global Assistance, Iman Australia Health Plans or GetMyPolicy Australia who could help you compare some of the major providers.
Where does HIF rate in comparison to Bupa and Medi Bank?
Hi.
According to the AMA Private Health Insurance Report Card 2018, HIF encompasses 0.9% of the health insurance market. Unlike Medibank and Bupa, HIF operates on a not-for-profit basis, meaning the surplus earnings they generate can be used to decrease premiums or improve customer benefits.
Do you have to have Extras Cover and Hospital Cover with the same health insurance company or can you choose 2 different ones?
Hi Jane.
Great question! You can generally purchase a Hospital only policy from one fund and an Extras only policy from another fund. They do not have to be from the same provider. However, you might want to consider the pros and cons of a combined Hospital and Extras policy vs two separate policies from different funds. If you'd like a specialist to assist you in your journey to finding private health insurance that meets your requirements, please call 1300 795 560.
Which health fund covers laser eye surgery? I am with HCF but they will not add this to their list, I am 61 and wish to have my eyes corrected.
Hi Gill.
Some private health insurance funds cover some of the costs for laser eye surgery under their Extras or Combined policy. For example, Medibank Gold Ultra Health provides a lifetime limit of $3,500 and AHM Lifestyle Extras cover pays $600 per financial year. Health funds generally define laser eye surgery as using laser beams to correct refractive vision problems by reshaping the cornea so you no longer need to wear glasses or contact lenses
Take note, the waiting period for laser eye surgery is generally 12 months, although this varies depending on the insurer you choose.
Please fill in the quote form at the top of this page or call 1300 795 560 and a specialist will assist you in comparing policies from some of Australias major health funds.
Hey, I've just turned 25 and am currently looking at a quote from health.com.au. I haven't heard much from this group, just wondering if they are generally a pretty good private healthcare provider and if they do the aged discounts for 25-31 year old's?
Thanks in advanced!
Hi Ash.
Health.com.au does not seem to be one of the companies currently offering aged based discounts. Whether they'll be a good fit for you depends on your health, budget and unique requirements.
Please feel free to request a quote at the top of this page and a specialist will be in contact to help you compare some of the major health funds in Australia.
Me and my family are planning to immigrate to SA from the uk and looking into which is the best insurance to have? Two adults and a 4 years old. No pre existing medical conditions. I wear glasses/contacts. I am an allied health profession, so unsure if I will get any cover with my job. Any advice would be great?
Hi Sarah.
You first might want to check if you and your family qualify for a Reciprocal HeathCare Agreement, wherein UK citizen with a British passport may be eligible for Australia Medicare, generally entitling you to limited subsidised health services for medically necessary treatments. Please visit humanservices.gov.au for more information.
For Hospital services and General treatments (like optical and dental) not covered by Medicare, you might want to consider private health insurance for your family. Your Visa type will usually indicate which policy you are able to purchase. Please feel free to visit websites such as allianzassistancehealth.com.au, hcfvisitorhealthcover.com, medibank.com.au, bupa.com.au and nib.com.au.
Hi.
My son is going over from U.K. to Vic for just over 3 months in March to take part in a research project on a 408 visa. Please can you confirm that I have understood the health insurance requirements properly and he isn't eligible for Medicare, meaning we should purchase an independent policy?
Hi Alsion.
A UK citizen travelling on a British passport may be eligible for medical care under Medicare due to the Reciprocal HeathCare Agreement that exists between Australia and the UK. This generally entitles UK citizens to limited subsidised health services for medically necessary treatments while visiting Australia. Please visit humanservices.gov.au for more information.
However, if your son is only visiting for a short time, it might be more convenient to get Overseas Visitors Health Cover (OVHC) when on a 408 Temporary Activity Visa, as he'll need to complete the enrolment process to get Medicare services and payments. OVHC can be purchased from websites such as allianzassistancehealth.com.au, hcfvisitorhealthcover.com, medibank.com.au, bupa.com.au and nib.com.au.
Hi, I am planning to get private care insurance but I'm not sure where is the best way to go and how much I need. I'm a single 36 y.o.
Hi Anne.
You might want to start by reviewing our guide on How to choose the best health insurance plan for you. The guide lists all the factors you might want to consider before choosing a private health insurance policy. If you require more assistance please give our health insurance specialists a call on 1300 795 560 or request a quote and a specialist will give you a call.