Not-for-Profit Health Funds in Australia

Published: August 29, 2019

When searching for private health insurance, you might have noticed that there are two types of health funds; not-for-profit and for-profit.

Unlike a for-profit health fund, a not-for-profit health insurance company doesn’t operate to make a profit for its shareholders. Its primary goal is to benefit its members by using any surplus earnings to decrease premiums or to create and improve benefits.

However, your choice of health insurance company should be based on your requirements and budget, not its business structure.

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What is not-for-profit health insurance?

A not-for-profit health insurance company uses the premiums it receives to operate the business (pay employees and utility bills) and provide benefits to its members. It is a mutual organisation without any shareholders, so any extra profits made are returned to members in the form of lower premiums or new benefits.

Benefits generally expected from a not-for-profit health insurance provider, include:

  • Members are the fund’s primary focus.
  • Cheaper premiums when earnings exceed operational requirements.
  • Surplus earnings could result in increased rebates.
  • Improved services and benefits for its members.

How does a not-for-profit health fund work?

There’s generally no real difference between how a non-profit vs for-profit health insurance company works. Both require you to pay a premium in exchange for coverage: Hospital, Extras or a Combination of both. However, the surplus profits generated from the premiums you pay will be spent differently.

For-profit health funds use surplus earnings to provide stakeholders with dividends. Not-for-profit companies use it to improve the quality of their services and possibly reduce premiums for the coming year.

Can anyone join?

It depends. Some non-profit health funds are open to anybody, while others are restricted to a specific industry. For example, the Nurses & Midwives Health fund is generally only accessible to people with the nursing and midwifery union. However, in most cases, restricted funds will be available to the specific group and their families.

Some health insurance companies are not available in all states and territories, so it's essential to provide the state you live in when requesting a quote.

Compare not-for-profit vs for-private health insurance companies

List of not-for-profit health insurance companies in Australia

Unrestricted

Restricted

  • ACA Health Benefits Fund (ACA): Open to current and past employees of the Seventh-day Adventist Church and its allied companies in Australia.
  • CBHS Health Fund Limited (CBH): Restricted to current and former employees, contractors and franchisees of the Commonwealth Bank Group.
  • Defence Health Limited (AHB): Available to the defence community and their families.
  • Emergency Services Health (ESH): Restricted to emergency services personnel (employed or volunteer).
  • Navy Health Ltd (NHB): Only available to current and former servicing or civilian ADF personal and similar groups.
  • Nurses & Midwives Health (NMW): Restricted to members of eligible nursing and midwifery union.
  • Police Health (SPE): Primarily open to current employees of a State, Territory or Federal police department.
  • Railway and Transport Health Fund Limited (RTE): Only available to transport and energy people.
  • Reserve Bank Health Society LTD (RBH): Membership is restricted to anyone who is or was an employee of the Reserve Bank.
  • Teachers Health (NTF): Restricted to members of the education community.
  • TUH Health Fund (QTU): Open to present and past members of any union.

Information was gathered from privatehealth.gov.au (August 2019).

Take note: Restricted funds are generally available to its specific members and their families. Most unrestricted not-for-profit health funds operate in all states and territories, except GMHBA that is limited to ACT, NSW, NT, QLD, SA, Tasmania, Vic and WA.

Where can you find health insurance quotes from not-for-profit funds?

You can get quotes from health insurance companies that don't operate for a profit by visiting their website and applying online. Alternatively, you can use a comparison website to find a non-profit private health insurance company that's available in your state or territory. You might want to compare major health funds available in Australia.

Frequently asked questions and answers

What are Members Own health funds?

Members Own Health Funds is a grouping of 19 not-for-profit health insurance companies in Australia, which joined forces in 2014. Together, they aim to always put their members first by investing surplus earning into improving services and products and making premiums more affordable. Members Own is run for the benefit of its members and not for shareholders.

Are not-for-profit health funds cheaper?

Not necessarily. Although non-profit private health company’s aim to provide its members with affordable premiums, some funds are just too small or new to generate the amount of extra earning needed to reduce premiums.

Request quotes and compare not-for-profit health insurance

  • HBF Private Health Insurance Review

    Request & compare Hospital and Extras quotes from HBF. Discover if the not-for-profit health fund offers health cover suited to your requirements in budget.
  • GMHBA Health Insurance Review

    Discover if GMHBA provides health cover suited to your requirements and budget. We review their pros and cons and the benefits you can expect to receive.
  • HCF Health Insurance Review

    Discover what HCF has to offer you and if it suits your specific requirements and budget. Review and compare their Hospital, Extras and Package options.
  • HIF Health Insurance Review

    Review their Hospital and Extras options and decide whether the not-for-profit health fund is a good option for you. Request a HIF health insurance quote now.
  • Review Peoplecare Health Insurance and Cover Options

    Find out if Peoplecare is the right health fund for you. We review their 3 Hospital and 4 Extras policy options, including their premiums & waiting periods.
  • Defence Health Insurance Review and Cover Comparison

    Learn about the benefits of Defence Health insurance; what they have to offer AFD members and the wider Defence community and whether you’re eligible to join.

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Ask an Expert?

2 Comments

  • Elaine Ayres |

    My grandson has a knee injury that requires surgery.
    I’m looking for a health fund that will allow a pre existing condition and have a reasonable waiting period before he can access service for an operation

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Elaine.

      The general waiting period for pre-existing conditions is 12 months. However, health funds may assess on a case-by-case basis. You might want to request quotes and compare providers.