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Megan Fraser Updated: 24 January 2022
Table Of Contents
- Top 10 private health insurance companies in Australia by market share
- Which type of health cover to consider?
- Hospital cover
- Extras cover
- Combined cover
- Compare top health insurers 2022
- Top 5 Bronze Hospital Cover Plans
- Top 5 Silver Hospital Plans Compared
- Top 5 Hospital Gold Plans Compared
- How many health insurance companies are there?
Finding the best health insurance companies in Australia can be difficult because there are so many factors that you need to take into consideration. you’ll need to compare the types of policies they offer, their premiums, the market share they hold as well as customer satisfaction ratings. This could help you find out which insurer is right for you and your family.
The Private Health Insurance Act 2007 currently has thirty-six insurance companies that are registered as open or restricted funds. An Open Fund is available for everyone while a Restricted fund only accepts applicants who meet specific criteria such as income level, nationality and age limitations before they’re allowed to join.
Key Facts
- The top 5 companies in 2022 by market share are Medibank, Bupa, HCF, nib, and HBF.
- Premiums for a Basic Hospital policy single adult range between $101.35 and $129.94 per month depending on the insurer you choose.
- To find the best company for your requirements look for a fund that offers the benefits you need at a premium you can afford.
Top 10 private health insurance companies in Australia by market share
- Medibank: 26.9% market share.
- Bupa: 25.4% market share.
- HCF: 11.7% market share.
- nib: 9.2% market share.
- HBF:7.3% market share.
- Australian Unity: 2.6% market share.
- Teachers Health: 2.5% market share.
- GMHBA: 2.1% market share.
- Defence Health: 0.4% market share.
- CBHS: 0.1% market share.
Source: Source: Ombudsman.gov.au, Australian Prudential Regulation Authority (December 2021)
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Which type of health cover to consider?
Select Private health insurance cover helps you avoid the Lifetime Health Cover (loading) and Medicare Levy Surcharge (MLS). You may also want to think about purchasing health cover if you have a health condition, are thinking about becoming pregnant, have a family, or are getting to an age where more medical assistance is required.
There are many private health funds in Australia, competing for your business. However, to find the most appropriate health fund to suit your requirements, you need to be clear about the type of plan you need. Typically you have the option to choose between the following types of cover:
Hospital cover
Covers some or all of the costs for treatments received in the hospital. The protection you’ll receive depends on the level of hospital insurance your purchase. Generally you’ll have the option to choose between gold, silver, bronze or basic. Each option offers different features and benefits so it may be a good idea to consider your requirements before deciding on a company that’s right for you.
Proportion of benefits paid by private health insurers for Hospital cover
| Service | Amount paid by private health insurance funds ($) |
| All other | 491,026,025 |
| Anaesthesia | 592,741,923 |
| Cardiothoracic | 109,092,499 |
| Colorectoral surgical | 133,846,635 |
| Diagnostics | 133,283,483 |
| General surgical | 130,160,158 |
| Obstetrics | 122,343,628 |
| Ophthalmology | 120,971,196 |
| Orthopaedic | 165,325,157 |
| Specialist | 221,082,504 |
| Pathology | 172,437,747 |
Source: APRA (December 2021)
Extras cover
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.
| Service | Amount paid by private health insurance funds ($) |
| All other | 491,026,025 |
| Ambulance | 143,210,50 |
| Chiropractic | 297,926,025 |
| Dental | 2,804,036,044 |
| Natural Therapies | 214,125,615 |
| Optical | 915,316,498 |
| Physiotherapy | 433,135,843 |
Source: APRA (December 2021)
Combined cover
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 plans from the same company. Find the option that works for you, even if that means buying a Hospital policy from one insurer and an Extras policy from another fund.
Compare top health insurers 2022
Medibank Health Insurance
The Australian government created Medibank in 1976 as a non-profit company. In 2009, they changed it over to for profit and continued operating that way ever since. Currently, they offer members the choice between several Hospital and Extras policies
Features and benefits
- Policies:
- 9 Hospital plans with premiums starting at an estimated $101.80 per month.
- 21 Extras policies, you can expect to look at premiums that start at $30.30
- Waiting periods: Between 0 days and 36 months depending on your requirements.
- Unique features: This insurer offers members the opportunity to make use of a large network of health providers with the Medibank Members’ choice benefit.
Bupa Private Health Insurance
With more than 4 million customers, Bupa is one of the leading private health insurers in Australia. Customers can choose from six different Hospital plans and seven Extra cover options to ensure that their needs are met at affordable prices.
Features and benefits
- Policies:
- 6 different Hospital cover options, premiums start at $101.35 per month.
- 21 Extras policies with premiums that start at $26.70 monthly.
- Waiting periods: Varies between 2 months and 3 years. However, this depends on the condition and type of coverage you have in place.
- Unique features: Access to the Members first network of health care providers which Bupa will typically pay between 60% to 100% of the cost on most dental, physio, chiro, and podiatry consultations.
HCF Health Insurance
HCF Health Fund is a private health insurer that offers policies to millions of people each year. With four different plans and five extras packages, they offer cover for a wide variety of requirements. HCF is a company that strives to give Australians access, protection and peace of mind when it comes to their health care needs.
Features and benefits
- Policies:
- 7 Hospital policies with premiums that start at $102.30 per month.
- 5 Extras cover options with monthly premiums that start at $16.90.
- Waiting periods: Between 2 – 12 months.
- Unique features: Get up to 100% back on selected Extras from over 10,000 participating program providers with the HCF provider network.
nib Private health insurer
With 5 Hospital policies and 4 Extras policies, nib offers their members the choice between a wide range of options. The rewards programme is available for those who live healthy lifestyles in order to encourage even more effective behavior change efforts by providing discounts at leading retail stores as well access exclusive programs.
Features and benefits
- Policies:
- Choose between 5 different Hospital policies with premiums starting in the range of $107.55 monthly.
- 4 Extras options available with monthly premiums starting at $43.97.
- Waiting periods: Range between 1 day and 12 months.
- Unique features: Join the nib Rewards program for meeting specific health goals.
HBF Private Health Insurance
HBF Health Insurance is a good choice for Australians who need health cover that fits their unique requirements. Combining policies into one plan and keeping all profits from premiums reinvested allows them to continue providing you with new or improved benefits.
Features and benefits
- Policies:
- This insurer offers 7 different Hospital policies with premiums that start at $102.45 each month.
- Choose between one of 13 different Extras policies with monthly premiums starting at $22.95.
- Waiting periods: Between 7 days and 12 months.
Private Health Insurance from Australian Unity
Australian Unity has a variety of policies to choose from, and it’s easy! They offer six Hospital plans and 6 Extras options for those who need them. Plus there are three pre-packaged packages which you also have the option to choose from.
Features and benefits
- Policies:
- 6 Hospital plans with premiums starting at an estimated $107.70 per month.
- 6 Extras cover options with monthly premiums that start at $38.55.
- Waiting periods: Between 2 and 12 months.
- Unique features: As a member of the health insurance company, you can receive a wide range of benefit and rewards.
Teachers Health Fund
Teachers health insurance provides a range of plans to meet the needs and requirements of any family. Choose between their Hospital and General over policies. Or, tailor your cover by combining Hospital and Extras policies
Features and benefits
- Policies:
- This insurer offers 10 different Hospital policies with premiums that start at $119.70 each month.
- Choose between one of 4 different Extras policies with monthly premiums starting at $51.49.
- Waiting periods: Between 0 days and 12 months depending on your circumstances.
- Unique features: The Teachers Health member app to view your cover details, check your remaining annual benefits and make claims.
GMHBA Health cover
GMHBA insurance is a not-for profit health care provider that has different policies, such as nine extras and six hospital plans on offer. GMHBA is a growing insurers having served over 300,000 clients in 2020.
Features and benefits
- Policies:
- GMHB offers 13 different Hospital policies with premiums starting at $104.95 monthly.
- Extras cover options with monthly premiums that start at $27.70.
- Waiting periods: Between 2 – 12 months.
- Unique features: Members may be eligible for a variety of discounts with the company’s Rewards program.
Defence Health Fund
The Defence Health Fund offers a wide range of policies to suit your needs. You can choose from seven different Hospital plans and three extras cover options, which gives you the freedom to create an individual policy that suits what’s most important for yourself or your loved ones.
Features and benefits
- Policies:
- 7 Hospital plans with premiums starting at an estimated $109.72 per month.
- Choose between one of 3 different Extras policies with monthly premiums starting at $30.38.
- Waiting periods: Between 2 and 12 months depending on your circumstances.
CBHS Health Insurance
CBHS health insurance is a private solution for past or present Commonwealth Bank of Australia employees, contractors and their family members. With six different Hospital policies and 3 Extras options, you may want to compare their policies to learn if they’re right for your requirements.
Features and benefits
- Policies:
- This insurer offers 10 different Hospital policies with premiums that start at $119.70 each month.
- Choose between one of 3 different Extras policies with monthly premiums starting at $37.01.
- Waiting periods: Between 1 day and 12 months depending on your circumstances.
- Unique features: Members generally have access to several different rewards and discounts.
Top 5 Bronze Hospital Cover Plans
Generally, health insurance providers are mandated to offer members the choice between policies which are categorized into Basic, Bronze, Silver and Gold tiers. A policy is assigned a tier based on the minimum level of cover it offers. These tiers will make it easier for you to compare and choose the right policy for you.
| Health Insurer | Product | Monthly Premium |
|---|---|---|
| Medibank Private & AHM | Everyday Hospital Bronze Plus | $113.84 – $122.11 |
| Medibank | Bronze Everyday | $114.45 – $131.95 |
| HCF | Hospital Bronze Plus | $115.20 – $139.40 |
| HBF | Bronze Hospital Plus | $116.30 – $139.95 |
| GMHBA | Bronze Essential Hospital | $116.55 |
Source: MyPrivatehealth.gov.au (December 2021; Premium estimates for a single adult with no dependents who lives in NSW)
Top 5 Silver Hospital Plans Compared
| Health Insurer | Product | Monthly Premium |
|---|---|---|
| Medibank Private & AHM | Hospital Standard Silver Plus | $143.60 – $171.00 |
| BUPA | Silver Plus Essential Hospital | $145.70 – $179.05 |
| Defence Health | Core Hospital Silver Plus 750 | $145.77 |
| Teachers Health | Mid Classic (Silver Plus) | $148.23 – $169.49 |
| nib | Silver Hospital | $156.21 – $167.68 |
Source: MyPrivatehealth.gov.au (December 2021; Premium estimates for a single adult with no dependents who lives in NSW)
Top 5 Hospital Gold Plans Compared
| Health Insurer | Product | Monthly Premium |
|---|---|---|
| Teachers Health | Medibank Gold Complete Hospital | $206.54 – $235.73 |
| CBHS | Gold Complete Hospital | $750 Excess – $217.97 |
| HBF | HCF hospital gold | $220.10 – $278.60 |
| Medibank | Gold Top Hospital | $224.90 – $290.95 |
| HCF | Gold Hospital | $234.00 – $284.50 |
Source: MyPrivatehealth.gov.au (December 2021; Premium estimates for a single adult with no dependents who lives in NSW
How many health insurance companies are there?
There are 37 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 Doctors Health fund generally only offers cover to members of the medical community and their families.
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
- HCF
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- health.com.au
- Latrobe Health Services
- Medibank Private Limited
- Mildura Health Fund
- National Health Benefits Australia Pty Ltd
- 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
Funds restricted to specific members
- ACA Health Benefits Fund
- CBHS Health Fund Limited
- Defence Health Limited
- Doctors’ Health Fund
- Navy Health Ltd
- Nurses & Midwives Health
- Police Health
- Railway and Transport Health Fund Limited
- Reserve Bank Health Society Ltd
- Teachers Health
- TUH Health Fund
Source: Privatehealth.gov.au (December 2021)
Frequently asked questions
Which health insurance company is the best in Australia?
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.
Can health insurance companies exclude pre-existing conditions?
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.
How much does health insurance cost in Australia?
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.
Which company offers the best cheap health insurance?
Premiums for health insurance typically varies according to the insurer and product tier. For Basic cover Bupa offers the cheapest health insurance while Teachers Health is the insurer who offers affordable cover for individuals who are looking for Gold level cover. Typically it’s a good idea to compare all of the options available to you before making a decision.
Who are the top 5 health insurance companies?
Typically, it’s up to you to compare offerings and premiums from the list of health insurance companies available in Australia. However, the top 5 private health insurance companies in Australia by market share are:
- Medibank
- BUPA
- HCF
- NIB
- HBF
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- Keep your family healthy
- Easy and convenient
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Want to talk to a specialist? Call 1300 795 560
FAQs
Which health insurance company has the highest customer satisfaction? ›
Twenty-four Humana plans received a four-star or better rating from the NCQA in 2022. 1 Humana led the pack for customer satisfaction among health insurers in 2020, according to data from the ACSI survey.
What health insurance company has the best rating? ›In our analysis, the best overall health insurance provider is Kaiser Permanente, which earned an overall quality rating of 4.28 out of 5 from the National Committee for Quality Assurance (NCQA). The runner-up was Blue Cross Blue Shield, with an overall score of 3.86.
Which health insurance company denies the most claims? ›In its most recent report from 2013, the association found Medicare most frequently denied claims, at 4.92 percent of the time; followed by Aetna, with a denial rate of 1.5 percent; United Healthcare, 1.18 percent; and Cigna, 0.54 percent.
Who is Australia's largest health insurer? ›- Medibank: 26.9% market share.
- Bupa: 25.4% market share.
- HCF: 11.7% market share.
- nib: 9.2% market share.
- HBF:7.3% market share.
- Australian Unity: 2.6% market share.
- Teachers Health: 2.5% market share.
- GMHBA: 2.1% market share.