Searching for the best private health insurance in Australia? There are countless health insurance providers out there – from the bigger HCF, Medibank and Bupa to smaller providers like HBF, nib and more.
With so many health insurance funds out there, how do you find the best cover for you and your family? The short answer is you have to play it smart, and comparing different policies and health insurance providers is the best way to find the perfect fit for your needs and wallet.
We’ve got your back, too. In this article, we’re highlighting the best 5 private health insurance providers in Australia for 2023, helping you make the best decision about your private health insurance. It’s all about making sure you’re covered without breaking the bank.
- The top five health insurance providers in Australia are HCF, Medibank, Bupa, nib and HBF
- There are 29 ‘open’ health insurers to choose from (meaning anyone can get covered, not just a certain group or industry)
- Choose from extras cover, hospital cover only, or combined hospital & extras (most popular)
- It’s a good idea to take out health insurance before your 31st birthday to avoid the Lifetime Health Cover Loading (LHC Loading)
- You may be eligible for a government rebate at tax time with the right health insurance cover
Australia’s 5 Best Health Insurance Companies
- Medibank: 27.3% market share.
- Bupa: 24.8% market share.
- HCF: 11.9% market share.
- nib: 9.3% market share.
- HBF: 7.3% market share.
Source: Private Health Insurance Ombudsman, August 2023
Best Health Funds Compared
Selecting the right health insurance in Australia is a tricky task with so many options on the table. But by carefully comparing costs, coverage, and benefits among different providers, you can make an informed decision that suits your needs.
Medibank has the largest market share of all Australian health insurance providers. With over 40 years of experience, Medibank is a popular choice because it caters to diverse healthcare needs and budgets. They’re known for reliable coverage and top-notch customer service. With Medibank, you get:
- Choice of hospital and doctor
- Gap-free preventative dental care
- Ambulance service coverage
- 24/7 health advice hotline
- Wellness programs, gym discounts
- No hospital excess for kids on family policies
- 100% back on optical items from a Medibank Members’ Choice provider
Bupa is a big name in healthcare, providing health insurance not just here but all over the world. Whether you’re an individual, have a family, or run a business, they’ve got a plan tailored for you. With Bupa, you get:
- Access to private hospitals and special treatments
- The freedom to pick your own doctors and hospitals
- Help with those pre-existing medical conditions
- Support for mental health, including counselling
- Handy online tools and apps to keep you healthy
- Bupa clinics for regular check-ups and preventive care
- Round-the-clock customer service
HCF, or the Hospitals Contribution Fund of Australia, is another popular non-profit health fund that’s all about helping Aussies stay healthy without breaking the bank. With HCF, you get:
- Private hospital care
- Pick your own doctor and specialist
- Shorter wait times for elective surgery
- Dental, optical, orthodontics, physiotherapy and more
- Wellness programs and health coaching
nib is another popular Australian health insurance provider, offering all sorts of coverage for individuals, families, and businesses. They’re big on keeping it affordable and full of benefits. Choose nib, and enjoy:
- More choices in healthcare services, including specialists, surgeries, and hospital stays
- Faster paths to elective surgeries and procedures
- Regular dental check-ups, vaccinations, cancer screenings – all in the coverage
- Help with unexpected medical costs, especially if you have chronic illnesses
- Exclusive member discounts on healthcare
HBF’s been around for over 80 years, so they know a thing or two about health insurance. Millions of Australians trust them, and here’s why:
- Access to private hospital care
- Choice of your favourite doctors and specialists
- Coverage for dental, optical, and more (from glasses to teeth cleanings)
- Lower out-of-pocket costs
- Discounts on gym memberships, health checks, and more
- Extra perks like ambulance and overseas health cover, depending on your policy
CHI TIP: Most of these top 5 providers offer similar benefits. That’s why we recommend using our online caparison tool to find the provider that offers the most benefits, at the most competitive price.
DENTAL INSURANCE IS 100% WORTH IT IF:
✔️ You See a Dentist for Check-Ups Twice a Year
A basic extras policy is already worth it if you’re currently seeing a dentist for two or more checkups a year (2 x per year is recommended by dentists.
✔️ You Want Peace of Mind for Major Work
For unexpected issues like a root canal, wisdom teeth or fillings, insurance can help cover big costs.
✔️ You Want Convenience
Dental insurance often means quicker appointments, cheaper visits and a wider choice of dentists.
RECONSIDER DENTAL INSURANCE IF:
🟠 Your Teeth Are in Great Shape
If you’re young, don’t visit the dentist often and have good oral health, you might not need it.
🟠 You’re Happy with Public Dental Services
Some people can get free or lower-cost public dental care, but there might be waiting lists.
🟠 You’re Watching Your Budget
If you don’t think you’ll use the dental benefits enough to make up for the cost of the policy, it might not be worth it for you.
Remember, dental insurance is a personal choice and what’s right for one person might not be right for someone else. Always consider your own dental health needs and financial situation.
The Different Types of Private Health Insurance
In Australia, there are three main types of health insurance:
- Hospital cover: deals with medical treatment and expenses related to hospital care, including room and surgery fees.
- Extras cover: is for non-hospital services like dental, eye care, and physiotherapy.
- Combined cover: puts Hospital and Extras together into one package
With different costs and services covered, these options let you pick the policy that fits your needs and budget.
Keeps your hospital stays comfy. Benefits:
- Private rooms and care
- Pick your doctor
- Quick access to elective surgery
- Covers everything from mental health to palliative care
- Available in Basic, Bronze, Silver, Gold (choose what suits you!)
For everything outside the hospital. Think:
- Dental check-ups, fillings, braces
- Eye tests, glasses, contacts
- Physio, chiro, osteopathy, massages, acupuncture
- Even podiatry, speech therapy, and gym memberships
Best of both worlds. You get:
- All the hospital perks (private care, quick surgery access)
- Plus, non-hospital benefits (dental, optical, physio)
- Wellness programs, like help to quit smoking
Do You Need Private Health Cover in Australia?
CHI TIP: Health insurance is key for getting the healthcare you need (faster) and without breaking the bank.
The healthcare system in Australia can be put into two baskets: Medicare and private health insurance. Medicare, the public health insurance system, provides essential coverage for many medical services. While this might suffice for some individuals, it’s worth noting that Medicare may not fully cover private hospital treatment costs.
Private health insurance fills this gap by offering benefits like reduced waiting times for elective surgeries and the freedom to choose specific doctors and hospitals. Though not mandatory, private health insurance can be a valuable addition to your healthcare plan, particularly if you seek more personalised care or quicker access to elective treatments.
Do you need it? It really depends on your situation, like your age or if you’re planning to start a family. And don’t forget about the budget! Knowing what you’ll have to pay before the benefits start can help you figure out if this is the right choice for your specific needs.
What to Look for When Choosing a Health Insurance Fund
Picking a health insurance company is a big decision, so here’s what you might want to look at:
Coverage: Make sure the plan covers what you’ll actually need, like hospital stays, specialist visits, or prescriptions.
Cost: Dig into the details like the premium, excess, and any out-of-pocket expenses to make sure it fits your wallet.
Network: Double-check if the company works with your favourite hospitals, clinics, or healthcare providers. You’ll want to know that upfront.
Reputation: Have a quick look online for customer reviews or ask around to get a feel for how good the company is with customer service and handling claims.
Flexibility: Keep an eye out for policies that let you pick your own doctor or hospital, or even customise what’s covered.
Keep these in mind, and you’ll be well on your way to finding the health insurance company that’s just right for you and your budget.
How Much Does Private Health Insurance Cost?
Private health insurance premiums in Australia vary significantly based on several key factors, including age, health status, geographic location, and your level of coverage. Generally, these premiums can range from approximately $50 to $500 per month, or even more.
CHI TIP: The cheapest private health insurance option would be extras only cover. However, this level of cover isn’t enough to exempt you from LHC Loading once you turn 31, and it won’t exempt you from the Medicare Levy Surcharge if you’re a high-income earner.
If you choose to take out hospital or hospital & extras cover, your premium will depend on whether you take out Basic, Bronze, Silver, and Gold hospital cover. Basic cover provides essential services, while Gold cover offers the most comprehensive range of benefits and features.
There are also potential out-of-pocket expenses. These may include deductibles, co-payments, and excesses, all of which can vary depending on the specific policy and level of cover selected.
TIP: Paying your health insurance premium annually is often more cost-effective, with many health funds providing discounts for annual upfront payments.
Choosing the right private health insurance requires careful consideration of both your immediate needs, and your future healthcare requirements. At the end of the day, it’s just good peace of mind.
That’s why it’s essential you take the time to research and evaluate different policies and health finds so you can find a health insurance plan that aligns with your unique needs and budget.
What Happens If You Don’t Have Private Health Insurance
Without private health insurance in Australia, you still have access to medical services through Medicare, but you may face out-of-pocket costs for certain treatments like dental work, physiotherapy, and some prescriptions.
Also, take note of the Lifetime Health Cover loading. If you haven’t obtained private hospital cover by the time you’re 30, you might end up paying more later on. Specifically, for each year over 30 without coverage, an extra 2% loading is added to your premium. It’s a nudge to encourage folks to invest in private health insurance a bit earlier in life.
Additionally, if you earn above a certain income threshold and don’t have private hospital cover, you might be subject to the Medicare Levy Surcharge. This extra charge is designed to encourage higher-income earners to take out private health insurance, reducing the demand on the public Medicare system. It’s another financial consideration that could make private health insurance a smart move for you.
Health Insurance Companies in Australia
In Australia, there are 38 private health insurance companies to choose from, but not all of them are accessible to everyone. Some of these funds are exclusive to specific groups. Here are a list of Australian private health insurance funds open to the public:
- AHM health insurance
- AIA Health Insurance Pty Ltd
- Australian Unity Health Limited
- Bupa HI Pty Ltd
- CBHS Corporate Health Pty Ltd
- CDH Benefits Fund
- CUA Health Limited
- GMHBA Limited
- GU Health
- HBF Health Limited
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Latrobe Health Services
- Medibank Private Limited
- Mildura Health Fund
- National Health Benefits Australia Pty Ltd (onemedifund)
- nib Health Funds Ltd.
- Peoplecare Health Insurance
- Phoenix Health Fund Limited
- Queensland Country Health Fund Ltd
- St.Lukes Health
- Transport Health Pty Ltd
- Westfund Limited
And here are a list of funds limited to specific industries/groups:
- TUH Health Fund
- Teachers Health
- Reserve Bank Health Society Ltd
- Police Health
- Navy Health Ltd
- Defence Health Limited
- Doctors’ Health Fund
- CBHS Health Fund Limited
- ACA Health Benefits Fund
Source: Privatehealth.gov.au (August 2023)
What are the typical waiting periods for private health insurance in Australia?
Waiting periods can vary between policies, but typically range from 3–9 months depending on the services covered.
What does “no gap” mean in private health insurance?
“No gap” refers to policies where the insurer covers the full cost of medical fees, meaning there’s no out-of-pocket expense. It’s typical to find 1–3 policies offering this feature.
What is the private health insurance rebate?
The private health insurance rebate is an Australian government initiative to subsidise the cost of private health insurance premiums.
What’s the difference between Basic, Basic Plus, Bronze Plus, etc.
- Basic: Provides the essential hospital services required by law.
- Basic Plus: Offers additional benefits over Basic, like more procedures or higher rebates.
- Bronze Plus: Includes everything in the standard Bronze tier, with a few more extra services or benefits. The “Plus” tiers generally provide more comprehensive coverage than their standard counterparts.
What does being a private patient in a public hospital mean?
As a private patient in a public hospital, you can choose your doctor if available and may have access to a private room. However, you might face higher costs, and being private doesn’t guarantee faster treatment.
Is just an extras policy enough cover?
An extras policy covers non-hospital treatments like dental, optical, and physiotherapy. If you’re young, healthy, and mainly need coverage for these services, it might be enough. But remember, it won’t cover you for hospital treatments, so assess your needs carefully.
Do I need ambulance cover?
Ambulance cover helps with the costs of emergency transport, which can be expensive. Some states provide free ambulance services, while others do not. If you’re in a state where these services aren’t covered, or if you want extra peace of mind, ambulance cover could be a wise choice.